Critical Thinking Questions: Chapter 8
Venipuncture Procedures
NAACLS Entry Level Competency 6.00
Objective #1
The only phlebotomist on duty one evening receives orders to collect a STAT
hemoglobin and hematocrit in the ER, STAT blood cultures on another ER patient, and
STAT glucose in the ICU. Which STAT specimen should he collect first? Explain your
answer.
NAACLS Entry Level Competency 6.00
Objective #2
A phlebotomist arrives to collect a blood specimen from an inpatient. The patient is not
wearing an ID band. There is an ID band attached to the nightstand next to the bed. The
information on that ID band matches the requisition. The name and date of birth stated by
the patient also match the requisition. What should the phlebotomist do?
NAACLS Entry Level Competency 6.00
Objective #2
A phlebotomist has an order to collect a blood specimen from an inpatient. The name of
the physician on the requisition does not match the physician’s name on the patient’s ID
band. What should the phlebotomist do?
Phlebotomy Essentials Critical Thinking Questions for Chapter 8.
© 2016 Wolters Kluwer.
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NAACLS Entry Level Competency 6.00
Objective #2
A phlebotomist is about to collect a fasting glucose specimen from an outpatient. The
patient is chewing gum but assures the phlebotomist that it is sugarless gum. When the
phlebotomist asks if the patient is fasting, the patient admits to having had a cup of black
coffee. How should the phlebotomist proceed?
NAACLS Entry Level Competency 6.00
Objective #2
After trying twice unsuccessfully to collect a specimen from a patient, the phlebotomist
now sees an excellent wrist vein that she had not noticed before. What should the
phlebotomist do?
NAACLS Entry Level Competency 9.3
Objective #3
A phlebotomist has an order to collect blood cultures from a 7-year-old child. The child is
crying and squirming in the chair. The child’s mother is getting frustrated and upset. How
should this situation be handled? What method of restraint should be used, and what
equipment should be used to collect the specimen?
NAACLS Entry Level Competency 7.0 and 7.1
Objective #1
A phlebotomist is assigned to answer the telephone in the laboratory. A physician calls
to “add-on” a test to previous orders that have already been collected. The phlebotomist
does not know if there is enough specimen remaining to run the additional test, so she
tells the doctor that he needs to write new orders and the patient’s specimen will need to
be redrawn. How should the phlebotomist have handled this situation ?
Phlebotomy Essentials Critical Thinking Questions for Chapter 8.
© 2016 Wolters Kluwer.
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NAACLS Entry Level Competency 6.9
Objective #4
A request for bloodwork was received in the laboratory. A newly hired phlebotomist
goes to the patient’s room to collect the blood. She notices a large vein on the left arm
and applies the tourniquet. When she palpates the vein, she feels a vibration or
“buzzing”. Should she draw from this vein ? What is she palpating ? What should she
have done differently ? Why does this patient require dialysis ?
NAACLS Entry Level Competency 6.0, 6.3, 6.9, 6.10, 6.11, 9.0, 9.1, and 9.3
Objective #3
A phlebotomist has orders to collect blood from an outpatient. She notices the patient is
elderly, so when she goes to the waiting room she yells loudly for Mrs. Smith. She gives
Mrs. Smith a urine collection cup and directs her to collect a specimen, then come to the
drawing room. When the patient finally sits down in the drawing chair, the phlebotomist
notices that she is well beyond the 5 minute limit per patient that her supervisor requires.
So, she ties the tourniquet tightly, palpates a vein, cleans the arm, assembles her
equipment, and inserts the needle before the alcohol is dry. The vein rolls so she
redirects the needle. Finally blood slowly enters the ETS tube, but she manages to fill all
the tubes needed. When releasing the tourniquet, she notices petechiae on the patient’s
arm. She places a cotton ball on the arm and holds it in place with tape. She directs the
patient to the exit. What errors has the phlebotomist made and what complications might
be expected in the patient ?
Phlebotomy Essentials Critical Thinking Questions for Chapter 8.
© 2016 Wolters Kluwer.
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