When drawing blood on a preschooler, the phlebotomist should:
Explain the procedure to the parent and child.
Not tell the child when the needle insertion is coming.
Obtain a heel stick.
Obtain a thumb stick.
The Correct Answer is A
Choice A Reason:
Explaining the procedure to both the parent and the child is crucial. It helps in preparing the child psychologically and ensures that the parent is informed and can provide support during the process. Clear communication can reduce anxiety and make the child more cooperative. It is also a part of informed consent, where the parent understands what the procedure entails and why it is necessary¹².
Choice B Reason:
Choosing not to tell the child when the needle insertion is coming might seem like a way to avoid causing them anticipatory anxiety. However, this approach can lead to mistrust. Children need to be prepared for what to expect, and surprising them can be more traumatic in the long run. It is better to be honest and use age-appropriate language to describe the sensation as a 'quick pinch' or 'poke'¹².
Choice C Reason:
Obtaining a heel stick is a common method for blood collection in infants, particularly newborns, as their veins are not as developed. However, for preschoolers, venipuncture is usually the preferred method because they have more developed veins, and it allows for a larger volume of blood to be collected if needed³.
Choice D Reason:
Obtaining a thumb stick is not a standard practice for blood collection in preschoolers. The thumb has bones and tendons close to the surface, which can increase the risk of injury. The preferred sites are the antecubital fossa of the arm or the back of the hand where the veins are more accessible and there is less risk of hitting bone³.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Chilling the sample is the correct method for preparing a lactic acid sample for processing and transportation. Lactic acid levels can continue to change after the blood is drawn due to ongoing cellular metabolism. Chilling the sample slows down this metabolism, preserving the accuracy of the lactic acid measurement. The sample should be placed on ice or in a refrigerated environment as soon as possible after collection.
Choice B reason:
While protecting the sample from light is important for some types of specimens, it is not the primary concern for lactic acid samples. The key factor for lactic acid stability is temperature control, not light exposure. Therefore, while it may be beneficial to keep the sample out of direct sunlight, chilling it is the priority to prevent changes in lactic acid levels.
Choice C reason:
Attaching a heat block to the sample is not a recommended method for lactic acid samples. Heat can increase metabolic activity, potentially altering the lactic acid levels in the sample. This would lead to inaccurate results, as the goal is to preserve the state of the sample at the time of collection.
Choice D reason:
Freezing the sample is not typically recommended for immediate processing and transportation of a lactic acid sample. While freezing can preserve certain types of specimens for long-term storage, it is not necessary for short-term transport and can cause issues such as hemolysis, which may interfere with the test results.
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.
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