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 C
Explanation
Choice A rationale
Massaging the legs frequently is not recommended for peripheral venous disease as it can dislodge clots that may be present, leading to serious complications.
Choice B rationale
Keeping the legs in a dependent position can worsen the symptoms of peripheral venous disease by increasing venous pressure and swelling.
Choice C rationale
Inspecting the legs daily for changes is a key part of self-management for peripheral venous disease. It helps in early detection of potential complications.
Choice D rationale
Decreasing activity is not advised unless specified by a healthcare provider. Regular activity can actually help improve circulation and manage symptoms.
Correct Answer is B
Explanation
Choice A rationale
Storing the medication at room temperature is a practical instruction but does not explain the therapeutic purpose of the medication, which is essential for patient understanding.
Choice B rationale
Epoetin alfa (Procrit) is used to treat anemia associated with chronic kidney disease by supplementing erythropoietin, a hormone the damaged kidneys can no longer produce effectively. This is the most informative statement for the patient's understanding of the medication's purpose.
Choice C rationale
While epoetin alfa can improve anemia and potentially improve quality of life, it does not directly delay the need for dialysis, which is determined by overall kidney function and not solely by the presence of anemia.
Choice D rationale
Epoetin alfa does not have a role in preventing AV fistula clotting. It is specifically used to stimulate red blood cell production and has no direct effect on clotting mechanisms.
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