Which of the following should be collected first for tests including CBC, chemistry panel, lead, and a toxicology screen via capillary puncture?

Choice A reason:
When encountering a patient who appears motionless and cyanotic, the first action should be to assess their level of consciousness. Asking loudly if they are okay can help determine if the patient is responsive or unresponsive. If there is no response, this indicates that the patient may be unconscious and requires further immediate assessment and potential intervention.

Choice B reason:
The head-tilt-chin-lift maneuver is used to open the airway of an unresponsive patient who is not suspected of having a spinal injury. However, this is not the first step. Before performing any maneuvers, it is essential to determine the patient's level of consciousness and whether they are breathing.

Choice C reason:
Administering rescue breaths is part of the process of cardiopulmonary resuscitation (CPR), which is only initiated after confirming that the patient is unresponsive and not breathing normally. This step comes after checking for responsiveness and breathing.

Choice D reason:
Looking, listening, and feeling for breathing movements is part of the assessment to determine if the patient is breathing normally. This is done after establishing unresponsiveness but before initiating CPR. It is a critical step, but it follows after confirming that the patient does not respond to verbal stimuli.

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.