Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
Utilizing tubes that have expired may result in which of the following?
A. Loss of vacuum
Expired tubes may lose their vacuum, which is necessary to draw the correct volume of blood into the tube. The vacuum in blood collection tubes ensures that the correct amount of blood is drawn. If the vacuum is lost, the blood will not be drawn into the tube properly, which can lead to underfilling and affect the test results.
B. Hemoconcentration
Hemoconcentration refers to an increase in the concentration of cells and solids in the blood, usually because of a loss of plasma. While this can occur due to prolonged tourniquet application or dehydration, it is not directly caused by the use of expired tubes.
C. Hemolysis
Hemolysis is the destruction of red blood cells, which can release hemoglobin and other intracellular components into the plasma. It can be caused by physical damage, such as from a needle during blood draw, but is not a consequence of using expired tubes. However, if an expired tube causes improper blood draw due to loss of vacuum, it could indirectly lead to hemolysis due to multiple attempts to draw blood.
D. Elevation of the red blood cell count
An elevation of the red blood cell count would not be directly caused by using expired tubes. The red blood cell count is determined by the body's production and destruction of red blood cells, not by the collection method or equipment used.
This question is an excerpt from Nurse Dive's nursing test bank - Phlebotomy Certification Proctored Exam 130. Take the full exam now
Full Explanation
Choice A reason:
Expired tubes may lose their vacuum, which is necessary to draw the correct volume of blood into the tube. The vacuum in blood collection tubes ensures that the correct amount of blood is drawn. If the vacuum is lost, the blood will not be drawn into the tube properly, which can lead to underfilling and affect the test results.
Choice B reason:
Hemoconcentration refers to an increase in the concentration of cells and solids in the blood, usually because of a loss of plasma. While this can occur due to prolonged tourniquet application or dehydration, it is not directly caused by the use of expired tubes.
Choice C reason:
Hemolysis is the destruction of red blood cells, which can release hemoglobin and other intracellular components into the plasma. It can be caused by physical damage, such as from a needle during blood draw, but is not a consequence of using expired tubes. However, if an expired tube causes improper blood draw due to loss of vacuum, it could indirectly lead to hemolysis due to multiple attempts to draw blood.
Choice D reason:
An elevation of the red blood cell count would not be directly caused by using expired tubes. The red blood cell count is determined by the body's production and destruction of red blood cells, not by the collection method or equipment used.
Similar Questions
A phlebotomist enters a patient's room and observes the patient to be motionless and cyanotic. Which of the following actions should the phlebotomist take first?
A. Ask the patient if they are okay in a loud voice.
When encountering a patient who appears motionless and cyanotic, the first action should be to assess their level of consciousness. Asking loudly if they are okay can help determine if the patient is responsive or unresponsive. If there is no response, this indicates that the patient may be unconscious and requires further immediate assessment and potential intervention.
B. Perform the head-tilt-chin-lift maneuver.
The head-tilt-chin-lift maneuver is used to open the airway of an unresponsive patient who is not suspected of having a spinal injury. However, this is not the first step. Before performing any maneuvers, it is essential to determine the patient's level of consciousness and whether they are breathing.
C. Administer two rescue breaths.
Administering rescue breaths is part of the process of cardiopulmonary resuscitation (CPR), which is only initiated after confirming that the patient is unresponsive and not breathing normally. This step comes after checking for responsiveness and breathing.
D. Look, listen, and feel for breathing movements.
Looking, listening, and feeling for breathing movements is part of the assessment to determine if the patient is breathing normally. This is done after establishing unresponsiveness but before initiating CPR. It is a critical step, but it follows after confirming that the patient does not respond to verbal stimuli.
Full Explanation
Choice A reason:
When encountering a patient who appears motionless and cyanotic, the first action should be to assess their level of consciousness. Asking loudly if they are okay can help determine if the patient is responsive or unresponsive. If there is no response, this indicates that the patient may be unconscious and requires further immediate assessment and potential intervention.
Choice B reason:
The head-tilt-chin-lift maneuver is used to open the airway of an unresponsive patient who is not suspected of having a spinal injury. However, this is not the first step. Before performing any maneuvers, it is essential to determine the patient's level of consciousness and whether they are breathing.
Choice C reason:
Administering rescue breaths is part of the process of cardiopulmonary resuscitation (CPR), which is only initiated after confirming that the patient is unresponsive and not breathing normally. This step comes after checking for responsiveness and breathing.
Choice D reason:
Looking, listening, and feeling for breathing movements is part of the assessment to determine if the patient is breathing normally. This is done after establishing unresponsiveness but before initiating CPR. It is a critical step, but it follows after confirming that the patient does not respond to verbal stimuli.
