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 A
Explanation
Choice A Reason:
For blood donation, a 16- to 18-gauge needle is typically used because it is large enough to allow the rapid flow of blood without causing hemolysis (destruction of red blood cells). The larger gauge needle also helps in minimizing the time the donor has to spend during the donation process. Using a needle that is too small could slow down the blood flow and potentially damage the blood cells, which is not ideal for the recipient of the blood donation.
Choice B Reason:
A 19- to 21-gauge needle is commonly used for routine venipuncture but is not ideal for blood donation. These needles are smaller than the 16- to 18-gauge needles and would not facilitate the quick collection of the volume of blood typically required for a donation. They are more suitable for collecting blood samples for testing rather than for donation purposes.
Choice C Reason:
A 22- to 24-gauge needle is even smaller and is often used for patients with smaller veins, such as children or elderly patients. These needles would not be appropriate for blood donation as they could significantly slow the blood flow and increase the donation time, which could be uncomfortable for the donor.
Choice D Reason:
A 25- to 28-gauge needle is the smallest size commonly used in medical practice and is suitable for patients with extremely small or fragile veins. These needles would be impractical for blood donation due to their small size, which would not allow for the efficient flow of blood required for a donation.
Correct Answer is A
Explanation
Choice A Reason:
When a patient is under "Contact Precautions," it is recommended that healthcare workers don a gown upon entering the patient's room. This is to prevent the spread of infection through contact with the patient or their environment. The gown should be removed before leaving the room to avoid contaminating other areas.
Choice B Reason:
While a face shield may be necessary for certain procedures, it is not specifically required for "Contact Precautions." The primary concern with contact precautions is preventing the transmission of infections through touch, not through droplets, which is what a face shield would protect against.
Choice C Reason:
Donning a mask is not a standard requirement for "Contact Precautions" unless there is a risk of droplet transmission. In this scenario, the precautions are specifically for contact, and therefore, a mask alone would not be sufficient.
Choice D Reason:
Gloves should be donned before any potential contact with the patient or their immediate environment, not just after cleaning and evaluating the venipuncture site. Gloves are a critical component of PPE when dealing with patients under "Contact Precautions."
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