Which of the following lancet positions should a phlebotomist recognize as part of the aseptic technique protocol?
Perpendicular to the fingerprint grooves
Parallel to the nail bed
Along the lateral portion of the first digit
Along the medial portion of the fifth digit
The Correct Answer is A
Choice A reason:
When performing a capillary blood collection, such as a fingerstick, the lancet should be positioned perpendicular to the fingerprint grooves. This orientation helps to ensure that the incision is made across the ridges of the fingerprint, which can facilitate a better blood flow and make it easier to collect an adequate sample without needing to squeeze the finger excessively, which could hemolyze the sample.
Choice B reason:
Positioning the lancet parallel to the nail bed is not recommended because it can result in a cut that runs along the length of the fingerprint grooves, which may not bleed as freely and could also be more painful for the patient.
Choice C reason:
Using the lancet along the lateral portion of the first digit is not part of the standard aseptic technique protocol for capillary blood collection. The first digit, or thumb, has a pulse and should generally be avoided because it can be more sensitive and is more prone to bruising.
Choice D reason:
The medial portion of the fifth digit, or the little finger, is also not a recommended site for capillary blood collection with a lancet. The little finger is typically smaller and may not provide an adequate site for blood collection, and similar to the thumb, it can be more sensitive and prone to injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Shoe covers are used to protect the shoes and prevent the spread of contaminants from one area to another. They are not specifically required for droplet precautions during blood glucose monitoring. Droplet precautions typically focus on protecting mucous membranes of the eyes, nose, and mouth from droplet spatter.
Choice B Reason:
Masks are essential when dealing with patients under droplet precautions. Droplets can transmit infections when a person coughs, sneezes, or talks, and a mask provides a barrier that prevents the inhalation of these potentially infectious droplets. For procedures like blood glucose monitoring, where close contact with the patient is necessary, wearing a mask is crucial to protect both the healthcare worker and the patient.
Choice C Reason:
A gown is used to protect the healthcare worker's skin and clothing from contamination with potentially infectious material. While it is an important piece of personal protective equipment, it is not the primary requirement for droplet precautions in the context of blood glucose monitoring, unless there is a risk of substantial splashing or spraying of bodily fluids.
Choice D Reason:
Goggles are used to protect the eyes from splashes of blood or other body fluids. They are important in procedures where there is a risk of splashing, but for blood glucose monitoring, the risk is minimal. Therefore, goggles are not the primary piece of equipment required for droplet precautions in this scenario.
Correct Answer is B
Explanation
Choice A Reason:
The red top tube is typically used for serum determinations in chemistry, serology, and blood bank. It contains no additive or may contain a clot activator. The red top tube is not the first choice for capillary puncture order of draw because it is designed for tests that require serum and not whole blood.
Choice B Reason:
The lavender top tube is used for whole blood hematology determinations, as it contains EDTA as an anticoagulant. According to the order of draw for capillary punctures, the EDTA tube should be collected first to ensure adequate volume and accurate hematology test results. This makes the lavender top tube the correct choice for the first collection in this scenario.
Choice C Reason:
The light blue top tube contains sodium citrate and is used for coagulation tests. In venipuncture, it is drawn after the blood culture bottle and before other tubes to prevent contamination with additives from other tubes. However, for capillary punctures, it is not the first choice as hematology tests take precedence.
Choice D Reason:
The royal blue top tube is used for trace element, toxicology, and nutrient determinations². While it may be used for lead and toxicology screens mentioned in the question, it is not the first tube to be drawn in a capillary puncture sequence. The EDTA tube (lavender top) is drawn first to prevent clotting and ensure accurate CBC results.
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