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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is C
Explanation
A. Simple face mask: This can deliver oxygen at flow rates of 5-10 liters per minute and typically provides an oxygen concentration of about 35-50%.
B. Nasal prongs: Nasal prongs deliver oxygen at lower flow rates and may not be sufficient to raise the client's oxygen saturation to 90%.
C. Non-rebreather mask: This mask can deliver high concentrations of oxygen (up to 90-100%) at flow rates of 10-15 liters per minute. It has one-way valves to prevent the patient from rebreathing exhaled air, thus maximizing the delivery of oxygen.
D. Nasal cannula: Nasal cannulas deliver oxygen at lower flow rates (typically up to 6 liters per minute) and may not provide the necessary concentration to achieve an oxygen saturation of 90%.
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