Chapter.7 Phlebotomy Techniques Exam Questions 7th Edition

Chapter 7: Phlebotomy Techniques

Multiple Choice

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

1. A nurse is preparing to draw blood from an older adult client using a butterfly safety needle. Which is the best angle for needle insertion during venipuncture?

A. 25 degrees

B. 35 degrees

C. 45 degrees

D. 90 degrees

2. A physician orders multiple blood tests for a client. A nurse preparing to collect blood samples knows that most diagnostic blood tests require:

A. anticoagulants.

B. shaking.

C. lancets.

D. syringes.

3. A quality-control nurse reviews procedures to decrease the incidence of errors in a hospital laboratory. Which type of test requisition has been shown to decrease laboratory errors?

A. Bar coded

B. Computer

C. Manual triplicate forms

D. Verbal requests

4. The nurse has an order test blood on a 93-year old client diagnosed with diabetes. Which method of blood collection is the best for this client?

A. Evacuated tube system

B. Syringe method

C. Capillary puncture

D. VAD withdrawal

5. How does the nurse’s facility help minimize laboratory personnel’s risk of exposure to blood during blood collection?

A. Use of the evacuated tube system

B. Use of hand hygiene protocols

C. Use of the syringe system

D. Use of the capillary puncture

6. Anticoagulants are used as an additive in blood collection tubes to prevent blood clotting. Which anticoagulant additive prevents clotting by inactivating clotting chemicals in thrombin and thromboplastin?

A. Oxalate

B. Citrate

C. EDTA

D. Heparin

7. The nurse performs a venipuncture on a newly admitted client who has a diagnosis of dehydration. What is the most common complication that the nurse has seen from performing a venipuncture?

A. Hematoma formation

B. Iatrogenic anemia

C. Infection

D. Nerve injury

8. The nurse is attempting to place an IV in a client’s arm at a site from a previous hospitalization. Why would the nurse need to further assess this attempt?

A. Numerous venipunctures can cause a buildup of scar tissue.

B. Use of this site may cause a hematoma to form.

C. Venipuncture of this site may cause an extravasation.

D. The client may require a PICC line due to peripheral IV overuse.

9. The nurse is preparing to place an IV in the forearm of a five-year old child. What is the nurse’s most therapeutic comment?

A. “This may pinch a bit, but it will be over quickly.”

B. “This will not hurt a bit, and it will be over quickly.”

C. “When this is over you can have a piece of candy.”

D. “This won't hurt, and you can have a piece of candy.”

10. The nurse is preparing to place an IV in the forearm of an elderly client. Which age-related change may require the expert skills from a phlebotomist?

A. Slower nerve conduction

B. Deeper veins

C. Superficial veins

D. Iatrogenic anemia

11. The nurse has an order to draw labs on a client diagnosed with possible sepsis. What is the correct order of blood collection draw to prevent contamination? SELECT ALL THAT APPLY.

A. Blood culture vials, gold top, gray top

B. Blood culture tubes, light blue top, red top

C. Blood culture tubes, green top, gray top

D. Gray top, pink top, green top

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

1. A clinic nurse is performing venipuncture on multiple clients. Which complications of venipuncture is the client at risk for that the nurse should anticipate when performing a venipuncture on a new client? (Select all that apply.)

A. Hematoma

B. Continued bleeding

C. Nerve injury

D. Traumatic neuroma

E. Vein damage

2. A nurse is preparing to obtain a blood sample from an infant. Which precautions should the nurse take when obtaining blood from a capillary puncture in an infant? (Select all that apply.)

A. Do not puncture deeper than 2.0 mm.

B. Do not puncture over bruised areas.

C. Obtain puncture over plantar surface of heel.

D. Obtain puncture over back of heel.

E. Obtain puncture in the scalp on infants.

3. A nurse is preparing to obtain a blood sampling from a CVAD? Which method should the nurse use when obtaining blood? (Select all that apply.)

A. The flushing method

B. The aspiration method

C. The mixing method

D. The push-pull method

E. The discard method

4. The nurse needs blood drawn per orders from a client with suspected sepsis. Which steps are utilized in the process of the evacuated tube system? (Select all that apply.)

A. Verify orders from healthcare provider.

B. Explain procedure to client.

C. Perform hand hygiene.

D. Attach vacutainer to venipuncture site needle.

E. Fill tubes halfway and invert twice upon removal.

5. What does the nurse have to take into consideration with clients when determining use of capillary puncture versus other types of blood collection? (Select all that apply.)

A. Unsuccessful venipunctures

B. Needle phobias

C. Vein accessibility

D. Manufacturer preference

E. Amount of blood required

6. Additives are often used to prevent blood clotting of blood samples after blood collection. Which anticoagulants are the most common? (Select all that apply.)

A. Oxalates

B. Citrates

C. Heparin

D. Warfarin

E. EDTA

7. The nurse has orders to start an infusion of ½ NS on a diabetic client who is dehydrated. The nurse should immediately remove the venipuncture needle when the client reports which sign? (Select all that apply.)

A. Extreme pain

B. Numbness of the arm

C. Electric shock sensation

D. Blindness

E. Referred abdominal pain

8. The nurse is taking care of a client diagnosed with sepsis who has a series of blood tests ordered. What are the complications associated with venipuncture for blood cultures? (Select all that apply.)

A. Hematoma

B. Infection

C. Nerve damage

D. Erythema

E. Vein damage

9. The nurse is collecting blood from an infant. Prior to collection what must the nurse do to prevent harm? (Select all that apply.)

A. Calculate 10% of the infant’s monthly blood volume.

B. Calculate 3% of blood volume per collection.

C. Determine oral sucrose levels.

D. Provide venipuncture to superficial veins.

E. Restrain infant in a blood drawing chair.

Chapter 7: Phlebotomy Techniques

Multiple Choice

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

1. A nurse is preparing to draw blood from an older adult client using a butterfly safety needle. Which is the best angle for needle insertion during venipuncture?

A. 25 degrees

B. 35 degrees

C. 45 degrees

D. 90 degrees