Which of the following samples should a phlebotomist present to the laboratory first for processing?
A sodium level from a patient who has a DNR order
A hemoglobin and hematocrit level from a patient who is postoperative
A stat potassium level from a patient in the emergency room
A peak antibiotic level from a patient who is NPO
The Correct Answer is C
Choice A reason:
A sodium level test is important for managing and monitoring a patient's electrolyte balance, particularly in critical care settings. However, a DNR order indicates that the patient has chosen not to undergo CPR, not necessarily that their condition is the most critical at the moment. Therefore, while important, it may not be the most urgent sample to process.
Choice B reason:
Postoperative monitoring of hemoglobin and hematocrit levels is crucial for detecting possible hemorrhage and ensuring proper recovery. However, unless there is an immediate concern for acute blood loss or other complications, these tests may not be as urgent as a stat test from the emergency room.
Choice C reason:
A stat potassium level is typically ordered when there is an urgent need to assess a patient's potassium due to conditions that can rapidly affect heart rhythm and muscle function. In the emergency room setting, where patients often present with acute and life-threatening conditions, stat tests are prioritized to provide rapid results that can influence immediate clinical decisions.
Choice D reason:
Peak antibiotic levels are measured to ensure therapeutic efficacy and to avoid toxicity. While important for managing a patient's treatment, especially for those who are NPO (nothing by mouth), it may not be as time-sensitive as a stat test required for an acute emergency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
Choice A Reason:
Signing a release for laboratory results is a form of expressed consent, not implied consent. Expressed consent is given explicitly, either orally or in writing, and is clearly and unmistakably communicated.
Choice B Reason:
Similarly, signing a document of agreement for a research study is another example of expressed consent. The patient is actively agreeing to participate in the study, which is a direct and informed action.
Choice C Reason:
Implied consent occurs when a patient's actions suggest consent without verbal or written confirmation. Offering an arm to a phlebotomist is a non-verbal communication that implies the patient is willing to have their blood drawn. This is a common practice in medical settings where the action of presenting an arm indicates readiness for the procedure.
Choice D Reason:
A family member nodding for a phlebotomist to proceed does not constitute the patient's implied consent. Consent must come directly from the patient unless they are unable to provide it, in which case a legal surrogate may give consent on their behalf.
Correct Answer is C
Explanation
Choice A Reason:
Reporting the needlestick to the supervisor is an important step in the post-exposure protocol, but it is not the first action that should be taken. The immediate priority is to address the potential exposure to pathogens by cleansing the wound.
Choice B Reason:
Completing the blood draw is not the appropriate first action after a needlestick injury. The phlebotomist's health and safety take precedence, and the procedure should be paused to address the injury.
Choice C Reason:
Washing the area with soap and water is the first and most critical action to take after an accidental needlestick. This helps to remove any blood or pathogens that may have been introduced to the wound site. It is essential to do this immediately to reduce the risk of infection.
Choice D Reason:
Seeking immediate treatment is a necessary step, but it follows the initial cleansing of the wound. After washing the area, the phlebotomist should then report the incident and seek medical advice to assess the need for further treatment, such as post-exposure prophylaxis.
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