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?

Place the specimen in a clean specimen cup.

Clamp the catheter tubing below the needleless port.

Clamp the catheter tubing for 60 min.

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

Answer and Explanation

The Correct Answer is B

A) Place the specimen in a clean specimen cup. - Urine collected from an indwelling urinary catheter should be obtained using a sterile technique, not placed directly into a clean specimen cup.
B) Clamping the catheter tubing for 10–30 minutes before collecting the sample allows fresh urine to accumulate in the tubing, ensuring a more accurate culture result. The urine should be collected from the designated port using aseptic technique, not from the catheter bag, as stagnant urine may contain contaminants.

C) Clamp the catheter tubing for 60 min. - Clamping the tubing for an extended period can cause urinary retention and discomfort for the client. It is not appropriate for collecting a urine specimen.
D) Only 3–5 mL of urine is needed for a culture. The nurse should collect the appropriate small amount to avoid unnecessary removal of urine.

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Correct Answer is B

Explanation

A) Apply cornstarch powder to the perineal area. - Cornstarch powder may increase the risk of infection and should be avoided in the perineal area, especially for clients with fecal incontinence.
B) Place a moisture barrier ointment over the perineal area. - Moisture barrier ointment helps protect the skin from irritation and breakdown caused by fecal incontinence.
C) Turn the client every 4 hr. - Turning the client every 2 hours is recommended for preventing pressure ulcers, but it does not specifically address fecal incontinence.
D) Cleanse the perineal area with povidone-iodine solution. - Povidone-iodine solution is not typically used for routine perineal care and may irritate the skin.

A. Placing the restraint across the client's chest B. Applying the restraint over the client's gown C. Using a quick-release tie to secure the restraint D. Tying the restraint to the bed frame

Correct Answer is A

Explanation

A) Placing the restraint across the client's chest - This is not a safe practice since it can restrict breathing increasing the risk of asphyxiation.
B) Applying the restraint over the client's gown - Restraints should be applied over the clients gown and not directly to the client's skin to prevent friction and skin breakdown.
C) Using a quick-release tie to secure the restraint - Quick-release ties are important for ensuring that restraints can be quickly removed in case of an emergency.
D) Tying the restraint to the bed frame – Tying restraints on the bed frame is the recommended practice. Restraints should not be tied on the bed rails to avoid injuries if the side rails are released.

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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?

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Naxlex Comprehensive Predictor Exams

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