Final Exam Practice Test 2

The term "proximal" refers to a position or location that is closest to the center of the body or the point of attachment. In anatomical terms, it is used to describe structures that are closer to the trunk or the point of origin of a limb. For example, the shoulder is considered proximal to the hand because it is closer to the center of the body. Similarly, the hip is proximal to the knee.

The term "distal" refers to something that is located farthest from the center of the body, origin, or point of attachment. In medical and anatomical contexts, it is often used to describe the position of a body part in relation to another. For example, if we consider the arm, the hand would be considered distal to the shoulder because it is farther away from the point of attachment.

When arriving to draw a specimen from an inpatient, it is important to respect the patient's privacy and personal space. Knocking softly and opening the doors slowly allows the patient to be aware of your presence and gives them the opportunity to grant permission for you to enter. This approach ensures that you are not intruding or catching the patient off guard, and it promotes a respectful and considerate interaction with the patient.

Leaving a tourniquet on for more than 1 minute can lead to complications such as tissue damage, nerve injury, and impaired blood flow. Tourniquets are only meant to be used temporarily to control severe bleeding, and prolonged use can cause harm. Therefore, it is important to remove the tourniquet within 1 minute to prevent potential complications.

In this scenario, the correct answer is to not draw the blood until the nurse has applied an ID bracelet. This is important because an unconscious patient without an ID band may not be properly identified, which could lead to potential errors or complications. Waiting for the nurse to apply an ID bracelet ensures that the patient's identity is confirmed and reduces the risk of any mistakes or confusion.

The term "medial" refers to a position or direction that is towards the midline or middle of the body. It is used to describe the location of a structure or body part that is closer to the midline of the body compared to another structure. In this context, "medial" indicates that the correct answer is a term that describes a position or direction towards the midline or middle.

During the Allen test, the ulnar artery is released first. The Allen test is performed to assess the patency of the ulnar and radial arteries before arterial blood gas sampling or any other procedure that may compromise blood flow. By releasing the ulnar artery first, the blood flow is temporarily occluded, allowing the hand to blanch. This test helps determine if the ulnar artery can adequately supply blood to the hand in case the radial artery is compromised during a procedure.

Heparin is used in ABG specimen collection to prevent clotting of the specimen. ABG (arterial blood gas) specimens are sensitive to clotting due to their high concentration of platelets and coagulation factors. Heparin is an anticoagulant that inhibits the formation of blood clots by blocking the activity of clotting factors. By adding heparin to the specimen, it prevents the formation of clots, ensuring that the blood sample remains in a liquid state and can be accurately analyzed for oxygen, carbon dioxide, and pH levels.

Establishing rapport with the child and parent, greeting the parent and child, and telling the child what to expect are all important steps to take before obtaining a blood specimen on a child. However, telling the child it won't hurt is not necessary, as it may not be true and can potentially create false expectations. It is important to be honest with the child about the procedure and provide reassurance and support throughout.

Vigorous mixing can cause hemolysis, which is the rupture or destruction of red blood cells. This can occur when the force of mixing is too strong and causes the delicate cell membranes of the red blood cells to break. Hemolysis can lead to the release of hemoglobin into the surrounding fluid, which can affect the accuracy of laboratory tests and may also have negative health consequences for the individual.

When labeling a nonblood specimen, it is important to include the specimen type and source. This additional information helps to accurately identify and track the specimen, ensuring that it is handled and processed correctly. The specimen type refers to the nature of the sample, such as urine, saliva, or tissue, while the source specifies where the sample came from, such as a specific organ or body site. Including this information on the label helps to prevent confusion and ensure proper handling and analysis of the specimen.

The correct answer is to tell the patient that it's best to discuss the test with his or her physician. This response is appropriate because as a healthcare professional, it is important to encourage open communication between patients and their physicians. The physician is the best person to provide accurate information and explain the purpose of the test in detail. By suggesting that the patient consult their physician, it ensures that they receive the most accurate and relevant information regarding their healthcare.

When an ABG (Arterial Blood Gas) specimen is left at room temperature for a prolonged period, all of the answers provided are correct. Blood cells continue to consume oxygen, leading to a decrease in oxygen levels. Continued metabolism in the specimen produces acids, causing a decrease in pH. Additionally, the levels of carbon dioxide increase due to ongoing cellular respiration. Therefore, all of the mentioned effects occur when an ABG specimen is left at room temperature for an extended period.

Blood culture tests require special skin antisepsis procedures before specimen collection in order to minimize the risk of contamination. The skin is typically cleansed with an antiseptic solution to remove any potential pathogens on the surface. This is crucial because any contamination can lead to false-positive results, which can have significant implications for patient diagnosis and treatment. Therefore, following proper skin antisepsis procedures is essential to ensure accurate and reliable blood culture results.

When using a needle and syringe, one can tell that they are in a vein by observing the appearance of blood in the hub of the needle. This indicates that the needle has successfully punctured a vein and blood is flowing into the syringe.

