When performing a blood smear, which of the following actions should a phlebotomist take to ensure a quality result?
Hold the two slides at 90 degrees to each other when performing the smear.
Allow the blood drop to clot slightly prior to performing the smear.
Hold the slides at 30 degrees to each other when performing the smear.
Allow the blood drop to clot completely prior to performing the smear.
The Correct Answer is C
Choice A reason:
Holding the two slides at a 90-degree angle is not the correct technique for performing a blood smear. This angle is too steep and would not allow the blood to spread thinly across the slide, which is necessary for creating a quality smear that can be examined under a microscope.
Choice B reason:
Allowing the blood drop to clot slightly before performing the smear is not advisable. Clotting can interfere with the spread of the blood and the formation of a monolayer, which is essential for accurate microscopic examination. The blood should be fresh and anticoagulated to prevent clotting.
Choice C reason:
Holding the slides at a 30-degree angle is the correct technique for performing a blood smear. This angle allows the spreader slide to push the blood drop smoothly across the patient slide, creating a thin, even layer of blood that is ideal for microscopic analysis. The angle, speed, and pressure must be consistent to achieve a quality smear.
Choice D reason:
Allowing the blood drop to clot completely before performing the smear would make it impossible to create a smear. Clotted blood cannot be spread into a thin layer, which is necessary for microscopic examination of the blood cells.
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Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is A
Explanation
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.
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