ASPT Patient Preparation 3 — Questions and Answers
Question 1: A patient with a latex allergy presents for routine venipuncture. The phlebotomist's first action should be to:
- Proceed normally since latex gloves are rarely used today
- Document the allergy and use latex-free gloves and supplies (Correct answer)
- Ask the patient if the allergy is severe before changing supplies
- Request a physician order waiving the latex-free requirement
Correct answer: Document the allergy and use latex-free gloves and supplies
All latex-containing items must be replaced with latex-free alternatives before any procedure begins for a patient with a documented latex allergy.
Question 2: Before collecting blood from a pediatric patient, the phlebotomist should obtain consent from:
- The child if they appear to understand the procedure
- The parent or legal guardian (Correct answer)
- The attending nurse on the unit
- No consent is required for minors under 12
Correct answer: The parent or legal guardian
Informed consent for procedures on minors must be obtained from a parent or legal guardian, as minors generally cannot provide legal consent.
Question 3: Which position is preferred for a patient during routine venipuncture to reduce the risk of vasovagal syncope?
- Standing at a counter-height draw station
- Seated upright in a phlebotomy chair with arm support (Correct answer)
- Lying flat in a supine position at all times
- Seated with legs crossed for comfort
Correct answer: Seated upright in a phlebotomy chair with arm support
A seated position in a phlebotomy chair with arm support is standard; lying supine is preferred for patients with a history of fainting.
Question 4: A patient states they are afraid of needles. The most appropriate response before the venipuncture is to:
- Proceed quickly without discussing the procedure to minimize anxiety
- Acknowledge the concern, explain the procedure calmly, and allow questions (Correct answer)
- Tell the patient not to worry because it only takes a second
- Ask another phlebotomist to perform the draw instead
Correct answer: Acknowledge the concern, explain the procedure calmly, and allow questions
Therapeutic communication that acknowledges the patient's fear and provides a clear explanation reduces anxiety and improves cooperation.
Question 5: Before collecting blood cultures, the site should be cleaned with:
- 70% isopropyl alcohol only, applied once
- Chlorhexidine gluconate or iodine-based antiseptic after alcohol, using concentric circles (Correct answer)
- Soap and water followed by a single alcohol wipe
- Povidone-iodine only, without prior alcohol preparation
Correct answer: Chlorhexidine gluconate or iodine-based antiseptic after alcohol, using concentric circles
Blood culture sites require a two-step antiseptic preparation (alcohol followed by chlorhexidine or iodine) applied in concentric outward circles to reduce contamination risk.
Question 6: Which patient preparation instruction is most critical before collecting a specimen for therapeutic drug monitoring (TDM)?
- The patient must fast for 12 hours regardless of the drug
- The specimen must be collected at the specified trough or peak time relative to the dose (Correct answer)
- The patient should skip the previous dose to obtain a baseline level
- Draw at any time because drug levels are constant throughout the day
Correct answer: The specimen must be collected at the specified trough or peak time relative to the dose
TDM specimens must be collected at precise trough or peak intervals after dosing to produce clinically meaningful and comparable results.
Question 7: When a patient is receiving an IV infusion, the phlebotomist should ideally collect the blood sample from:
- The same arm as the IV, below the infusion site
- The opposite arm from the IV infusion (Correct answer)
- The same arm, above the infusion site, after turning off the drip for 1 minute
- Any available site regardless of IV location
Correct answer: The opposite arm from the IV infusion
Drawing from the opposite arm prevents IV fluid dilution or contamination of the specimen, which would produce false results.
ASPT Patient Preparation 3
A patient with a latex allergy presents for routine venipuncture.
The phlebotomist's first action should be to: