Phlebotomy Venipuncture Procedures Questions and Answers

Question 1

A phlebotomist is preparing for a routine venipuncture on an adult patient. Which of the following is the most critical first step in this procedure?

Accepted Answer

Positively identifying the patient

Answer

The most critical initial step in any patient procedure, including venipuncture, is to ensure the correct patient is being treated. The Joint Commission mandates using at least two patient identifiers to prevent errors. All other steps follow after the patient's identity has been confirmed.

Question 2

During a venipuncture, the patient complains of a sharp, radiating pain down their arm. The phlebotomist should immediately:

Accepted Answer

Release the tourniquet, remove the needle, and apply pressure

Answer

A sharp, radiating pain is a primary indicator of possible nerve injury. The procedure must be stopped immediately to prevent further damage. The tourniquet should be released, the needle withdrawn, and pressure applied to the site.

Question 3

What is the proper angle for needle insertion during a routine venipuncture in the antecubital fossa?

Accepted Answer

15 to 30 degrees

Answer

The recommended angle of needle insertion for a standard venipuncture is between 15 and 30 degrees. This angle allows the needle to enter the vein smoothly without passing through it. A lower angle risks being too shallow, while a higher angle increases the risk of puncturing the back wall of the vein or injuring underlying structures.

Question 4

A phlebotomist must draw blood for a coagulation test, a complete blood count (CBC), and a serum chemistry panel. Which is the correct order of draw using the evacuated tube system?

Accepted Answer

Light Blue top (sodium citrate), Red top (serum), Lavender top (EDTA)

Answer

The correct order of draw is critical to prevent cross-contamination of additives between tubes. For these tests, the Light Blue top (sodium citrate for coagulation) must be drawn first. The Red top (serum tube, which may have a clot activator but no anticoagulant) comes next. Finally, the Lavender top (EDTA) is drawn for the CBC.

Question 5

Which of the following veins is the last choice for venipuncture due to its proximity to the brachial artery and median nerve?

Accepted Answer

Basilic vein

Answer

The basilic vein, located on the inner side of the antecubital fossa, is considered the last choice for venipuncture. It is close to the brachial artery and the median nerve, increasing the risk of accidental puncture of these structures. The median cubital vein is the first choice, followed by the cephalic vein.

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Phlebotomy Venipuncture Procedures Questions and Answers