Which of the following actions is required immediately after a phlebotomist experiences an accidental needlestick injury when drawing blood from a patient who has HIV?
Report the exposure to the supervisor.
Report the exposure to the CDC.
Send the patient for further STI testing.
Save the collection device for future evaluation.
The Correct Answer is A
Choice A reason:
Reporting the exposure to the supervisor is the immediate and required action after experiencing a needlestick injury. The supervisor will then guide the phlebotomist through the institution's post-exposure protocol, which includes immediate care of the wound, evaluation of the exposure, and initiation of post-exposure prophylaxis (PEP) if necessary. This step is crucial to ensure that the risk of HIV transmission is minimized and that the phlebotomist receives appropriate medical attention and follow-up.
Choice B reason:
Reporting the exposure to the Centers for Disease Control and Prevention (CDC) is not the immediate action required. The CDC provides guidelines and recommendations for handling such incidents, but the initial report and response are managed at the healthcare facility level. The CDC may be involved in the tracking of such incidents on a larger scale or providing statistical data, but they are not the first point of contact.
Choice C reason:
Sending the patient for further sexually transmitted infection (STI) testing is not an immediate action required following a needlestick injury. The patient's HIV status is already known, and the focus should be on the treatment and protection of the healthcare worker who experienced the needlestick. Any additional testing of the patient would be unrelated to the immediate management of the injury.
Choice D reason:
Saving the collection device for future evaluation is not a standard procedure. While the device may be retained as part of the incident investigation to determine how the injury occurred and to improve safety measures, the immediate concern is the treatment of the injured healthcare worker. The device itself does not play a role in the post-exposure management of the worker.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Explaining the procedure to both the parent and the child is crucial. It helps in preparing the child psychologically and ensures that the parent is informed and can provide support during the process. Clear communication can reduce anxiety and make the child more cooperative. It is also a part of informed consent, where the parent understands what the procedure entails and why it is necessary¹².
Choice B Reason:
Choosing not to tell the child when the needle insertion is coming might seem like a way to avoid causing them anticipatory anxiety. However, this approach can lead to mistrust. Children need to be prepared for what to expect, and surprising them can be more traumatic in the long run. It is better to be honest and use age-appropriate language to describe the sensation as a 'quick pinch' or 'poke'¹².
Choice C Reason:
Obtaining a heel stick is a common method for blood collection in infants, particularly newborns, as their veins are not as developed. However, for preschoolers, venipuncture is usually the preferred method because they have more developed veins, and it allows for a larger volume of blood to be collected if needed³.
Choice D Reason:
Obtaining a thumb stick is not a standard practice for blood collection in preschoolers. The thumb has bones and tendons close to the surface, which can increase the risk of injury. The preferred sites are the antecubital fossa of the arm or the back of the hand where the veins are more accessible and there is less risk of hitting bone³.
Correct Answer is C
Explanation
Choice A Reason:
Shaking the tubes vigorously can cause hemolysis, which is the rupture of red blood cells, leading to inaccurate test results. It is not recommended as it does not provide gentle mixing and can damage the blood cells.
Choice B Reason:
Moving the tubes in a figure-eight motion is not a standard practice for mixing blood samples. This method may not provide the consistent and gentle inversion needed to mix the anticoagulant with the blood effectively.
Choice C Reason:
Rolling the tubes between the palms of the hands 4 to 8 times after collection is the recommended method. This technique allows for gentle and thorough mixing of the blood with the anticoagulant, preventing clotting without causing hemolysis. The number of inversions ensures that the anticoagulant coats the inner surface of the tube and mixes with the blood, which is essential for accurate laboratory results.
Choice D Reason:
Passing the tubes from hand to hand is not an effective method for mixing blood samples. This action may not provide the necessary inversion and can lead to inadequate mixing, resulting in clotted specimens.
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