Deck 3: Venipuncture Techniques

Question 1

Failure to allow the alcohol to dry on the patient's arm after site cleansing can cause which of the following?

A) Sample hemolysis
B) A stinging sensation for the patient
C) A possible unsterile site
D) All of the above

Answer 1

D

Question 2

The vein of choice for routine venipuncture is the:

A) median cubital.
B) radial.
C) cephalic.
D) basilic.

Answer 2

A

Question 3

Patient reassurance includes:

A) explaining the purpose of the tests ordered.
B) lowering the bedrails.
C) briefly explaining the procedure.
D) assuring the patient that the procedure will not hurt.

Answer 3

C

Question 4

Prolonged application of a tourniquet will cause:

A) excessive bleeding.
B) difficulty locating a vein.
C) hemolysis.
D) clotting.

Question 5

The most important purpose of a requisition form is:

A) authorization to perform the procedure.
B) providing a system to report results.
C) location of the patient.
D) monitoring test result turnaround time.

Question 6

Failure to check the requisition form prior to leaving the laboratory may cause the blood collector to:

A) collect the wrong sample.
B) have inadequate equipment.
C) misidentify the patient.
D) require assistance from the nurse.

Question 7

A large,rigid cord located during palpation indicates:

A) an acceptable vein.
B) the brachial artery.
C) a tendon.
D) an unacceptable vein.

Question 8

Blood should not be drawn from a patient who is:

A) standing.
B) nervous.
C) unable to make a fist.
D) not fasting.

Question 9

Palpate means to:

A) perform a venipuncture.
B) examine by touch.
C) examine by sound.
D) obtain a sample from an IV line.

Question 10

The vein located on the thumb side of the arm is the:

A) brachial.
B) median cubital.
C) basilic.
D) cephalic.

Question 11

Basic information that should be present on all requisition forms includes which of the following?

A) Patient's name
B) Patient's identification number
C) Tests requested
D) All of the above

Question 12

To aid in sample processing,requisition forms may contain:

A) special collection information.
B) the blood collector's initials.
C) a bar code.
D) the patient's date of birth.

Question 13

The veins that are the easiest to anchor are the:

A) hand veins.
B) cephalic veins.
C) basilic veins.
D) median cubital veins.

Question 14

The appearance of petechiae on a patient's arm during site selection indicates that the:

A) patient has deep veins.
B) tourniquet is tied too tightly.
C) basilic vein should not be used.
D) radial pulse beat is very strong.

Question 15

Proper sample collection begins with:

A) sanitizing the hands.
B) locating the patient.
C) obtaining a requisition.
D) organizing the equipment.

Question 16

The maximum time a tourniquet should remain on the patient's arm is:

A) 1 minute.
B) 2 minutes.
C) 3 minutes.
D) 5 minutes.

Question 17

Correct palpation of a vein includes which of the following?

A) Determining the depth of the vein
B) Probing with the index finger
C) Determining the direction of the vein
D) All of the above

Question 18

The most important procedure in blood collection is to:

A) organize equipment at the bedside.
B) introduce yourself to the patient.
C) initial the requisition form.
D) identify the patient correctly.

Question 19

Which of the following are used to identify a patient?

A) Bar codes
B) Requisition form
C) Identification band
D) All of the above

Question 20

Before you draw a blood sample you must always:

A) check the patient's identification number and name on the wrist band.
B) ask the patient his or her name.
C) ask the nurse in charge to identify the patient.
D) Both A and B

Question 21

After needle removal,pressure is applied to the site:

A) by having the patient bend the elbow.
B) after labeling the tubes.
C) prior to removing the tourniquet.
D) to prevent hematoma formation.

Question 22

Which of the following is acceptable sterile technique?

A) Cleansing the site in a circular motion
B) Cleansing the palpating finger
C) Allowing the alcohol to completely air-dry
D) All of the above

Question 23

Prior to leaving a patient's room,a blood collector should do which of the following?

