Which of the following sites is appropriate to prepare for dermal specimen collection on a toddler?

Choice A Reason:
The right antecubital fossa is not the optimal site for blood collection in this case because the presence of a shunt in the right forearm can complicate the procedure and potentially damage the shunt, which is a critical access point for dialysis treatments.

Choice B Reason:
The right hand should also be avoided for blood collection due to the shunt placement in the right forearm. Using the same arm as the shunt for venipuncture could lead to complications such as infection, clotting, or accidental damage to the shunt.

Choice C Reason:
The left antecubital fossa might seem like a viable option; however, with an IV placed in the left hand, it is generally recommended to avoid using the same limb for blood collection to prevent contamination of the sample and reduce the risk of infection at the IV site.

Choice D Reason:
Capillary collection from the left hand is the most appropriate choice in this scenario. It avoids the arm with the shunt and the IV, reducing the risk of complications. Capillary blood collection is a suitable alternative when venipuncture sites are limited, and it can provide an adequate sample for a CBC.

Choice A Reason:
Occult blood detection is a test that a phlebotomist is allowed to perform according to CLIA regulations. This test is typically used to detect hidden blood in the stool, which can be an early sign of colorectal cancer or other digestive system diseases. It is considered a waived test under CLIA, meaning it is simple and carries a low risk for an incorrect result.

Choice B Reason:
Flow cytometry is a complex test that requires specialized training and equipment. It is used to analyze the physical and chemical characteristics of particles in a fluid as they pass through at least one laser. Phlebotomists are not typically trained to perform this type of analysis, as it falls under the category of high complexity testing.

Choice C Reason:
Genetic molecular tests are used to detect specific sequences in DNA or RNA that may or may not lead to disease. These tests are complex and require specialized knowledge and equipment. They are not within the scope of practice for phlebotomists, who are trained primarily in blood collection.

Choice D Reason:
Electrophoresis is a laboratory technique used to separate DNA, RNA, or protein molecules based on their size and electrical charge. This type of test is also complex and requires specialized training and equipment, which is beyond the scope of a phlebotomist's duties.