American Society for Clinical Pathology (ASCP) Histotechnician Certification Practice Exam

When should a phlebotomist not use a site for venipuncture?

1. If there is swelling

2. If it is the dominant arm

3. If the patient is nervous

4. If there is a bandage on the site

The correct answer is: If there is swelling

A site should not be used for venipuncture if there is swelling present. Swelling may indicate an underlying issue such as inflammation, infection, or other complications that could complicate the procedure and potentially lead to further injury or complications for the patient. Additionally, swelling can make it more difficult to identify a suitable vein, increasing the risk of multiple punctures or failure to obtain blood. In contrast, using the dominant arm for venipuncture is typically acceptable unless other contraindications exist. The nervousness of the patient does not affect the suitability of the venipuncture site; however, it may require the phlebotomist to provide additional reassurance to facilitate the procedure. A bandage on the site may suggest a recent attempt at venipuncture or other medical procedures, but it does not automatically render the site unsuitable for another venipuncture unless there are signs of complications such as swelling or active bleeding. Thus, swelling is a decisive factor that makes a site inappropriate for venipuncture, leading to this choice being the most appropriate.