A) Dispose of gauze and alcohol pads in a biohazard container.
B) Return bedrails to their original position.
C) Discard the needle and holder into a sharps container.
D) All of the above

Question 24

The Clinical Laboratory and Standards Institute (CLSI) recommends that all patient samples be delivered to the laboratory no more than 2 hours after collection to reduce preexamination variables caused by cellular action and the effects of prolonged exposure of samples to room temperatures because of:

A) glycolysis caused by cells' use of glucose,hemolysis and leakage of potassium from the cells into the plasma or serum,and the destruction of coagulation factors from exposure to room temperatures.
B) leakage of coagulation factors into the serum or plasma by cellular metabolism,increased potassium values caused by exposure to room temperature,and increased glucose values caused by cellular metabolism.
C) glycolysis caused by leakage from cells,increased levels of coagulation factors caused by prolonged exposure to room temperatures,and decreased potassium levels caused by cellular metabolism.
D) glycolysis caused by exposure to room temperatures,hemolysis and leakage of coagulation factors from the cells,and decreased potassium levels in the serum and plasma by cellular utilization.

Question 25

The best way to prevent fainting in a patient during blood collection is to:

A) have the patient stand during the procedure.
B) have the patient lie down during the procedure.
C) have the patient pump the fist three times.
D) place a pillow under the patient's head.

Question 26

If a patient refuses to have blood drawn,the blood collector should:

A) send another blood collector to collect the sample.
B) report the situation to the supervisor.
C) return the requisition form to the laboratory.
D) ask someone to hold the patient and collect the sample.

Question 27

Hemoconcentration can be caused by:

A) prolonged tourniquet application.
B) IV therapy.
C) excessive probing.
D) failure to clench the fist.

Question 28

An example of improper disposal of venipuncture supplies and equipment is:

A) placing gauze and alcohol pads in a biohazard container.
B) recapping the needle.
C) removing gloves and sanitizing hands.
D) placing the plastic needle cover in the wastebasket.

Question 29

Which of the following is performed first when the last tube is collected?

A) Gauze is placed over the needle.
B) The filled tube is removed from the holder.
C) The needle is removed.
D) Pressure is applied to the site.

Question 30

Firmly anchoring the vein prior to needle insertion is necessary to prevent:

A) sample hemolysis.
B) incompletely filled tubes.
C) an accidental needlestick.
D) the vein from rolling.

Question 31

During the venipuncture,the blood collector should do which of the following?

A) Brace the hand holding the holder on the patient's arm.
B) Insert the needle with the bevel up.
C) Insert the needle at a 15- to 30-degree angle.
D) All of the above

Question 32

A blood collector can interrupt a physician-patient visit:

A) when the physician is not examining the patient.
B) if the collection is a timed sample.
C) if the patient has visitors present.
D) when the patient is scheduled for routine phlebotomy rounds.

Question 33

Bracing the hand holding the needle assembly against the patient's arm:

A) decreases the patient discomfort.
B) prevents excess needle movement.
C) decreases the possibility of hemolysis.
D) causes the tubes to fill more quickly.

Question 34

Tubes are angled downward during blood collection to:

A) ensure that they fill completely.
B) prevent patient discomfort.
C) prevent blood refluxing into the needle.
D) ensure mixing of blood and anticoagulant.

Question 35

Physician approval is required when collecting blood from:

A) patients with diabetes.
B) lower arm veins.
C) feet veins.
D) pediatric patients.

Question 36

Which identifiers for patient identification before sample collection are routinely used?

A) Comparing information obtained verbally and from the patient's identification band with the information on the test requisition
B) Asking the patient to state his or her first name and last name
C) Asking the patient "Are you John Doe?" or "Are you Mary Doe?"
D) Both A and B

Question 37

Prior to bandaging the puncture site,the blood collector should:

A) thank the patient.
B) instruct a fasting patient to eat.
C) examine the site for bleeding.
D) apply pressure for at least 5 minutes.

