Deck 14: Arterial Blood Collection

Question 1

The modified Allen test is used to determine collateral circulation in the:

A) ulnar artery.
B) brachial artery.
C) radial artery.
D) cephalic artery.

Answer 1

A

Question 2

To achieve a steady state in a patient prior to collection of arterial blood gases, the patient should:

A) empty the bladder.
B) fast for 12 hours.
C) cough 5 to10 times to clear lungs.
D) rest for 30 minutes.

Answer 2

D

Question 3

Additional information required on the requisition form when collecting arterial blood gases (ABGs) includes all of the following except:

A) patient's respiration rate.
B) type of ventilation the patient is receiving.
C) type of patient activity.
D) initials of the requesting physician.

Answer 3

D

Question 4

The artery of choice for collecting arterial specimens is the:

A) ulnar.
B) brachial.
C) cephalic.
D) radial.

Question 5

An alternate pathway capable of supplying blood to an area if the main pathway is obstructed is referred to as:

A) circulatory bypass.
B) collateral circulation.
C) shunt circulation.
D) an arterial fistula.

Question 6

The anticoagulant in syringes used to collect arterial blood gases (ABGs) is also found in:

A) gray stopper tubes.
B) green stopper tubes.
C) light blue stopper tubes.
D) yellow stopper tubes.

Question 7

Upon completion of an arterial puncture, the syringe is rotated to:

A) expel air from the syringe.
B) activate the needle safety device.
C) attach the Luer tip cap.
D) mix the anticoagulant.

Question 8

Arterial punctures would be most frequently requested on patients located in:

A) labor and delivery.
B) outpatient testing.
C) intensive care.
D) orthopedics.

Question 9

The thumb should not be used to palpate an artery for arterial punctures, because it:

A) is too large.
B) lacks nerve endings.
C) contains a pulse.
D) cannot be adequately disinfected.

Question 10

Arterial blood may be requested for all of the following except:

A) ammonia.
B) potassium.
C) lactic acid.
D) PCO₂.

Question 11

The artery located on the thumb side of the wrist is the:

A) brachial.
B) ulnar.
C) radial.
D) femoral.

Question 12

Under normal conditions arterial blood will have a(an):

A) higher PO₂ than PCO₂.
B) decreased PO₂ and PCO₂.
C) equal amount of PO₂ and PCO₂.
D) higher PCO₂ than PO₂.

Question 13

Syringes used to collect arterial blood gases (ABGs):

A) are coated with mineral oil.
B) are designed to inject the specimen into an analyzer.
C) must be made of glass.
D) should hold at least 10 mL of blood.

Question 14

When collecting blood from an artery, the designated collector should:

A) ask the patient to make a tight fist.
B) tighten the tourniquet to stop arterial flow.
C) request a nurse to be present.
D) make sure the patient is as calm as possible.

Question 15

Phlebotomist training in the performance of arterial punctures should include all of the following except:

A) safety precautions.
B) possible complications.
C) femoral puncture procedures.
D) supervised practice.

Question 16

When performing the modified Allen test, pressure is released from the:

A) radial and ulnar arteries.
B) ulnar and brachial arteries.
C) radial artery only.
D) ulnar artery only.

Question 17

When performing an arterial puncture, the finger of the nondominant hand is:

A) used to anchor the artery.
B) placed where the needle enters the skin.
C) placed where the needle enters the artery.
D) used to measure the patient's heart rate.

Question 18

Which of the following tests requires anaerobic conditions?

A) Glucose
B) Blood gases
C) Blood urea nitrogen (BUN)
D) Sodium

Question 19

A large artery located near the basilic vein and the median nerve is the:

A) ulnar.
B) brachial.
C) radial.
D) cephalic.

Question 20

Arterial punctures should be performed:

A) on pediatric patients.
B) only when authorized.
C) only from the radial artery.
D) after an unsuccessful venipuncture.

