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","D","E"]
Explanation
Choice A rationale
While family history can contribute to the risk of developing certain conditions, it is not a direct risk factor for peptic ulcer disease.
Choice B rationale
A long-term smoking history is a known risk factor for peptic ulcer disease as it can increase gastric acid secretion and reduce the production of substances that protect the stomach lining.
Choice C rationale
The client denies alcohol use; therefore, it is not a contributing risk factor in this case. However, alcohol use is generally a risk factor for PUD due to its irritating effect on the stomach lining.
Choice D rationale
Being positive for Helicobacter pylori is one of the strongest risk factors for peptic ulcer disease. This bacterium damages the protective mucosal layer of the stomach and duodenum, leading to chronic inflammation and allowing acid to injure the underlying tissue. It is the leading cause of most gastric and duodenal ulcers worldwide.
Choice E rationale
NSAID use is a well-established risk factor for peptic ulcer disease as these medications can disrupt the protective lining of the stomach, leading to ulcers.
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