When using the evacuated tube method, which of the following will result in a failed venipuncture if the needle is at a 45° angle upon insertion?
The needle will collapse the vein.
The needle will go completely through the vein.
The needle will miss the vein superficially.
The needle will contact the upper wall of the vein.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
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.
Correct Answer is C
Explanation
Choice A reason:
A patient's room number is not a unique identifier as it is subject to change. Patients may be moved to different rooms during their hospital stay, and room numbers are not specific to individuals.
Choice B reason:
A patient's bed label is also not a unique identifier. Like room numbers, bed labels can change if patients are moved within the hospital for various reasons, such as changes in their medical condition or room availability.
Choice C reason:
The patient's inpatient chart demographic information is the correct unique identifier to use. This typically includes the patient's name, date of birth, and a unique medical record number assigned by the healthcare facility. These details are specific to the individual and do not change, making them reliable for patient identification.
Choice D reason:
A patient's verbal confirmation alone is not sufficient as a unique identifier. While it is important to engage the patient in the identification process, verbal confirmation must be used in conjunction with other identifiers to ensure accuracy, as patients may be confused or unable to communicate effectively.
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