Question 21

After pressure is released in the modified Allen test, if color returns to the patient's palm within 5 seconds, the:

A) radial artery can be punctured.
B) ulnar artery can be punctured.
C) brachial artery should be used.
D) test must be repeated.

Question 22

The presence of excess heparin in the syringe used to collect arterial blood gases (ABGs) will:

A) increase clotting speed.
B) decrease the pH.
C) decrease the anticoagulant effect of heparin.
D) increase the pH.

Question 23

Which of the following arterial puncture complications would cause a patient to lose consciousness rapidly?

A) Arteriospasm
B) Nerve damage
C) Vasovagal reaction
D) Hemorrhage

Question 24

After the artery has been entered, the syringe plunger:

A) will be pushed back by the blood.
B) should be rapidly pulled back.
C) must be rotated.
D) should be moved back and forth.

Question 25

Following arterial specimen collection, pressure is applied to the puncture site for:

A) 2 minutes by the phlebotomist.
B) 2 minutes by the phlebotomist or patient.
C) 3 to 5 minutes by the phlebotomist.
D) 10 minutes by the phlebotomist or patient.

Question 26

Physicians may collect newborn specimens from the:

A) ulnar artery.
B) brachial artery.
C) radial artery.
D) umbilical artery.

Question 27

When performing an arterial puncture, the needle is inserted bevel:

A) down at a 90-degree angle.
B) up at a 45- to 60-degree angle.
C) up at a 15- to 20-degree angle.
D) down at a 10-degree angle.

Question 28

An error that would falsely elevate a patient's PO₂ reading is:

A) failing to seal the syringe needle after specimen collection.
B) failing to expel excess heparin from the syringe.
C) delayed analysis of a specimen not on ice.
D) both A and C

Question 29

Collateral circulation is necessary to prevent complications caused by:

A) arteriospasm.
B) infection.
C) vasovagal reaction.
D) hemorrhage.

Question 30

Failure to locate a radial pulse after arterial puncture of the radial artery indicates:

A) venous blood was collected.
B) the ulnar artery is occluded.
C) a possible arteriospasm.
D) the patient has expired.

Question 31

Capillary blood gas specimens collected in heparinized pipettes:

A) are not suitable for analysis.
B) are mixed using a magnet.
C) do not require mixing.
D) should not be cooled during transport.

Question 32

Extended pressure may need to be applied to the arterial puncture site when patients are receiving all of the following except:

A) streptokinase.
B) tissue plasminogen activator (t-PA).
C) insulin.
D) Coumadin.

Question 33

A phlebotomist would be most likely to perform an accidental arterial puncture when attempting to puncture the:

A) cephalic vein.
B) median cubital vein.
C) radial vein.
D) basilic vein.

Question 34

Capillary blood drawn from a site that has been warmed:

A) closely resembles venous blood.
B) tends to clot rapidly.
C) may be contaminated.
D) closely resembles arterial blood.

Question 35

During an arterial puncture, a hypodermic syringe with a 25-gauge needle is used for:

A) collecting the specimen.
B) administering an anesthetic.
C) transferring the specimen to a tube.
D) transporting the specimen to the lab.

Question 36

Arterial blood gas specimens are immediately placed in an ice water bath:

A) when a lactate is also ordered.
B) if the patient has a high white blood cell (WBC) count.
C) when a plastic syringe is used.
D) both A and B

Question 37

The site of an arterial puncture is cleansed with:

A) soap and water to prevent irritation.
B) alcohol in the same manner as for a venipuncture.
C) iodine followed by alcohol and air-drying.
D) iodine and air-drying.

Question 38

A major source of error in capillary blood gas specimens is:

A) mixing with a magnetic "flea."
B) warming the site for 10 minutes.
C) the presence of air bubbles.
D) collection in a heparinized pipette.

