A nurse is collecting a urine specimen for culture and sensitivity from a client who has an indwelling urinary catheter. Which of the following actions should the nurse take?

Remove 45 mL of urine from the catheter with a syringe.

Clamp the catheter tubing for 60 min.

Clamp the catheter tubing below the needleless port

Place the specimen in a clean specimen cup.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Removing 45 mL of urine from the catheter with a syringe is correct. To obtain a sterile urine specimen from an indwelling urinary catheter, the nurse should use a sterile syringe to aspirate a specific volume of urine from the catheter tubing. This method ensures minimal contamination and an accurate representation of the urine in the bladder at that moment.

Choice B Reason:

Clamping the catheter tubing for 60 min is incorrect.

Clamping the catheter tubing can lead to potential complications such as urinary retention, backflow of urine, or discomfort for the client. It's not a standard practice and could compromise the client's care.

Choice C Reason:

Clamping the catheter tubing below the needleless port is incorrect.

Clamping the catheter tubing can disrupt the urinary drainage and potentially cause issues like urinary stasis or increase the risk of infection. It's not an appropriate method for collecting a sterile urine specimen.

Choice D Reason:

Place the specimen in a clean specimen cup is incorrect. While placing the specimen in a clean cup is necessary, the method of collecting a urine sample from an indwelling catheter involves using a sterile syringe to aspirate a specific volume of urine directly from the catheter tubing, rather than pouring it into a cup from the collection bag.

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Correct Answer is B

Explanation

Choice A Reason:

The stoma bleeds lightly when touched is incorrect. Some minor bleeding during the initial postoperative period is expected due to surgical trauma. Light bleeding when touched might not be unusual in the immediate days following colostomy placement.

Choice B Reason:

The stoma appears dark in color is correct. A dark-colored stoma could indicate compromised blood supply or ischemia, which is a concerning finding postoperatively. It's crucial to report this change in color promptly to the provider for further evaluation and intervention.

Choice CReason:

The stoma is draining a small amount of liquid stool is incorrect. In the early postoperative period, drainage of liquid stool from the stoma is normal. The digestive system needs time to adapt to the new anatomy created by the colostomy, and initially, the stool consistency might be liquid before it starts to normalize.

Choice DReason:

The stoma protrudes slightly from the abdomen is incorrect. A slightly protruding stoma is a common and expected finding after colostomy surgery. It's often a normal part of the healing process as the stoma settles and adjusts.

A. Type 1 diabetes mellitus B. Orthostatic hypotension C. BMI of 24 D. Family history of osteoporosis

Correct Answer is A

Explanation

Choice A Reason:

Type 1 diabetes mellitus is correct. individuals with diabetes, especially Type 1 diabetes mellitus, are at an increased risk of developing cardiovascular disease. Diabetes can contribute to atherosclerosis, increasing the risk of heart disease, stroke, and other cardiovascular complications.

Choice B Reason:

Orthostatic hypotension is not correct. It refers to a drop-in blood pressure when moving from a lying to a standing position and is more related to blood pressure regulation than a direct risk factor for cardiovascular disease.

Choice C Reason:

A BMI of 24 is incorrect because it is within the normal range is not typically considered a significant risk factor for cardiovascular disease. However, higher BMIs, especially in the overweight or obese categories, can increase the risk.

Choice D Reason:

A family history of osteoporosis is incorrect because it is related to bone health and susceptibility to osteoporosis, a condition characterized by weak and brittle bones. While it's an important health consideration, it's not directly linked to cardiovascular disease risk.

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A nurse is collecting a urine specimen for culture and sensitivity from a client who has an indwelling urinary catheter. Which of the following actions should the nurse take?

Nursing Test Bank

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