Question 1

This federal law aims to prevent accidental needle stick injuries and blood exposure during specimen processing.

Accepted Answer

The Safety Needle Act passed in 1990 and changed the Blood borne Standard to include better record keeping of needle sticks and stricter requirements for providing safety needles. It requires input from healthcare workers on equipment selection and practices to prevent needle stick injuries.

Question 2

"All equipment that contains needles must have a system to single-handedly permanently resheath the needle." Is the above a federal requirement of healthcare employers?

Accepted Answer

The Safety Needle Act requires healthcare employers to provide needle-containing equipment that permanently resheath the needle by a single-handed method.

Question 3

The first step of the venipuncture procedure is:

Accepted Answer

The first step for a successful venipuncture is to determine the right patient, by identifying the patient. Selecting and preparing a suitable puncture site, correctly collecting samples (proper tubes, proper times) will not be successful, if the samples are drawn from the wrong patient. Outpatient facilities ask the patient their full name and birth date while comparing the answer provided against the requisition form, if the patient is unable to answer, a government- issued identification card, can aid in proper identification. If an inpatient is able to provide information, comparing the name and birth date printed on the patients' wristband to the requisition is acceptable. Nurses can help identify an inpatient that is unable to answer. Blood should never be drawn from an inpatient that does not have proper facility-issued wristband.

Question 4

Which of the following maybe found on equipment check forms?

Accepted Answer

Equipment check forms are used for recording quality assurance procedures. The forms are maintained for inspections or as legal documents when litigation issues arise. Equipment check forms are part of a facility's plan for quality assurance.

Question 5

What is the difference between capillary blood and venous blood?

Accepted Answer

Because a capillary network is connected to arterioles and venules, capillary blood is a mixture of arterial and venous blood, along with fluid from surrounding tissue. It contains both oxygen and carbon dioxide.

Question 6

What does respondeat superior mean, and what is the purpose?

Accepted Answer

Respondeat superior is a Latin term meaning "let the master answer." It is a concept that holds an employer responsible for an employee's actions. It does not completely protect the employee from suit, but allows a patient to sue both the employer and employee.
It is also known sometimes as the Master-Servant Rule. This legal notion is relevant to medical malpractice when it can be proven that the employer or hospital can be held liable for the actions of doctors or employees.
This vicarious liability occurs if the negligence or harm committed by the employee occurred during the scope of their normal and routine work performance. This legal concept is important to plaintiffs in medical malpractice cases because it ensures that there is an institution that can be held financially responsible.
In many hospitals, attending physicians and health care providers are considered to be independent contractors and in these cases, the concept of respondeat superior will not apply. In such cases, the hospital itself can only be held liable if it can be proven that it granted a position of privilege to a physician or employee that was uncertified, unlicensed, or incompetent.

Question 7

A senior nurse is explaining the procedure for arterial puncture to a new nurse. She is explaining to the new nurse the sign to watch for to confirm the needle is in the artery. Which of the following terms refers to this sign?

Accepted Answer

Flashback is the term used for the sign that confirms the needle has been advanced into an artery. Flashback is the appearance of bright red arterial blood in the syringe, it indicates correct placement of the needle, and no further advancement of the needle is necessary.

Question 8

Standard Precautions are:

Accepted Answer

Standard Precautions are guidelines recommended by the CDC for all patients regardless of disease or infectious status, and an OSHA standard for compliancy. It is a method of infection control designed to prevent transmission of pathogenic organism from any source of body fluid, regardless of the presence of blood. Standard Precautions are a combination of two previous standards, Universal Precautions and Body Substance Isolation. Universal precautions, implemented in 1985, are guidelines designed to prevent transmission of blood-borne pathogens. Universal Precautions instructed healthcare workers to use personal protective equipment when contact with blood or blood-containing body fluid was a possibility. Body substance isolation (BSI) was added in 1987 and expanded protection guidelines to include all body fluids and substances, regardless of presence of blood.

Question 9

A nurse is working in the ER when an unconscious patient is received from rescue paramedics, without family members in attendance. The nurse performs a stat draw for several tests, while the entire ER team begins lifesaving treatment. This is an example of what form of consent?