Question 39

Prior to completing an arterial puncture procedure, the phlebotomist should: 1. notify the nursing station.
2) check the site for hematoma.
3) check a radial pulse.
4) apply a pressure bandage.

A) 1 and 3
B) 2 and 4
C) 3 and 4
D) 2, 3, and 4

Question 40

The purpose of placing arterial blood gas (ABG) specimens that cannot be tested within 30 minutes in an ice bath is to:

A) prevent air bubble formation.
B) slow cellular metabolism.
C) prevent excess anticoagulant dilution.
D) decrease clot formation.

Question 41

Administering a local anesthetic before performing an arterial puncture may interfere with arterial blood gas (ABG) results.

Question 42

Glass syringes are used to collect arterial blood gas (ABG) specimens that must be placed on ice.

Question 43

Both ends of a capillary blood gas pipette are sealed before the specimen is mixed.
Matching

Question 44

When performing a modified Allen test, pressure is released on the radial artery.

Question 45

Match the following arterial puncture complications with the possible cause or collection error.
a.Arteriospasm
d.Infection
b.Hematoma
e.Nerve damage
c.Hemorrhage
f.Vasovagal reaction
Failure to apply adequate pressure

Question 46

Samples for arterial blood gas (ABG) analysis drawn by arterial puncture differ from samples drawn by venous access because in arterial puncture:

A) site selection is not as critical as in venous access.
B) the anticoagulant is in the evacuated tube.
C) the appearance of blood in the needle hub means that the blood vessel has been entered.
D) the anticoagulant is in the syringe.

Question 47

Pulling too hard on the syringe plunger may cause capillary blood to enter the specimen.

Question 48

The color of arterial blood is dark red.

Question 49

A patient receiving thrombolytic therapy requires application of additional pressure following arterial puncture.

Question 50

Match the following arterial puncture complications with the possible cause or collection error.
a.Arteriospasm
d.Infection
b.Hematoma
e.Nerve damage
c.Hemorrhage
f.Vasovagal reaction
Coagulation disorders

Question 51

Arterial blood has a more uniform composition than venous blood.

Question 52

Match the following arterial puncture complications with the possible cause or collection error.
a.Arteriospasm
d.Infection
b.Hematoma
e.Nerve damage
c.Hemorrhage
f.Vasovagal reaction
Apprehensive patient

Question 53

Match the following arterial puncture complications with the possible cause or collection error.
a.Arteriospasm
d.Infection
b.Hematoma
e.Nerve damage
c.Hemorrhage
f.Vasovagal reaction
Tissue destruction

Question 54

Following specimen collection, the needle is first stuck into a rubber or plastic block to prevent an accidental needlestick.

Question 55

When preparing a syringe for arterial blood gas (ABG) collection, the needle is pointed up when expelling the excess heparin.

Question 56

Match the following arterial puncture complications with the possible cause or collection error.
a.Arteriospasm
d.Infection
b.Hematoma
e.Nerve damage
c.Hemorrhage
f.Vasovagal reaction
Deep puncture

Question 57

Match the following arterial puncture complications with the possible cause or collection error.
a.Arteriospasm
d.Infection
b.Hematoma
e.Nerve damage
c.Hemorrhage
f.Vasovagal reaction
Cleansing the site with alcohol

Question 58

Examples of diseases and patient conditions that require the collection of a blood specimen by arterial puncture include all of the following except:

A) newborn metabolic disease screening.
B) diabetic coma.
C) cardiac and respiratory failures.
D) chronic obstructive pulmonary disease (COPD).

Question 59

Situation: A phlebotomist is attempting to perform a standard venipuncture using the basilic vein in the patient's right arm. Signs that the patient's brachial artery has been accidentally accessed include all of the following except:

A) vascular dilation and a rapid drop in blood pressure.
B) appearance of dull red blood in the needle hub.
C) a vasovagal reaction with a rapid drop in blood pressure.
D) appearance of bright red blood that pulsates into the evacuated tube or syringe.