A female patient with a suspected urinary tract infection is to provide a clean-catch midstream urine specimen for culture and sensitivity testing. What should the nurse do to obtain the specimen?
Tell the patient to clean the urethral area, void a small amount into the toilet, then void directly into a sterile container.
Have the patient empty the bladder completely; then obtain the next urine specimen that the patient is able to void.
Clean the area around the patient's meatus with a povidone-iodine (Betadine) swab and then have the patient void into a sterile specimen cup.
Insert a short sterile "mini" catheter attached to a collecting container into the urethra and bladder to obtain the specimen.
The Correct Answer is A
Choice A rationale
This method is the standard procedure for obtaining a clean-catch midstream urine specimen. The initial voiding washes away organisms near the meatus, and the midstream urine is less likely to be contaminated by bacteria from the skin or urethral area, providing a sample that more accurately represents the bacteria in the bladder.
Choice B rationale
Having the patient empty the bladder completely and then obtaining the next specimen does not ensure a clean-catch sample. This method could lead to contamination of the specimen with bacteria from the skin or urethral area.
Choice C rationale
Cleaning the area with povidone-iodine is not recommended for routine urine culture as it may kill some of the bacteria, leading to a false-negative result. The standard practice is to clean the area with mild soap and water.
Choice D rationale
Inserting a catheter is an invasive procedure and is not the first choice for obtaining a urine specimen. It is used when a patient is unable to provide a clean-catch specimen or if there are specific medical indications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Wearing barrier protection during vaginal intercourse is a general precaution to prevent the transmission of sexually transmitted infections (STIs), including hepatitis B and C. However, hepatitis A is primarily transmitted through the fecal-oral route, not sexual contact.
Choice B rationale
Avoiding needle sharing is critical for preventing the spread of bloodborne pathogens, including hepatitis B and C. While it is always good practice, hepatitis A is not typically transmitted through blood.
Choice C rationale
The suggestion to avoid eating at fast food restaurants does not directly relate to the prevention of hepatitis A. The virus is usually spread through contaminated food or water, so ensuring food safety is important, but singling out fast food restaurants is not necessary.
Choice D rationale
Practicing effective hand hygiene is the most effective way to prevent the transmission of hepatitis A. The virus can be spread through close contact or ingestion of contaminated food or water, so washing hands can significantly reduce the risk.
Correct Answer is B
Explanation
Choice A rationale
Potassium levels are not directly affected by lactulose. While cirrhosis can lead to imbalances in electrolytes, including potassium, lactulose is not used to manage potassium levels in the bloodstream.
Choice B rationale
Ammonia is produced by the breakdown of proteins in the intestines and is normally processed by the liver. In cirrhosis, the liver's ability to convert ammonia to urea is impaired, leading to increased levels in the blood. Lactulose helps reduce blood ammonia levels by converting it into ammonium, which is then excreted.
Choice C rationale
Bicarbonate levels are related to the body's pH balance and are not the target of lactulose treatment. Cirrhosis does not typically result in bicarbonate imbalances that would be treated with lactulose.
Choice D rationale
Glucose levels are managed by insulin and other metabolic processes, not lactulose. While cirrhosis can affect overall metabolism, lactulose does not have a direct effect on blood glucose levels.
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