Advanced Venipuncture Procedure

Winged infusion sets are often referred to as:
1. the phlebotomist’s nightmare
2. Butterflies
3. the major reason for hemoconcentration
4. Caterpillars
The smaller the needle bore:
1. the larger the gauge number
2. the less hemolysis that occurs
3. the less chance there is of hemoconcentration
4. all of the above
Use of winged infusion sets are:
1. the major reason for needle-stick injuries
2. required for collecting skin puncture samples
3. required when the patient’s skin is extremely calloused
4. only to be used when collecting from the antecubital fossa area
Winged infusion sets are recommended:
1. for drug levels
2. when drawing blood from normal healthy veins
3. when drawing blood from from thin, fragile veins
4. for blood bank testing
Nerve compression may occur:
1. when blood is collected from the basilic vein
2. when the vein is transfixed
3. when blood leaks from the vein
4. all of the above
The following practices may result in litigation:
1. injury to nerves
2. reflux of vacuum tube contents
3. injury to veins
4. all of the above
The following steps should be performed when the phlebotomist suspects nerve injury to the patient:
1. immediately withdraw the needle
2. apply pressure to the site to prevent formation of a hematoma
3. document the incident
4. all of the above
The following is a high risk procedure that should not be used by the phlebotomist:
1. inserting the needle at a 15-degree angle
2. anchoring the vein
3. collecting blood from the cephalic vein
4. probing
Nerve injury may be caused by:
1. nicking the nerve with the blood collection needle
2. severing the nerve with the blood collection needle
3. compression or pinching caused by a hematoma
4. all of the above
Identify the safest choices for vein selection:
1. basilic, median cubital, cephalic
2. cephalic, accessory cephalic, median cubital
3. great saphenous, cephalic, basilic
4. dorsal, basilic, median cubital
Tissue thromboplastin:
1. may interfere with coagulation studies
2. occurs during passage of the needle through the skin and tissue
3. affects PT and PTT testing
4. all of the above
Winged infusion sets may be required:
1. to prevent excessive bleeding
2. for small, fragile veins
3. when performing skin punctures
4. all of the above
It is acceptable to use winged infusion sets routinely:
1. for normal healthy veins
2. because I can’t hold the needle steady
3. to prevent hemolysis
4. none of the above
Venipuncture training should promote:
1. confidence in the ability of the trainee
2. bleeding at the site
3. safety
4. both a) and c)
Knowing when to quit is an important aspect of venipuncture. What is the maximum number of attempts that should be made to collect a specimen from a patient, before having someone else attempt to collect the specimen?
1. once
2. twice
3. three times
4. until I get it
While performing a venipuncture, the blood starts to flow into the tube and then stops. What is/are the most likely causes?
1. the vein has collapsed
2. the tube vacuum is defective
3. the needle bevel is in the lumen of the vein
4. both a) and b)
The following is/are true concerning pre/trough and post/peak gentamicin levels:
1. this drug is toxic and may cause damage to the kidneys and hearing
2. pre- levels are collected to ensure that the previous dose has cleared before administering the next dose
3. post- levels are collected to ensure that the dose is high enough to be effective but not so high that it is toxic
4. all of the above
Technical errors that could result in litigation include the following:
1. incorrect angle of insertion
2. probing
3. placing the needle bevel in the lumen of the vein
4. both a) and b)
Bleeding time tests are performed to determine:
1. the platelet count
2. blood coagulation factor deficiencies
3. platelet function
4. all of the above
Glucose tolerance tests may be performed:
1. to assist in the diagnosis of diabetes mellitus
2. when patients have borderline fasting glucose results
3. when patients have borderline postprandial glucose results
4. all of the above