Which of the following needles should a phlebotomist use for a venipuncture using a winged infusion set and a 5 mL syringe?
23-gauge
18-gauge
25-gauge
27-gauge
The Correct Answer is A
Choice A reason:
A 23-gauge needle is commonly used for venipuncture with a winged infusion set and a small volume syringe like a 5 mL syringe. This size provides a balance between patient comfort and the ease of drawing blood without causing hemolysis or excessive damage to blood cells. It is large enough to allow blood to flow easily into the syringe but small enough to minimize discomfort and the risk of bruising.
Choice B reason:
An 18-gauge needle is quite large and is typically used for situations requiring rapid administration of fluids or for blood donation where larger volumes are collected quickly. It is not ideal for a standard venipuncture, especially with a small syringe, as it can cause more pain and increase the risk of bruising.
Choice C reason:
A 25-gauge needle is on the smaller side and may be used for patients with very fragile veins or for pediatric patients. However, it may not be the best choice for a 5 mL syringe as it could make the blood draw process slower and more difficult, potentially leading to clotting in the needle or syringe.
Choice D reason:
A 27-gauge needle is very small and is typically used for subcutaneous injections, such as insulin injections, rather than for venipuncture. It would be too small for an efficient blood draw with a 5 mL syringe, as it would likely cause the blood to hemolyze or clot before the draw is completed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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."
Correct Answer is C
Explanation
Choice A reason:
Simply observing the site to see if the hematoma worsens is not an appropriate response. While monitoring the development of a hematoma is part of the process, it is not a proactive measure to address the immediate issue. The phlebotomist must take action to prevent further injury or complication.
Choice B reason:
Asking the patient to apply pressure may be part of the post-venipuncture care, especially after the needle has been removed, to aid in stopping any bleeding. However, this does not address the immediate concern of a developing hematoma during the draw.
Choice C reason:
Releasing the tourniquet and stopping the draw is the correct action to take when a hematoma is observed. This response is in line with the standard procedure for when a complication arises during venipuncture. Stopping the draw helps prevent further blood from pooling and exacerbating the hematoma.
Choice D reason:
While calling for a nurse and assessing the patient's condition is important, especially if the phlebotomist needs assistance or the patient shows signs of distress, it should not be the first action taken. The immediate response should be to address the hematoma by stopping the draw.

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