Accepted Answer

Implied consent is used when immediate treatment is necessary to prevent permanent injury or to perform lifesaving treatment. Implied consent is allowed only in emergency situations. It works under the assumption that if the patient were able to speak for himself, he would want medical personnel to perform all lifesaving treatments or life preserving treatment. Implied consent laws vary from state to state.

Question 10

Is the umbilical artery a possible site for arterial blood collection in an infant?

Accepted Answer

Collection of arterial blood from an umbilical artery is an alternate site in newborns. Arteries in the scalp are another. Capillary blood can be collected for blood gas analysis; this is the preferred method for infants and children.

Question 11

A nurseTech is working in the ER when an unconscious patient is brought in with a massive hemorrhagic injury. A card is found in the patient's wallet indicating the patient's wishes in the event she is unable to speak for herself. The card indicates she would not want transfusion of blood products. What is this card known as and which type of consent does it cancel out?

Accepted Answer

An advance directive would negate implied consent. The legal requirements of advance directives vary by state; however, federal law allows competent adults the right to pre-specify decisions about medical treatment in the event that they are unable to speak for themselves. With the presence of the advance directive, implied consent is invalid.

Question 12

The appropriate time for labeling a patient specimen is:

Accepted Answer

The appropriate time for labeling a patient specimen is immediately after collection. In order to ensure accurate patient specimen identification, proper labeling must occur. The best time to label a specimen is immediately after collection, in the presence of the patient.

Question 13

Is a splash-proof face shield necessary to enter a contact isolation room?

Accepted Answer

A splash-proof face shield is not necessary to enter a contact isolation room. Splash-proof face shields are usually used when exposure to splashing of body fluids or substances is anticipated.

Question 14

What is the maximum size of a lancet intended for use on an infant?

Accepted Answer

The size of a lancet intended for use on an infant should be no longer than 2.4 mm. Using a larger sized lancet on an infant can cause injury to tissue and bone and excessive bruising.

Question 15

Standard precautions include the use of ___________ when touching or exposure to body fluid is anticipated.

Accepted Answer

Standard Precautions recommend hand washing, as well as barriers such as gloves, gowns and masks, to reduce the risk of transmission from known and unknown sources of infection.

Question 16

The purpose of an incident report is:

Accepted Answer

An incident is required for any kind of incident, it should be completed within twenty-four hours of an occurrence. It is an internal document used to document the details of an unusual event. Incidents are not only patient injuries, an incident can be a visitor tripping, or missing patient belongings, or using the wrong colored topped tube. Incidents reports are not an admission of guilt, simply a report of the incident.

Question 17

A patient has just returned from a radiology test that included an IV injection of dye. The nurse collects the blood specimen and notes the radiographic test and time it was performed on the requisition form. Why did the nurse do this?

Accepted Answer

The nurse noted on the requisition form the name and time of the radiographic procedure because the IV dye may interfere with the blood test. The clinical laboratory relies on the nurses to provide information that may affect the results of a test. The lab techs would not know this without the aid of the nurse.

Question 18

Which of the following is the "proper order of draws"?

Accepted Answer

Yellow top (or yellow and black), light blue top, red top, and lastly additive tubes, is the proper order of draws. Following the proper order is crucial when drawing for multiple tests. Not adhering to the proper order of draws may result in additive cross-contamination and ultimately, incorrect lab results.

Question 19

What is the purpose(s) of the medical record?

Accepted Answer

The medical record serves as a legal record of the patient's illness, treatment and outcome of treatments, documents the chronological order of care received during the patient's stay, and serves as a communication tool for physicians and the healthcare team. Because the medical record is a legal document, using white-out or erasing a mistake is not permitted. If a treatment or procedure is not documented in the medical record, it is legally considered not to have happened.

Question 20

For which of the following test(s) should alcohol wipes NOT be used when drawing samples?

Accepted Answer

Alcohol wipes should not be used when drawing samples for an ETOH level and blood cultures. An ETOH level is ordered to measure the blood alcohol level of a person. Using an alcohol wipe may increase the ETOH level when the needle pierces alcohol-moistened skin and contaminates the sample. Betadine is used to cleanse the skin when drawing a sample for blood cultures.

Quiz 2: Vascular Access