Question 38

When encountering a patient who is sleeping,the blood collector should:

A) return at another time.
B) try to collect the sample without waking the patient.
C) notify the nursing station.
D) awaken the patient before collecting the sample.

Question 39

A properly labeled tube must have which of the following information?

A) Blood collector's initials
B) Patient identification number
C) Date of collection
D) All of the above

Question 40

When properly used and organized before performing a venipuncture,the patient requisition forms will allow the blood collector to do which of the following?

A) Review the tests ordered and the time and date for sample collection.
B) Confirm that all requisitions for a specific patient are organized by the day and time of draw.
C) Review any special conditions or patient preparation for this sample collection.
D) All of the above

Question 41

The puncture site may require additional pressure to stop bleeding when the patient:

A) has low blood pressure.
B) is taking anticoagulants.
C) frequently takes aspirin.
D) Both B and C

Question 42

A blood collector may be required to obtain information from a second wrist band when collecting samples for:

A) blood bank.
B) chemistry.
C) coagulation.
D) HIV.

Question 43

When collecting blood from a patient with an IV line,the blood collector should:

A) collect from the IV line after it has been stopped for 5 minutes.
B) draw from the opposite arm.
C) draw from above the IV line.
D) draw from below the IV line in the same vein.

Question 44

Areas that should be avoided for venipuncture include which of the following?

A) Hematomas
B) Deep cephalic veins
C) Sclerosed veins
D) Both A and C

Question 45

When using a blood pressure cuff as a tourniquet,the cuff is inflated:

A) below the systolic and above the patient's diastolic pressure.
B) to 40 mm Hg.
C) and deflated three times.
D) above the systolic and below the patient's diastolic pressure.

Question 46

Collection of blood from an area that is edematous:

A) is acceptable for venipuncture.
B) may produce a hemoconcentrated sample.
C) is acceptable for dermal puncture.
D) should be avoided.

Question 47

If a suitable vein is not located in the left arm,the blood collector should:

A) check the right arm.
B) apply a blood pressure cuff.
C) apply the tourniquet above the hand.
D) puncture in the area of the median cubital vein.

Question 48

Difficult-to-locate veins can be made more prominent by which of the following?

A) Massaging the arm
B) Having the patient clench the fist
C) Applying hot compresses
D) All of the above

Question 49

When encountering a patient with a fistula,the blood collector should:

A) apply the tourniquet below the fistula.
B) use the other arm.
C) collect the blood from the fistula.
D) attach a syringe to the T-tube connector.

Question 50

Collection of samples from feet veins is not recommended in which of the following?

A) Cardiac patients
B) Diabetic patients
C) Patients with coagulation disorders
D) All of the above

Question 51

Prolonged tourniquet application will cause:

A) edema.
B) clotting.
C) hemoconcentration.
D) hematoma.

Question 52

Which of the following patient conditions will prolong the time it takes to stop the bleeding from a venipuncture site?

A) Low blood pressure
B) Low blood sugar
C) Patient taking Coumadin
D) Patient taking vitamin K

Question 53

While performing a venipuncture,the blood collector notices bright red blood spurting into the tube.The blood collector should:

A) immediately withdraw the needle.
B) immediately remove the tourniquet.
C) lower the patient's head.
D) apply pressure for 5 minutes after withdrawing the needle.

Question 54

The word meaning "an abnormal accumulation of fluid in the tissues" is:

A) phlebitis.
B) edema.
C) anemia.
D) plasma.

Question 55

A patient's identification band may contain special stickers to be applied to samples for:

A) blood bank.
B) chemistry.
C) microbiology.
D) hematology.

Question 56

Incorrect collection of blood from a patient who has had a mastectomy can result in which of the following?