Sputum samples are typically collected to diagnose tuberculosis. Tuberculosis is an infectious disease caused by the bacteria Mycobacterium tuberculosis, which primarily affects the lungs. Sputum samples are collected to detect the presence of the bacteria in the respiratory system. This diagnostic method helps in identifying tuberculosis and initiating appropriate treatment.

The system of choice to identify laboratory specimens from an unconscious, unidentified woman in the emergency room would be to use a three-part identification band and labels. This system ensures that the specimens are accurately matched to the patient by utilizing a band with unique identification information and labels that are attached to the specimens. This method allows for proper tracking and prevents any mix-ups or errors in specimen identification, even if the patient is unconscious or unidentified.

If the specimen for the Type and crossmatch test is misidentified, it can result in fatal consequences for the patient. This test is used to determine the compatibility of blood for transfusion, ensuring that the donor blood matches the recipient's blood type. If the wrong blood type is transfused, it can lead to a severe immune reaction, causing hemolysis (destruction of red blood cells) and potentially leading to organ failure or death. Therefore, misidentification of the specimen for this test can have serious and fatal consequences for the patient.

If the patient has just finished a big breakfast, it is likely that their blood glucose levels will be elevated, which can affect the results of the fasting specimen. Therefore, it is important to check with the nurse first to determine if the specimen should still be collected. If the decision is made to collect the specimen, it is necessary to indicate on the slip that it is a nonfasting specimen to ensure accurate interpretation of the results.

Lumbar puncture is a medical procedure in which a needle is inserted into the lower back to collect cerebrospinal fluid (CSF). CSF is a clear, colorless fluid that surrounds the brain and spinal cord, acting as a protective cushion. It is obtained through lumbar puncture to diagnose various neurological conditions, such as infections, bleeding, or inflammation in the central nervous system. The fluid is analyzed for abnormalities in its composition, including the presence of white blood cells, proteins, glucose, and other substances, which can provide valuable information about a patient's health.

Human chorionic gonadotropin (HCG) is a hormone that is produced during pregnancy. It is primarily responsible for maintaining the production of progesterone, which is necessary for the development of the fetus. HCG is also used as a marker in pregnancy tests, as its presence in urine or blood indicates pregnancy. The initials HCG stand for Human chorionic gonadotropin.

The recommended procedure for collecting a 24-hour urine sample is to void the first morning specimen, start the timing, and collect all of the following specimens including the next morning's specimen. This ensures that all urine voided within the 24-hour period is collected, providing an accurate representation of the individual's urine composition and eliminating any potential bias from excluding certain specimens.

The purpose of waiting 30 seconds for the alcohol to dry before inserting the needle is to allow the evaporation process to help destroy microbes, to avoid a tingling sensation, and to prevent hemolysis of the specimen. Waiting for the alcohol to dry ensures that any microbes on the skin are killed, reducing the risk of infection. It also prevents a tingling sensation that may occur if the alcohol is not fully evaporated before inserting the needle. Additionally, allowing the alcohol to dry helps prevent hemolysis, which is the rupture of red blood cells, during the needle insertion process.

A patient who has been asleep for 30 minutes while breathing room air would be considered to be in a "steady state" for ABG specimen collection because during sleep, the body's metabolic processes tend to stabilize, resulting in relatively consistent levels of arterial blood gases. Additionally, breathing room air indicates that the patient is not receiving any supplemental oxygen or undergoing any specific respiratory treatments that could affect the ABG levels.

The proper angle of insertion for a radial artery puncture is 45 degrees. This angle allows for easier access to the artery and reduces the risk of complications such as nerve damage or arterial spasm. It also ensures that the needle is inserted at the correct depth to successfully access the radial artery for procedures such as blood sampling or arterial catheterization.

The correct answer is Creatine clearance. Creatine clearance is a test that measures the amount of creatinine in a 24-hour urine sample. Creatinine is a waste product that is produced by the muscles and excreted by the kidneys. This test is used to assess kidney function and determine the glomerular filtration rate (GFR), which is a measure of how well the kidneys are able to filter waste from the blood. By collecting urine over a 24-hour period, a more accurate measurement of creatinine clearance can be obtained.

The test used to diagnose cystic fibrosis is the sweat chloride test. This test measures the amount of chloride in a person's sweat, as individuals with cystic fibrosis have higher levels of chloride in their sweat. This test is a reliable and non-invasive method to confirm the diagnosis of cystic fibrosis.

The radial artery is the artery of choice for ABG (arterial blood gas) collection. This is because it is easily accessible, located on the wrist, and has a superficial position. The radial artery also has a relatively low risk of complications compared to other arteries, such as the femoral artery. Additionally, the radial artery provides accurate and reliable blood samples for ABG analysis, making it the preferred choice for this procedure.

The radial artery is the artery located on the thumb side of the wrist that is commonly used for arterial punctures. It is the first choice and most common site for this procedure due to its accessibility and relatively low risk of complications.

