A nurse is preparing to obtain a capillary blood specimen from a client. Which of the following actions should the nurse take? (Select all that apply.)

Squeeze the client's finger until a blood drop forms.

Apply clean gloves.

Prick the side of the client's finger.

Elevate the client's hand above the level of the heart.

Cleanse the client's finger with an iodine swab.

Answer and Explanation

Correct Answer : B,C,E

A. Squeezing the client's finger until a blood drop forms can result in hemolysis and inaccurate results; instead, gentle milking or massaging of the finger is recommended.
B. Applying clean gloves is necessary to maintain infection control practices.

C.   Pricking the side of the client's finger is the appropriate technique for obtaining a capillary blood specimen.

D.   Elevating the client's hand above the level of the heart is not necessary and may impede blood flow.
E.   Cleansing the client's finger with an iodine swab helps to disinfect the area prior to obtaining the blood specimen.

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Correct Answer is A

Explanation

A. Removing the client's dentures should be performed by a licensed nurse rather than an assistive personnel to ensure proper handling and documentation.
B. Washing the client's face is appropriate postmortem care.
C. Closing the client's eyes is appropriate postmortem care.
D. Gathering the client's personal belongings is appropriate postmortem care.

A. Unnecessary sterile items are placed on the field. B. The sterile solution is poured with the bottle held over the field. C. The handle of a pair of sterile scissors is resting 5 cm (2 in) from the field's edge. D. A pair of sterile forceps is allowed to rest in a container of sterile water on the field.

Correct Answer is B

Explanation

A. Placing unnecessary sterile items on the field is not ideal, but it does not indicate contamination of the surgical field.

B. Pouring sterile solution with the bottle held over the field is an inappropriate technique since it breaches the sterility of the field.

C. The handle of a pair of sterile scissors resting 5 cm (2 in) from the field's edge does not indicate contamination of the surgical field. The scissors should be placed within easy reach of the nurse but should not touch non-sterile items.

D. Allowing sterile forceps to rest in a container of sterile does not affect the sterility of the field.

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A nurse is preparing to obtain a capillary blood specimen from a client. Which of the following actions should the nurse take? (Select all that apply.)

Nursing Test Bank

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A nurse is preparing to obtain a capillary blood specimen from a client. Which of the following actions should the nurse take? (Select all that apply.)