Exam Prep Arterial Blood Collection Chapter 12

Chapter 12: Arterial Blood Collection

Multiple Choice

1. Phlebotomist training in the performance of arterial punctures should include all of the following except:

A. safety precautions.

B. possible complications.

C. femoral puncture procedures.

D. supervised practice.

2. Arterial punctures should be performed:

A. on pediatric patients.

B. only when authorized.

C. only from the radial artery.

D. after an unsuccessful venipuncture.

3. Arterial blood may be requested for all of the following except:

A. ammonia.

B. potassium.

C. lactic acid.

D. PCO₂.

4. Arterial punctures would be most frequently requested on patients located in:

A. labor and delivery.

B. outpatient testing.

C. critical care.

D. orthopedics.

5. The artery located on the thumb side of the wrist is the:

A. brachial.

B. ulnar.

C. radial.

D. femoral.

6. Which of the following tests requires anaerobic conditions?

A. Glucose.

B. Blood gases.

C. Blood urea nitrogen (BUN).

D. Sodium.

7. A large artery located near the basilic vein and the median nerve is the:

A. ulnar.

B. brachial.

C. radial.

D. cephalic.

8. An alternate pathway capable of supplying blood to an area if the main pathway is obstructed is referred to as:

A. circulatory bypass.

B. collateral circulation.

C. shunt circulation.

D. arterial fistula.

9. Under normal conditions, arterial blood will have a(an):

A. higher PO₂ than PCO₂.

B. decreased PO₂ and PCO₂.

C. equal amount of PO₂ and PCO₂.

D. higher PCO₂ than PO₂.

10. Syringes used to collect arterial blood gases (ABGs):

A. are coated with mineral oil.

B. are designed to inject the specimen into an analyzer.

C. must be made of glass.

D. should hold at least 10 mL of blood.

11. The anticoagulant in syringes used to collect arterial blood gases (ABGs) is also found in:

A. gray stopper tubes.

B. green stopper tubes.

C. light blue stopper tubes.

D. yellow stopper tubes.

12. When performing an arterial puncture, the finger of the nondominant hand is:

A. used to anchor the artery.

B. placed where the needle enters the skin.

C. placed where the needle enters the artery.

D. used to measure the patient’s heart rate.

13. Upon completion of an arterial puncture, the syringe is rotated to:

A. expel air from the syringe.

B. activate the needle safety device.

C. attach the Luer tip cap.

D. mix the anticoagulant.

14. When collecting blood from an artery, the designated collector should:

A. ask the patient to make a tight fist.

B. tighten the tourniquet to stop arterial flow.

C. request a nurse to be present.

D. make sure the patient is as calm as possible.

15. The thumb should not be used to palpate an artery for arterial punctures because it:

A. is too large.

B. lacks nerve endings.

C. contains a pulse.

D. cannot be adequately disinfected.

16. To achieve a steady state in a patient prior to collection of arterial blood gases, the patient should:

A. empty the bladder.

B. fast for 12 hours.

C. cough 5 to 10 times to clear lungs.

D. rest for 30 minutes.

17. The modified Allen test is used to determine collateral circulation in the:

A. ulnar artery.

B. brachial artery.

C. radial artery.

D. cephalic artery.

18. Additional information required on the requisition form when collecting arterial blood gases (ABGs) includes all of the following except:

A. patient’s respiration rate.

B. type of ventilation the patient is receiving.

C. type of patient activity.

D. initials of the requesting physician.

19. When performing the modified Allen test, pressure is released from the:

A. radial and ulnar arteries.

B. ulnar and brachial arteries.

C. radial artery only.

D. ulnar artery only.

20. When performing an arterial puncture, the needle is inserted bevel:

A. down at a 90-degree angle.

B. up at a 30- to 45-degree angle.

C. up at a 15- to 20-degree angle.

D. down at a 10-degree angle.

21. The site of an arterial puncture is cleansed with:

A. soap and water to prevent irritation.

B. alcohol in the same manner as for a venipuncture.

C. iodine followed by alcohol and air-drying.

D. iodine and air-drying.

22. After the artery has been entered, the syringe plunger:

A. will be pushed back by the blood.

B. should be rapidly pulled back.

C. must be rotated.

D. should be moved back and forth.

23. Following arterial specimen collection, pressure is applied to the puncture site for:

A. 2 minutes by the phlebotomist.

B. 2 minutes by the phlebotomist or patient.

C. 3 to 5 minutes by the phlebotomist.

D. 10 minutes by the phlebotomist or patient.

24. Prior to completing an arterial puncture procedure, the phlebotomist should:

1. notify the nursing station.

2. check the site for hematoma.

3. check a radial pulse.

4. apply a pressure bandage.

A. 1 and 3.

B. 2 and 4.

C. 3 and 4.

D. 2, 3, and 4.

25. An error that would falsely elevate a patient’s PO₂ reading is:

A. failing to seal the syringe needle after specimen collection.

B. failing to expel excess heparin from the syringe.

C. delayed analysis of a specimen not on ice.

D. both A and C.

26. A phlebotomist would be most likely to perform an accidental arterial puncture when attempting to puncture the:

A. cephalic vein.

B. median cubital vein.

C. radial vein.

D. basilic vein.

27. The presence of excess heparin in the syringe used to collect arterial blood gases (ABGs) will:

A. increase clotting speed.

B. decrease the pH.

C. decrease the anticoagulant effect of heparin.

D. increase the pH.

28. During an arterial puncture, a hypodermic syringe with a 25-gauge needle is used for:

A. collecting the specimen.

B. administering an anesthetic.

C. transferring the specimen to a tube.

D. transporting the specimen to the laboratory.

29. Extended pressure may need to be applied to the arterial puncture site when patients are receiving all of the following except:

A. streptokinase.

B. tissue plasminogen activator (t-PA).

C. insulin.

D. Coumadin.

30. Collateral circulation is necessary to prevent complications caused by:

A. arteriospasm.

B. infection.

C. vasovagal reaction.

D. hemorrhage.

31. Which of the following arterial puncture complications would cause a patient to lose consciousness rapidly?

A. Arteriospasm.

B. Nerve damage.

C. Vasovagal reaction.

D. Hemorrhage.

32. Failure to locate a radial pulse after arterial puncture of the radial artery indicates:

A. venous blood was collected.

B. the ulnar artery is occluded.

C. a possible arteriospasm.

D. the patient has expired.

33. Examples of diseases and patient conditions that require the collection of a blood specimen by arterial puncture include all of the following except:

A. newborn metabolic disease screening.

B. diabetic coma.

C. cardiac and respiratory failures.

D. chronic obstructive pulmonary disease (COPD).

34. Deep puncture

35. Tissue destruction

36. Failure to apply adequate pressure

37. Coagulation disorders

38. Apprehensive patient

KEY: Topic: Arterial puncture complications

DIF: Level 2

Learning Objective: 12.9

KEY: Topic: Arterial puncture complications

DIF: Level 2

Learning Objective: 12.9

KEY: Topic: Arterial puncture complications

DIF: Level 2

Learning Objective: 12.9

Short Answers

39. List eight reasons why a specimen for arterial blood gases determination may be rejected.

40. State four factors that should be considered when selecting a site for arterial puncture and name the preferred site.