After performing an arterial puncture, it is important to check the pulse distal to the puncture site. This is because checking the pulse distal to the puncture site allows for the assessment of blood flow beyond the puncture site. It helps to ensure that the puncture has not caused any damage or obstruction to the arterial blood flow. By checking the pulse distal to the puncture site, healthcare professionals can monitor the circulation and assess for any complications or abnormalities that may have occurred as a result of the arterial puncture.

Amniotic fluid must be protected from light because it contains bilirubin, a light-sensitive substance. Exposure to light can cause the breakdown of bilirubin and lead to inaccurate test results. Therefore, it is important to store and transport amniotic fluid in dark containers to prevent light-induced degradation.

The best way to collect specimens from a dorsal hand vein is to use a butterfly and small, pediatric ETS tubes. This is because the dorsal hand vein is a smaller vein, and using a butterfly needle and small, pediatric ETS tubes would be more appropriate for this size of vein. Using a regular ETS or full-sized ETS tubes may cause discomfort or difficulty in drawing blood from the smaller vein. Therefore, using a butterfly needle and small, pediatric ETS tubes would be the most suitable option for collecting specimens from a dorsal hand vein.

Ascites is the correct answer because it refers to the accumulation of fluid in the peritoneal cavity, which is the space between the abdominal organs and the abdominal wall. This fluid can be aspirated through a procedure called paracentesis, which involves inserting a needle into the peritoneal cavity to remove the fluid. Ascites can be caused by various conditions such as liver disease, heart failure, or certain cancers.

A urine C&S (culture and sensitivity) test is typically ordered to detect the presence of a urinary tract infection (UTI). This test helps identify the specific bacteria causing the infection and determine the most effective antibiotic treatment. By analyzing the urine sample, the test can detect the presence of bacteria and measure their growth in a laboratory setting. This information is crucial in diagnosing and treating UTIs, which are commonly caused by bacterial infections in the urinary system.

Human Chorionic Gonadotropin (HCG) is a hormone that is produced by the placenta during pregnancy. It can be detected in both urine and serum approximately 10 days after conception. This hormone is the substance that is detected in pregnancy tests, as its presence indicates the occurrence of pregnancy.

To maintain the integrity of an ABG specimen collected in a plastic syringe, it should be analyzed within 30 minutes. This is because ABG specimens are sensitive to changes in temperature and exposure to air. Delayed analysis can lead to alterations in the gas levels, pH, and other parameters, which can affect the accuracy of the results. Therefore, it is important to analyze the specimen promptly to obtain reliable and accurate results.

The femoral artery is typically the easiest to access during low cardiac output because it is a large artery located in the groin area, making it easily accessible for medical procedures such as inserting a catheter or performing a cardiac catheterization. Additionally, the femoral artery has a straight path and is less prone to kinking or twisting, making it a reliable option for accessing the arterial system in patients with low cardiac output.

Misidentifying a patient specimen is the most crucial error a phlebotomist can make. This mistake can have serious consequences as it can lead to incorrect diagnosis, wrong treatment, or even harm to the patient. Proper identification of patient specimens is essential to ensure accurate test results and prevent any potential harm or miscommunication in the healthcare setting. Therefore, it is crucial for phlebotomists to be diligent and attentive in correctly identifying and labeling patient specimens to maintain patient safety and quality care.

Arteriospasm is the most common arterial puncture complication even when proper technique is used. Arteriospasm refers to the constriction or narrowing of the artery, which can occur as a natural response to injury or irritation. This can lead to reduced blood flow and difficulty in obtaining a blood sample or performing procedures such as angiography. Despite proper technique, arteriospasm can still occur due to individual variations in vascular response. Hematoma, infection, and thrombus formation are also potential complications of arterial puncture, but arteriospasm is the most common.

A first morning specimen is usually more concentrated because the urine has been in the bladder for a longer period of time, allowing the HCG hormone to accumulate. This makes it easier to detect the presence of HCG and increases the accuracy of the test. Additionally, a first morning specimen is less likely to be contaminated compared to specimens collected later in the day, which can also affect the accuracy of the test. The pH of the urine is not necessarily related to the timing of the specimen collection, so it is not a factor in this case.

When a specimen is arterial, the blood is oxygenated and therefore appears bright cherry red. This is because arterial blood carries oxygen from the lungs to the tissues. The other options are not indicative of arterial blood. Containing visible air bubbles could be a sign of improper collection technique, and looking dark bluish red would suggest venous blood, which is deoxygenated. The phrase "pump into the syringe" does not provide any information about the color or oxygenation of the blood, so it is not a reliable indicator of arterial blood.

Providone-iodine is the proper cleaning solution for preparing an arterial puncture site. Providone-iodine is a commonly used antiseptic solution that is effective in killing bacteria, viruses, and fungi. It is known for its broad-spectrum antimicrobial properties and is commonly used in healthcare settings for preoperative skin preparation and wound cleansing. When preparing an arterial puncture site, it is crucial to use an effective antiseptic solution to reduce the risk of infection. Providone-iodine is a trusted and widely used antiseptic that meets the requirements for cleaning and disinfecting the site before an arterial puncture.