Chapter 34 Phlebotomy and Blood Specimens

Chapter 34  Phlebotomy and Blood Specimens

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. As the nurse attempts venipuncture in the patient’s right hand, the vein rolls. To stabilize the vein, the nurse will
A.
Carefully apply enough pressure with the index and middle fingers to trap the rolling vein.
B.
Use the index finger and thumb of the nondominant hand to anchor the vein above and below the intended venipuncture site.
C.
Use a winged-infusion set with a syringe rather than a vacutainer.
D.
Apply heat for several minutes to enhance the visibility of the vein.

____ 2. An 86-year-old female patient has orders for a complete blood cell count this morning. When gathering the necessary equipment to collect the patient’s blood, the nurse will gather
A.
A winged-infusion set.
B.
A vacutainer holder.
C.
A 50-mL syringe.
D.
An 18-gauge vacutainer needle.

____ 3. Prior to drawing the patient’s blood, the nurse carefully lines up evacuated tubes in the order in which they will be filled. The nurse collects blood in the correct order because
A.
Lab draws are time-consuming and collecting blood in the correct order will be a more efficient use of time.
B.
The medical technologist in charge of the lab has designated the order based upon the facility’s protocol.
C.
Some tubes have additives that have the potential to contaminate each of the remaining tubes to be filled.
D.
The collection tube that is filled first has an anticoagulant, which prevents blood from clotting in the remaining tubes to be collected.

____ 4. A nurse has successfully inserted the vacutainer needle into the patient’s right median cubital vein. Next the nurse will
A.
Draw the appropriate amount of blood.
B.
Release the tourniquet to reduce pressure on the vein.
C.
Transfer the collected blood into the appropriate evacuated tube.
D.
Gently push the vacutainer tube onto the sheathed end of the needle.

____ 5. The nurse will not label an evacuated tube prior to entering the patient’s room because
A.
The nurse could accidently use the labeled tube for the wrong patient.
B.
The tube should be labeled after leaving the patient’s room.
C.
It is less time efficient, although it’s less likely to result in an error.
D.
It ensures that the writing on the label is more legible.

Chapter 34. Phlebotomy and Blood Specimens
Answer Section

MULTIPLE CHOICE

1. ANS: B

Feedback
A
Using the index and middle fingers does not provide as much stability or allow adequate distance to stabilize above and below, as does using the index finger and thumb.
B
To stabilize a rolling vein, use the index finger and thumb to apply gentle pressure above and below the site. Chapter Objective: Explain how to find and access a vein.
C
A winged-infusion set with syringe is generally utilized when a patient has fragile, tiny, or collapsing veins.
D
Applying heat over the intended venipuncture site increases the blood flow, which improves its visibly, but doesn’t help stabilize the vein.

PTS: 1 REF: Chapter: 34 | Page: 808 OBJ: Chapter Objective: 34-4
KEY: Content Area: Reduction of Risk Potential | Integrated Process: Nursing Process/Implementation | Client Need: Physiological Integrity/Reduction of Risk Potential/Laboratory Values | Cognitive Level: Application

2. ANS: A

Feedback
A
Elderly patients have fragile veins; using a winged-infusion set is especially helpful and can be more easily stabilized. Chapter Objective: Identify types of equipment used to perform venipuncture.
B
Because an elderly patient’s veins are smaller and more fragile, using the vacutainer method increases the risk for collapsing the vein.
C
A 50-mL syringe is not necessary.
D
A vacutainer needle is used with the vacutainer method of blood collection and can collapse fragile veins.

PTS: 1 REF: Chapter: 34 | Page: 812 OBJ: Chapter Objective: 34-5
KEY: Content Area: Reduction of Risk Potential | Integrated Process: Nursing Process/Planning | Client Need: Physiological Integrity/Reduction of Risk Potential/Laboratory Values | Cognitive Level: Analysis

3. ANS: C

Feedback
A
Collecting tubes of blood in the wrong order could require them to be drawn again, costing time, as well as discomfort to the patient, but it is not the established reason that tubes are filled in a certain order.
B
The lab director will most likely have an established protocol concerning the order in which tubes are collected, but it is not the reason tubes must be drawn in a certain order.
C
Collection tubes are filled with blood in a specified order to prevent preservatives found in certain tubes from contaminating subsequent tubes collected. Chapter Objective: Designate the order of draw for collections tubes when performing venipuncture.
D
Tubes containing an anticoagulant, such as green and lavender tubes, will contaminate red tiger-striped, light blue, red, and yellow tubes, and possibly alter the blood tests.

PTS: 1 REF: Chapter: 34 | Page: 812 OBJ: Chapter Objective: 34-8
KEY: Content Area: Reduction of Risk Potential | Integrated Process: Nursing Process/Planning | Client Need: Physiological Integrity/Reduction of Risk Potential/Laboratory Values | Cognitive Level: Application

4. ANS: D

Feedback
A
The nurse must first activate the evacuated tube before it can fill with blood.
B
The tourniquet is not released until the last tube to be filled is activated.
C
Blood is not transferred when using the vacutainer method of collecting blood.
D
The next step is to activate the vacutainer tube by gently pushing the tube onto the sheathed end of the vacutainer needle. Chapter Objective: Compare the process of venipuncture usin ghte evacuated tube method, syringe method, and butterfly infusion set.

PTS: 1 REF: Chapter: 34 | Page: 810 OBJ: Chapter Objective: 34-6
KEY: Content Area: Reduction of Risk Potential | Integrated Process: Nursing Process/Implementation | Client Need: Physiological Integrity/Reduction of Risk Potential/Laboratory Values | Cognitive Level: Application

5. ANS: A

Feedback
A
If tubes are labeled prior to collecting blood, it can result in an error, such as wrong tests being done on the wrong patient. Chapter Objective: Describe how to properly label specimens.
B
Labeling tubes while still in the room helps to ensure that the drawn samples will not be inadvertently mislabeled for one of the next patients from whom the phlebotomist draws blood.
C
Labeling tubes prior to the blood collection is more likely to result in an error.
D
Labeling a tube prior to the blood draw does not guarantee improved legibility of handwriting.

PTS: 1 REF: Chapter: 34 | Page: 813 OBJ: Chapter Objective: 34-9
KEY: Content Area: Reduction of Risk Potential | Integrated Process: Nursing Process/Implementation | Client Need: Physiological Integrity/Reduction of Risk Potential/Laboratory Values | Cognitive Level: Application