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 B
Explanation
Choice A reason:
Using a needle at a 45° angle does not typically result in collapsing the vein. A collapsed vein is more likely due to excessive vacuum pressure from the tube, a very small or fragile vein, or the tourniquet being too tight.
Choice B reason:
At a 45° angle, the needle is more likely to penetrate through the entire depth of the vein, especially if the vein is superficial. This can result in a failed venipuncture because the needle has entered and exited the vein, missing the opportunity to collect blood.
Choice C reason:
While a steep angle like 45° could cause the needle to miss the vein superficially, it is more likely that the needle would go through the vein at this angle rather than merely missing it superficially. A superficial miss is more likely with an angle that is too shallow.
Choice D reason:
Contacting the upper wall of the vein alone would not necessarily result in a failed venipuncture. However, at a 45° angle, the needle could easily slip through the vein entirely after contacting the upper wall, especially if the vein is not anchored well.
Correct Answer is B
Explanation
Choice A reason:
The BUN test measures the amount of urea nitrogen in the blood, which can indicate kidney function. Fasting is not typically required for a BUN test unless it is being conducted alongside other tests that may require fasting.
Choice B reason:
An HDL test is part of a lipid profile that measures the levels of good cholesterol in the blood. Fasting before a cholesterol test, including HDL, is often recommended to ensure accuracy, although recent guidelines have changed, allowing for nonfasting cholesterol testing in certain individuals.
Choice C reason:
An ABG test measures oxygen and carbon dioxide levels in the blood and assesses the body's acid-base balance. Preparation for an ABG test does not typically require fasting, but patients may need to stop supplemental oxygen before the test to get accurate measurements.
Choice D reason:
A CBC test, or complete blood count, does not require fasting. It measures various factors of the blood, including red and white blood cells and platelets. Fasting is not necessary unless the CBC is part of a panel of tests that includes tests requiring fasting.
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