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Clinical Procedures and Protocols Flashcards

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Read the first 7 Clinical Procedures and Protocols flashcards as text

  1. When performing a venipuncture, which vein is the FIRST choice for routine blood collection in adults?

    Answer: Median cubital vein

    The median cubital vein is preferred because it is large, well-anchored, and poses less risk of arterial puncture or nerve injury.

  2. A patient requires a nasogastric (NG) tube insertion. After placement, which is the MOST reliable bedside method to confirm correct gastric positioning?

    Answer: Checking pH of aspirate (pH ≤ 5.5)

    Aspirate pH ≤ 5.5 is the most reliable bedside confirmation; auscultation alone is unreliable and can miss bronchial placement.

  3. During urinary catheterization of a male patient, resistance is encountered at the external sphincter. What is the correct next step?

    Answer: Ask the patient to take slow deep breaths and gently advance during relaxation

    Having the patient breathe deeply relaxes the external urethral sphincter, allowing gentle advancement of the catheter without trauma.

  4. Which landmark is used for a standard lumbar puncture (LP) in adults?

    Answer: L3–L4 interspace

    The L3–L4 interspace (or L4–L5) is used because the spinal cord ends at L1–L2, minimizing risk of cord injury.

  5. When performing a wound closure with interrupted sutures, how far from the wound edge should the needle typically enter the skin?

    Answer: 5–10 mm

    Entering 5–10 mm from the wound edge ensures adequate tissue bite for secure closure without causing ischemia from excessive tension.

  6. A patient develops a tension pneumothorax. After needle thoracocentesis, where is a chest drain (intercostal tube) most safely inserted?

    Answer: 4th–5th intercostal space, anterior axillary line (safe triangle)

    The safe triangle (bordered by pectoralis major, latissimus dorsi, and the 5th rib) minimizes risk of injury to vessels, nerves, and solid organs.

  7. Which of the following steps is ESSENTIAL immediately before performing a joint aspiration (arthrocentesis)?

    Answer: Use strict aseptic technique and skin antisepsis

    Strict aseptic technique is mandatory to prevent introducing infection into the joint space during arthrocentesis.

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