Choice A reason:
A. When encountering a patient who appears motionless and cyanotic, the first action should be to assess their level of consciousness. Asking loudly if they are okay can help determine if the patient is responsive or unresponsive. If there is no response, this indicates that the patient may be unconscious and requires further immediate assessment and potential intervention.
Occult blood detection is not a process that occurs naturally after a venipuncture to control bleeding. It is a laboratory test used to detect blood in the stool that is not visible to the naked eye. This test is unrelated to the venipuncture process.
B. Choice B reason:
The term "Phlebotomists" refers to healthcare professionals who perform venipuncture. It is not a process but a profession. Therefore, it does not fit the context of the question regarding the control of bleeding after venipuncture.
C. The head-tilt-chin-lift maneuver is used to open the airway of an unresponsive patient who is not suspected of having a spinal injury. However, this is not the first step. Before performing any maneuvers, it is essential to determine the patient's level of consciousness and whether they are breathing.
Hematopoiesis is the process of creating new blood cells in the body and occurs in the bone marrow. While it is an ongoing process essential for replenishing the body's blood supply, it is not directly related to controlling bleeding after a venipuncture.
D. Choice C reason:
Hemoconcentration is a condition where the blood concentration of cells and solids is higher than normal, usually due to a loss of plasma. This can occur during venipuncture if the tourniquet is left on for too long, but it is not a process used to control bleeding.
None
Full Explanation
Choice A reason:
Occult blood detection is not a process that occurs naturally after a venipuncture to control bleeding. It is a laboratory test used to detect blood in the stool that is not visible to the naked eye. This test is unrelated to the venipuncture process.
Choice B reason:
The term "Phlebotomists" refers to healthcare professionals who perform venipuncture. It is not a process but a profession. Therefore, it does not fit the context of the question regarding the control of bleeding after venipuncture.
Choice C reason:
Hematopoiesis is the process of creating new blood cells in the body and occurs in the bone marrow. While it is an ongoing process essential for replenishing the body's blood supply, it is not directly related to controlling bleeding after a venipuncture.
Choice D reason:
Hemoconcentration is a condition where the blood concentration of cells and solids is higher than normal, usually due to a loss of plasma. This can occur during venipuncture if the tourniquet is left on for too long, but it is not a process used to control bleeding.
When a serum separation tube (SST) is collected, which of the following actions should the phlebotomist take to ensure optimal test results?
A. Invert the tube 5 to 8 times and then set for 30 minutes prior to centrifugation.
Inverting the tube 5 to 8 times ensures that the clot activator mixes thoroughly with the blood, promoting proper clotting. Setting the tube aside for 30 minutes allows sufficient time for the blood to clot before centrifugation. This is the recommended procedure to ensure that the serum is properly separated from the clot, resulting in a quality specimen suitable for testing.
B. Invert the tube 1 to 3 times and then set for 1 hour prior to centrifugation.
Inverting the tube only 1 to 3 times may not be enough to mix the clot activator with the blood adequately, which could lead to incomplete clotting and potentially compromised test results. Additionally, setting the tube for 1 hour before centrifugation is longer than necessary and does not offer any advantage over the recommended 30 minutes.
C. Invert the tube 2 to 4 times and then set for 15 minutes prior to centrifugation.
Inverting the tube 2 to 4 times might not fully mix the clot activator with the blood, and setting it for only 15 minutes does not provide enough time for proper clot formation. This could result in a suboptimal separation of serum and clot, affecting the integrity of the test results.
D. Invert the tube 8 to 10 times and then set for 2 hours prior to centrifugation.
Inverting the tube 8 to 10 times could potentially cause hemolysis or disruption of the blood cells due to excessive agitation. Setting the tube for 2 hours prior to centrifugation is not recommended as it could lead to serum degradation or other changes that may affect the test results.
Full Explanation
Choice A reason:
Inverting the tube 5 to 8 times ensures that the clot activator mixes thoroughly with the blood, promoting proper clotting. Setting the tube aside for 30 minutes allows sufficient time for the blood to clot before centrifugation. This is the recommended procedure to ensure that the serum is properly separated from the clot, resulting in a quality specimen suitable for testing.
Choice B reason:
Inverting the tube only 1 to 3 times may not be enough to mix the clot activator with the blood adequately, which could lead to incomplete clotting and potentially compromised test results. Additionally, setting the tube for 1 hour before centrifugation is longer than necessary and does not offer any advantage over the recommended 30 minutes.
Choice C reason:
Inverting the tube 2 to 4 times might not fully mix the clot activator with the blood, and setting it for only 15 minutes does not provide enough time for proper clot formation. This could result in a suboptimal separation of serum and clot, affecting the integrity of the test results.
Choice D reason:
Inverting the tube 8 to 10 times could potentially cause hemolysis or disruption of the blood cells due to excessive agitation. Setting the tube for 2 hours prior to centrifugation is not recommended as it could lead to serum degradation or other changes that may affect the test results.