When a phlebotomist performs a heel stick for the purposes of obtaining a PKU test, it is important to:
Wrap the site with a heel warmer for 30 minutes.
Wipe away the first drop of blood.
Keep a pressure dressing on the site for the day.
Target the central arch area of the foot for the least amount of discomfort.
The Correct Answer is B
Choice A Reason:
Wrapping the site with a heel warmer for 30 minutes is a preparatory step before the heel stick procedure. It is used to increase blood flow to the area to make the collection easier. However, it is not the action to take after the blood has been collected. The heel warmer should be removed before performing the heel stick.
Choice B Reason:
Wiping away the first drop of blood is the correct procedure. The initial drop may be contaminated with tissue fluids or alcohol if the site was cleaned prior to the stick, which can affect the accuracy of the test results. Therefore, the first drop should be wiped away, and subsequent blood should be used for the PKU test.
Choice C Reason:
Keeping a pressure dressing on the site for the entire day is not necessary and is not part of the standard heel stick procedure. After the blood is collected, a small bandage is typically applied to stop any bleeding. The site should be monitored for a short time for any signs of continued bleeding or bruising, but a pressure dressing for the day is excessive.
Choice D Reason:
Targeting the central arch area of the foot for the heel stick is incorrect and can be harmful. The recommended area for a heel stick is the lateral portions of the heel to minimize discomfort and avoid injury to the bone or nerves. The central arch area should be avoided to prevent potential harm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
While maintaining compliance with Clinical Laboratory Improvement Amendments (CLIA) standards is important, it is not the primary reason for explaining the venipuncture procedure to the patient. CLIA standards primarily deal with laboratory testing and do not specifically require the explanation of procedures to patients.
Choice B reason:
Evaluating the patient's understanding is a beneficial practice as it ensures that the patient is informed and can participate in their own care. However, it is not the primary legal or ethical requirement for explaining the procedure.
Choice C reason:
Maintaining compliance with Occupational Safety and Health Administration (OSHA) standards is crucial for ensuring the safety of both the healthcare provider and the patient. OSHA standards require that certain safety protocols be followed, but they do not specifically mandate that the procedure be explained to the patient for the purpose of obtaining consent.
Choice D reason:
Obtaining the patient's consent is the primary reason a phlebotomist should explain the procedure prior to venipuncture. Informed consent is a fundamental ethical and legal principle in healthcare. It involves informing the patient about the procedure, its risks, benefits, and alternatives, and ensuring that the patient understands this information before agreeing to proceed. This process respects the patient's autonomy and right to make decisions about their own healthcare.
Correct Answer is D
Explanation
Choice A reason:
Covering a quarter of the slide is not an acceptable criterion for the quality of a peripheral blood smear. The smear should be spread across the slide in a manner that allows for proper examination under a microscope, and covering only a quarter of the slide would not provide enough area for an adequate assessment.
Choice B reason:
Having a well-defined edge is not specifically indicative of the quality of a peripheral blood smear. While the edges should be clean to allow for clear viewing of the cells at the margins, the quality is more accurately determined by the distribution and integrity of the cells on the slide.
Choice C reason:
Covering the entire slide is also not a criterion for a quality peripheral blood smear. In fact, if the blood covers the entire slide, it may be too thick to allow for proper cell differentiation and examination. A proper smear should have a gradient of cell distribution, ending with a feathered edge.
Choice D reason:
A feathered edge is the correct criterion for a quality peripheral blood smear. The feathered edge is the thinnest part of the smear and is where the cells are ideally distributed in a single layer, which is optimal for microscopic examination. This allows for the best visualization of cell morphology and is essential for accurate diagnosis.
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