When using a butterfly needle for venipuncture on dorsal hand veins, which of the following actions should the phlebotomist take?
Position the needle at a 45° angle to the skin.
Hold the needle by the wings of the butterfly.
Instruct the patient to hold the collection tubes.
Apply the tourniquet at the antecubital area.
The Correct Answer is B
Choice A Reason:
Positioning the needle at a 45° angle to the skin is not the recommended approach for venipuncture using a butterfly needle on dorsal hand veins. The correct angle for insertion is usually less than 45°, often around 15-30°, to ensure a shallow entry and reduce the risk of going through the vein.
Choice B Reason:
Holding the needle by the wings of the butterfly is the correct technique. This allows for better control and stability during insertion. The wings are designed to be held between the thumb and forefinger, providing an easy grip for the phlebotomist to maneuver the needle with precision.
Choice C Reason:
Instructing the patient to hold the collection tubes is not standard practice and could lead to pre-analytical errors. The phlebotomist should maintain control of the tubes to ensure proper blood flow and fill volume, as well as to prevent contamination or accidents.
Choice D Reason:
Applying the tourniquet at the antecubital area is not specific to the use of a butterfly needle for venipuncture on dorsal hand veins. While a tourniquet is used to engorge the veins and make them more prominent, its placement may vary depending on the selected puncture site and is not the action in question here.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Hemophilia is a genetic disorder that impairs the body's ability to make blood clots, a process needed to stop bleeding. This condition is not caused by shaking a blood collection tube; it is an inherited disorder typically caused by a mutation in one of the clotting factor genes.
Choice B Reason:
Hemoconcentration refers to an increase in the concentration of cells and solids in the blood, usually resulting from a loss of plasma. While this can occur due to various reasons, such as dehydration, it is not caused by shaking a blood collection tube. Shaking a tube does not change the ratio of cells to plasma in the blood.
Choice C Reason:
Hemolysis is the rupture of red blood cells, which can occur when a blood sample is handled roughly, such as by excessive shaking. This can cause the cells to break open and release their contents into the plasma, which can interfere with laboratory tests and lead to inaccurate results.
Choice D Reason:
Hemostasis is the process by which the body stops bleeding, which involves the clotting of blood. This process is not caused by shaking a blood collection tube. Hemostasis is a complex process that involves blood vessels, platelets, and clotting factors.
Correct Answer is A
Explanation
Choice A Reason:
The chain of custody form is crucial in the context of a toxicology drug screen for legal purposes. It is a document that records the sequence of custody, control, transfer, analysis, and disposition of physical and electronic evidence. It is particularly important in legal cases where the results of the toxicology screen can be used as evidence in court. The chain of custody ensures that the sample has been handled properly and that the integrity of the sample has been maintained throughout the testing process.
Choice B Reason:
A requisition form is used to request a specific test or service. While it is an essential document in the process of ordering a toxicology drug screen, it does not serve the same purpose as the chain of custody in terms of legal proceedings. The requisition form typically includes patient information, the tests ordered, and the reason for the test, but it does not track the handling of the sample.
Choice C Reason:
An encounter form, also known as a superbill, is used in medical billing to capture the services provided during a patient's visit. It includes information about the patient's diagnosis, the procedures performed, and the codes for billing purposes. However, it is not specifically related to the legal aspects of a toxicology drug screen.
Choice D Reason:
The CMS 1500 form is the standard claim form used by healthcare providers to bill Medicare and Medicaid services. It is also used by some private insurers and managed care plans. Like the encounter form, it is related to billing and not to the legal chain of custody required for a toxicology drug screen.
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