A) Patient developing lymphedema
B) Patient developing an infection
C) Samples being affected by lymphostasis
D) All of the above

Question 57

When collecting blood from a patient with a very edematous right arm and a large hematoma in the antecubital area of the left arm,the blood collector should collect the sample from:

A) below the hematoma.
B) above the hematoma.
C) the antecubital area of the right arm.
D) the antecubital area of the left arm.

Question 58

Fistulas are seen in patients who:

A) are receiving dialysis.
B) have very fragile veins.
C) must be rapidly transfused.
D) are receiving frequent medications.

Question 59

The surgical fusion of a vein and artery frequently seen in dialysis patients is called:

A) an aneurysm.
B) hemoconcentration.
C) a fistula.
D) an angioplasty.

Question 60

A tourniquet is not applied when collecting a sample for:

A) lactic acid.
B) cortisol.
C) ammonia.
D) glucose.

Question 61

The tourniquet is applied twice during the venipuncture procedure.

Question 62

When collecting blood into an evacuated tube using a winged blood collection set,it is not necessary to use a holder.

Question 63

Supplies should be placed on the same side of your free hand during blood collection to avoid reaching across the patient.

Question 64

Bandages should not be applied to children younger than 2 years of age.

Question 65

Patients should be encouraged to pump their fists during venipuncture.

Question 66

Evacuated tubes containing anticoagulant do not need to be mixed immediately.

Question 67

When using a syringe to fill blood collection tubes:

A) fill all of the evacuated tubes with the same needle used for collection.
B) use a blood transfer device and allow the evacuated tubes to fill according to the vacuum in the tube; do not force the plunger.
C) activate the needle safety device after filling all of the evacuated tubes with the blood transfer device.
D) use the blood transfer device only for potentially combative patients.

Question 68

Samples that require mixing should be inverted after they have been labeled.

Question 69

The most difficult vein to anchor in the antecubital area is the basilic vein.

Question 70

The plastic wings on a winged blood collection set:

A) help hold the needle in place after insertion.
B) allow the angle of insertion to be lowered.
C) allow the angle of insertion to be raised.
D) Both A and B

Question 71

Applying a tourniquet to or drawing blood from an arm located on the same side of the body as a recent mastectomy can be harmful to the patient and may produce erroneous test results.The application of a tourniquet as part of such blood collections is discouraged for which of the following reasons?

A) Increases the danger of developing lymphedema in the affected area
B) Interferes with the flow of lymph fluid in the area
C) Causes increases in the blood level of lymphocytes and waste products in the area
D) All of the above

Question 72

Hyperextending the patient's arm may make vein location more difficult.

Question 73

To transfer blood from a syringe to an evacuated tube:

A) puncture the evacuated tube stopper.
B) make sure all of the blood in the syringe enters the evacuated tube.
C) hold the tube in your hand while puncturing the evacuated tube stopper.
D) use a blood transfer device attached to the syringe.

Question 74

When using a syringe:

A) the plunger should be pulled back slowly.
B) the needle should be inserted bevel down.
C) a tourniquet should not be used.
D) blood should be rapidly withdrawn.

Question 75

Prolonged application of a tourniquet (for greater than 1 minute) during routine blood collection procedures results in which of the following events?

A) No effect on patient results will occur except for tests for lactic acid.
B) Hemoconcentration will occur because cells and large molecules are forced into the bloodstream.
C) No significant effects on patient results will occur.
D) Hemoconcentration will occur as the plasma portion of the blood is forced into the tissues.

Question 76

After needle removal,the patient can apply pressure to the site by bending the elbow.

Question 77

A patient has the right to refuse to have blood drawn.

Question 78

When a patient is receiving an IV line,blood should be collected from:

A) the other arm.
B) an area above the IV line.
C) an area below the IV line.
D) Both A and C

Question 79

When collecting blood using a winged blood collection set,which of the following are acceptable?

A) Lowering the angle of insertion
B) Drawing blood into the syringe
C) Threading the needle into the vein
D) All of the above

Question 80

Isopropyl alcohol is a stronger antiseptic than is povidone-iodine.