A patient has bilateral scarring on their forearms from past burn injuries and needs a venipuncture procedure. Which of the following veins should the phlebotomist use for the venipuncture draw?
Axillary
Median cubital
Basilic
Dorsal hand
The Correct Answer is D
Choice A reason:
The axillary vein is not commonly used for routine venipuncture due to its location in the armpit area, where it is more difficult to access and poses a higher risk of complications.
Choice B reason:
The median cubital vein is often the vein of choice for venipuncture due to its size and accessibility. However, in the case of a patient with bilateral scarring on the forearms, this vein may be compromised, making it a less suitable option.
Choice C reason:
The basilic vein, while also a common site for venipuncture, is located on the inner aspect of the arm and may be affected by the scarring on the patient's forearms. Additionally, it is closer to nerves and arteries, which increases the risk of complications.
Choice D reason:
The dorsal hand veins are a good alternative for venipuncture when the more common sites are not available, such as in the case of a patient with bilateral scarring on the forearms. These veins are usually more superficial and can be accessed with minimal risk of complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Anchoring a vein is a technique used to stabilize the vein during venipuncture to prevent it from rolling. The recommended practice is to anchor the vein 1 to 2 inches below the puncture site. This is done by applying gentle traction on the skin downward with the thumb, which helps to stabilize the vein and facilitate the insertion of the needle.
Choice B Reason:
Anchoring 1 to 2 inches above the puncture site is not the standard practice. This position would not provide the necessary tension on the vein to prevent it from rolling and could make the venipuncture more difficult.
Choice C Reason:
Anchoring 2 inches left of the puncture site does not provide the correct angle or tension for stabilizing the vein for a venipuncture and is not a recommended technique.
Choice D Reason:
Anchoring 1 inch right of the puncture site is also not a recommended practice. Similar to anchoring to the left, this does not provide the proper stabilization needed for a successful venipuncture.
Correct Answer is B
Explanation
Choice A reason:
Capturing the initial stream of urine, also known as the "first catch," is not recommended for a urine culture. This part of the urine stream can contain contaminants from the urethral opening and is not ideal for culture testing, which requires a clean sample.
Choice B reason:
Cleaning the genital area prior to collection is crucial for obtaining a clean-catch urine specimen. This reduces the risk of contamination from bacteria that are normally present on the skin around the urinary opening. Patients should be instructed to use antiseptic wipes to clean the area before collecting the urine sample.
Choice C reason:
Filling the container to capacity is not necessary and is not a specific instruction for urine culture collection. The focus should be on obtaining a midstream sample after the genital area has been cleaned, which provides a more accurate representation of the urine for culture purposes.
Choice D reason:
Labeling the lid prior to collection is an important step in the process to ensure proper identification of the specimen. However, it is not the primary instruction related to the actual collection of the urine sample. The label should include the patient's name, date, and time of collection and should be done after the sample is collected to avoid confusion or contamination.
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