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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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A rationale
Pericardiocentesis is a procedure used to remove fluid from the pericardial sac and is not typically used to treat atrial fibrillation. It is more commonly indicated for conditions such as pericardial effusion or cardiac tamponade.

Choice B rationale
Septal myectomy is a surgical intervention to remove part of the thickened septal wall that separates the ventricles of the heart. It is primarily used to treat hypertrophic cardiomyopathy, not atrial fibrillation.

Choice C rationale
A pericardial window is a procedure that creates an opening in the pericardium to allow fluid to drain into the surrounding chest cavity. This procedure is not a treatment for atrial fibrillation.

Choice D rationale
Synchronized electrical cardioversion is a procedure where a controlled electric shock is delivered to the heart to restore a normal rhythm. It is a common and effective treatment for atrial fibrillation, especially when the condition is causing significant symptoms like palpitations, lightheadedness, and shortness of breath.

A. Place the patient on a cardiac monitor. B. Insert a urinary retention catheter. C. Give the prescribed spironolactone. D. Administer epoetin alfa (Epogen).

Correct Answer is A

Explanation

Choice A rationale
In the case of hyperkalemia, which can cause fatal cardiac arrhythmias, the most immediate nursing action is to place the patient on a cardiac monitor. This allows for continuous monitoring of the heart's rhythm and immediate detection of any life-threatening changes, which is crucial for timely intervention.

Choice B rationale
Inserting a urinary retention catheter may be necessary for managing oliguria, but it is not the most urgent action when compared to the potential cardiac risks associated with hyperkalemia.

Choice C rationale
Administering spironolactone, a potassium-sparing diuretic, could be part of the treatment for hyperkalemia, but it is not the first action to take. Spironolactone works more slowly and does not address the immediate risk of cardiac arrhythmias.

Choice D rationale
Epoetin alfa (Epogen) is used to treat anemia, particularly in chronic kidney disease, to increase red blood cell production. However, it does not have an immediate effect and is not the priority in the presence of hyperkalemia and potential cardiac complications.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has atrial fibrillation and reports heart palpitations, lightheadedness, and shortness of breath. Which of the following procedures should the nurse anticipate for this client?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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