NHA Phlebotomy Certification Practice Exam

What technique should be used if a patient is difficult to draw?

1. Change the needle size

2. Use a deeper angle for the needle

3. Try a different venipuncture site

4. Increase the tourniquet time

The correct answer is: Try a different venipuncture site

When encountering a patient who is difficult to draw blood from, trying a different venipuncture site is often the best approach. This technique can be particularly useful in situations where the initial site may have inadequate veins, such as if the veins are small, rolling, or have been previously used multiple times. Exploring other sites can increase the likelihood of successfully obtaining a blood sample, as different areas may present more viable or accessible veins. Utilizing an alternate site allows phlebotomists to assess various vascular locations, such as the other arm or different areas within the same arm. Some sites might be more prominent or less affected by prior draws, leading to a successful collection with less discomfort and complication for the patient. In contrast, changing the needle size may not always resolve the issue, as the problem may not be related to the needle dimensions but rather the vascular access. Using a deeper angle for the needle could lead to complications such as accidental puncture of surrounding tissues or nerves, which can cause pain or injury. Increasing tourniquet time is usually counterproductive, as prolonged application can cause vein collapse, hemoconcentration, and discomfort to the patient, compounding difficulties in sampling. Therefore, trying a different venipuncture site is a