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A fasting period of 1 to 2 hours is too short and would not provide an accurate representation of the body's baseline levels for most tests that require fasting. It is important for certain levels, like blood sugar and lipids, to stabilize, which takes longer than 1 to 2 hours.

Fasting for 4 to 6 hours may be appropriate for some tests, but it is not the standard fasting duration for most blood tests that require fasting. The shorter time might not allow for the clearance of lipids and glucose from the bloodstream that can influence the test outcomes.

A 24-hour fast is generally not required for routine fasting blood tests and could be potentially harmful, as it may lead to hypoglycemia, especially in diabetic patients or those with metabolic disorders. It is excessive for the purposes of standard blood tests.

Sodium fluoride is a common additive in collection tubes that serves as a glycolysis inhibitor. It preserves glucose levels and is not specifically indicative of serum. However, it is often used in grey-top tubes, which are typically used for glucose testing and may contain plasma, not serum.

Sodium citrate is an anticoagulant that binds calcium in the blood, preventing clotting. Tubes with sodium citrate are used to collect plasma for coagulation studies, not serum. Therefore, this statement is incorrect as sodium citrate indicates plasma, not serum.

EDTA, or Ethylenediaminetetraacetic acid, is an anticoagulant that binds calcium ions, preventing blood from clotting. Tubes with EDTA are used for collecting plasma because they prevent clotting and allow for the separation of plasma from the blood cells upon centrifugation. This is the correct choice as EDTA indicates plasma.
 

Signing a release for laboratory results is a form of expressed consent, not implied consent. Expressed consent is given explicitly, either orally or in writing, and is clearly and unmistakably communicated.

Similarly, signing a document of agreement for a research study is another example of expressed consent. The patient is actively agreeing to participate in the study, which is a direct and informed action.

A family member nodding for a phlebotomist to proceed does not constitute the patient's implied consent. Consent must come directly from the patient unless they are unable to provide it, in which case a legal surrogate may give consent on their behalf.

Signing a release for laboratory results is a form of expressed consent, not implied consent. Expressed consent is given explicitly, either orally or in writing, and is clearly and unmistakably communicated. It involves a clear action of agreement to the specific procedure or intervention proposed.

Signing a document of agreement for a research study is also an example of expressed consent. The patient is actively agreeing to participate in the study, which is a direct and informed action. This type of consent is necessary for research studies to ensure that participants are fully aware of the study's nature and any potential risks involved.

A family member nodding for a phlebotomist to proceed does not constitute the patient's implied consent. Consent must come directly from the patient unless they are unable to provide it, in which case a legal surrogate may give consent on their behalf. The nod of a family member cannot be assumed as the patient's consent.

Using only one patient identifier is not sufficient to ensure patient safety and accuracy in healthcare settings. It increases the risk of misidentification, which can lead to serious medical errors. Therefore, one identifier is not the standard practice for patient verification before a blood draw.

While two identifiers are commonly used in many healthcare settings as a minimum requirement, they may not always provide enough differentiation, especially in larger facilities where patient names may be similar. Two identifiers are often the minimum standard, but they are not the most comprehensive approach.

While using four unique identifiers could further reduce the risk of patient misidentification, it is not typically required as the standard minimum. Three identifiers are generally considered adequate for most healthcare settings to ensure patient safety and proper identification.
 

While informing the patient of the procedure is important, it is not the immediate next step after greeting. The technician should first ensure the patient's safety and comfort before proceeding with the details of the blood draw.

Stating the technician's name to the patient helps build rapport but is not as critical as ensuring the patient's safety. It is a part of good communication and patient care practices but should follow after confirming any potential allergies or other immediate health concerns.

Asking the patient which arm they prefer for the blood draw is a part of the procedure that involves patient preference and comfort. However, this should come after ensuring there are no allergies that could lead to complications during the draw.

Shoe covers are used to protect the shoes and prevent the spread of contaminants from one area to another. They are not specifically required for droplet precautions during blood glucose monitoring. Droplet precautions typically focus on protecting mucous membranes of the eyes, nose, and mouth from droplet spatter.

A gown is used to protect the healthcare worker's skin and clothing from contamination with potentially infectious material. While it is an important piece of personal protective equipment, it is not the primary requirement for droplet precautions in the context of blood glucose monitoring, unless there is a risk of substantial splashing or spraying of bodily fluids.

Goggles are used to protect the eyes from splashes of blood or other body fluids. They are important in procedures where there is a risk of splashing, but for blood glucose monitoring, the risk is minimal. Therefore, goggles are not the primary piece of equipment required for droplet precautions in this scenario.

Positioning the needle at a 45° angle to the skin is not the recommended approach for venipuncture using a butterfly needle on dorsal hand veins. The correct angle for insertion is usually less than 45°, often around 15-30°, to ensure a shallow entry and reduce the risk of going through the vein.

Instructing the patient to hold the collection tubes is not standard practice and could lead to pre-analytical errors. The phlebotomist should maintain control of the tubes to ensure proper blood flow and fill volume, as well as to prevent contamination or accidents.

Applying the tourniquet at the antecubital area is not specific to the use of a butterfly needle for venipuncture on dorsal hand veins. While a tourniquet is used to engorge the veins and make them more prominent, its placement may vary depending on the selected puncture site and is not the action in question here.
 

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.

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.

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.
 

A requisition form is used to request a specific test or service. While it is an essential document in the process of ordering a toxicology drug screen, it does not serve the same purpose as the chain of custody in terms of legal proceedings. The requisition form typically includes patient information, the tests ordered, and the reason for the test, but it does not track the handling of the sample.

An encounter form, also known as a superbill, is used in medical billing to capture the services provided during a patient's visit. It includes information about the patient's diagnosis, the procedures performed, and the codes for billing purposes. However, it is not specifically related to the legal aspects of a toxicology drug screen.

The CMS 1500 form is the standard claim form used by healthcare providers to bill Medicare and Medicaid services. It is also used by some private insurers and managed care plans. Like the encounter form, it is related to billing and not to the legal chain of custody required for a toxicology drug screen.