A nurse is collecting a specimen for urinalysis and culture from a client who has an indwelling urinary catheter. Which of the following actions should the nurse take during collection?
Clamp the catheter distal to the injection port.
Drain the specimen from the drainage bag.
Collect 2 mL of urine for each specimen.
Obtain the urinalysis specimen before the culture specimen.
The Correct Answer is A
Rationale:
A. Clamp the catheter distal to the injection port: Clamping the catheter allows urine to accumulate in the tubing, ensuring a fresh specimen can be obtained from the sampling port rather than from stagnant urine in the drainage bag, which could be contaminated.
B. Drain the specimen from the drainage bag: Urine in the drainage bag may be old and contaminated, which can lead to inaccurate culture results. Specimens should be collected aseptically from the catheter sampling port.
C. Collect 2 mL of urine for each specimen: For accurate urinalysis and culture, a larger volume typically 3–10 mL for culture and 10–15 mL for routine urinalysis is recommended to ensure enough specimen for testing and repeat analysis if needed.
D. Obtain the urinalysis specimen before the culture specimen: Culture specimens should be collected first to prevent contamination. Performing urinalysis first can alter the bacterial composition of the sample and compromise culture accuracy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. 1 cup sliced peaches: Peaches contain some vitamin C but in lower amounts compared with other fruits. They are not the highest source for meeting daily vitamin C needs in toddlers.
B. 1 cup sliced banana: Bananas provide minimal vitamin C and are better known for their potassium content. They are not an effective choice for significantly increasing vitamin C intake.
C. 1 cup sliced kiwifruit: Kiwifruit is exceptionally high in vitamin C, providing more than the daily requirement for a toddler in a single cup. It is an excellent choice for boosting vitamin C intake.
D. 1 cup cubed cantaloupe: Cantaloupe contains vitamin C but in moderate amounts. While beneficial, it is less concentrated than kiwifruit for meeting vitamin C needs.
Correct Answer is B
Explanation
A. Observe the client's range of movement: While monitoring physical status is important, mechanical restraints restrict movement, so assessing the client’s psychological triggers and safety is higher priority to prevent further aggression.
B. Identify stressors that caused the client's aggression: Understanding and addressing the factors that led to aggressive behavior is essential while the client is in restraints. This assessment helps in developing strategies to reduce agitation and prevent future episodes.
C. Hold a critical incident debriefing about the client: Debriefing is conducted after the event to support staff and evaluate interventions. It is not performed while the client is actively restrained.
D. Maintain sensory stimulation for the client: Providing excessive sensory stimulation during restraint can increase agitation and risk of injury. The focus should be on calming the client and ensuring safety rather than maintaining stimulation.
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