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:
Collecting stool directly into a sterile container is not related to providing a sputum specimen. Stool samples are collected for different types of tests, such as fecal occult blood tests or microbiological cultures, and are not used for respiratory assessments.
Choice B reason:
Discarding the first urine of the day and collecting for 24 hours is a procedure for a 24-hour urine collection test, which is used to assess kidney function and other conditions. This process is unrelated to sputum specimen collection, which is used to evaluate respiratory infections or conditions.
Choice C reason:
Aggressively swabbing the inside of the cheek is a method used to collect cells for DNA testing or to check for oral infections. This action does not pertain to sputum collection, which requires a sample from the lower respiratory tract.
Choice D reason:
Taking a deep breath and then expectorating (coughing up and spitting out) is the correct method for providing a sputum specimen. This technique ensures that the sputum comes from deep within the lungs, which is necessary for accurate analysis of respiratory pathogens or cells.
Correct Answer is D
Explanation
Choice A Reason:
Keeping the patient as upright as possible is not recommended in cases of shock. When a patient is in shock, it is important to lay them down and elevate their legs slightly, unless this position causes pain or further injury. This position helps improve blood flow to the brain.
Choice B Reason:
Providing a cooling blanket is not a standard first aid measure for shock due to a medication reaction. A cooling blanket may be used in cases of hyperthermia or heatstroke to reduce body temperature, but not typically for shock, which requires maintaining normal body temperature and preventing chilling.
Choice C Reason:
Administering oral fluids to a patient in shock is not advisable. During shock, a patient may have an impaired swallowing reflex or be unconscious, increasing the risk of aspiration. It is best to avoid giving anything by mouth until medical personnel arrive.
Choice D Reason:
Maintaining an open airway is crucial for a patient in shock. Ensuring that the airway is clear allows the patient to breathe effectively, which is essential for delivering oxygen to the tissues and organs. If the patient is unconscious or has an altered level of consciousness, the phlebotomist should check for breathing and begin CPR if necessary.

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