Which of the following should be collected first for tests including CBC, chemistry panel, lead, and a toxicology screen via capillary puncture?
Red top tube
Lavender top tube
Light blue top tube
Royal blue top tube
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Collecting the specimen in an SST (serum separator tube) is not suitable for ABG (arterial blood gas) analysis. SST tubes are used for chemistry tests that require serum separation after centrifugation and are not designed for the preservation of blood gases.
Choice B reason:
Placing the specimen in ice is the correct action when transporting a specimen for ABG analysis. Cooling the specimen slows down metabolic processes, which can alter the levels of gases and pH in the blood if not promptly analyzed. This is particularly important if there is a delay expected in the analysis of the ABG specimen.
Choice C reason:
Collecting the specimen in sodium citrate is not appropriate for ABG analysis. Sodium citrate is an anticoagulant used in coagulation studies and would interfere with the measurement of blood gases and pH levels in an ABG analysis.
Choice D reason:
Inserting the specimen in a light-resistant package is not a standard requirement for ABG specimens. While protecting specimens from light is important for certain types of tests, such as those for bilirubin, it is not necessary for ABG analysis.
Correct Answer is C
Explanation
Choice A reason:
A 16-gauge needle is quite large and is typically used for rapid fluid administration or blood donation in adults. It is not suitable for pediatric patients due to the size of their veins and the potential for causing trauma and discomfort.
Choice B reason:
An 18-gauge needle is also large and commonly used for adult patients in situations where larger volumes of blood are needed quickly. For a 6-year-old patient, this gauge would be too large and could cause significant pain and increase the risk of damaging the vein.
Choice C reason:
A 23-gauge needle is recommended for pediatric patients, including those who are 6 years old. It is small enough to minimize discomfort and the risk of injuring the vein, yet it allows for adequate blood flow for collection³. This size needle is often used with a winged infusion set, which is suitable for the smaller, more fragile veins of pediatric patients.
Choice D reason:
A 27-gauge needle is very small and is typically used for intradermal injections or for very small veins, such as those in neonates. While it would cause minimal discomfort, it may not provide an adequate flow rate for venipuncture in a 6-year-old patient.
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