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 A
Explanation
Choice A reason:
The standard recommendation for fasting before a blood specimen collection is typically between 8 to 12 hours¹²³. This duration is considered sufficient to ensure that food intake does not affect the blood test results, such as glucose or lipid levels.
Choice B reason:
A fasting period of 1 to 2 hours is too short and would not provide an accurate representation of the body's baseline levels for most tests that require fasting. It is important for certain levels, like blood sugar and lipids, to stabilize, which takes longer than 1 to 2 hours.
Choice C reason:
Fasting for 4 to 6 hours may be appropriate for some tests, but it is not the standard fasting duration for most blood tests that require fasting. The shorter time might not allow for the clearance of lipids and glucose from the bloodstream that can influence the test outcomes.
Choice D reason:
A 24-hour fast is generally not required for routine fasting blood tests and could be potentially harmful, as it may lead to hypoglycemia, especially in diabetic patients or those with metabolic disorders. It is excessive for the purposes of standard blood tests.
Correct Answer is C
Explanation
Choice A reason:
Having the bevel down at a 30° angle is not the correct needle position for venipuncture. The bevel of the needle should be facing up to allow for a smoother insertion and to minimize the risk of damaging the vein or causing discomfort to the patient.
Choice B reason:
Positioning the bevel up at a 45° angle is not recommended for venipuncture as this angle is too steep and could lead to the needle penetrating through the vein, potentially causing a hematoma or other complications.
Choice C reason:
The bevel up at a 30° angle is the correct position for venipuncture. This position allows the phlebotomist to insert the needle with the bevel facing upwards, which is the sharpest part of the needle, ensuring a clean entry into the vein. The 30° angle is shallow enough to enter the vein without going through it and causing injury.
Choice D reason:
A bevel down at a 45° angle is incorrect for the same reasons as choice B. Additionally, with the bevel down, the non-beveled side, which is duller, would make the initial contact with the skin, potentially causing more pain and making it more difficult to penetrate the vein.
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