A nurse is obtaining a sterile urine specimen from a client who has an indwelling urinary catheter. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)
Wipe the sample port with an alcohol wipe and let the alcohol dry.
Clamp the catheter tubing distal to the sampling port for 15 min.
Attach a sterile needleless syringe to the sample port and aspirate the specimen
Document in the client's electronic medical record that the specimen was sent to the laboratory.
Empty the urine into a sterile container labeled with the client identifiers
The Correct Answer is B, A, C, E, D
Clamp the catheter tubing distal to the sampling port for 15 min. By clamping the tubing distal to the sampling port, it allows urine to accumulate in the tubing, ensuring that the urine specimen obtained is fresh and not from the stagnant urine that has been sitting in the tubing.
Wipe the sample port with an alcohol wipe and let the alcohol dry. Cleaning the sampling port with an alcohol wipe helps reduce the risk of introducing contaminants into the sample during collection, ensuring a more sterile procedure.
Attach a sterile needleless syringe to the sample port and aspirate the specimen. Using a sterile syringe prevents contamination and allows for the collection of a clean urine sample directly from the catheter tubing, maintaining the sterility of the specimen.
Empty the urine into a sterile container labeled with the client identifiers. Transferring the collected urine into a sterile container labeled with the client's identifiers ensures proper identification and handling of the specimen for laboratory analysis.
Document in the client's electronic medical record that the specimen was sent to the laboratory. Documenting in the client's medical record ensures that there is a clear record of the specimen collection, its handling, and its dispatch to the laboratory for analysis, maintaining proper documentation and continuity of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Replace the unit when the drainage chamber is full is correct. Regularly emptying the drainage chamber when it becomes full is essential to ensure the drainage system functions properly and continues to effectively remove fluids or air from the chest cavity.
Choice B Reason:
Clamp the tube for 30 min every 8 hr. is incorrect.
Clamping a chest tube without a specific medical order or indication can lead to complications such as a buildup of pressure within the chest cavity or potential damage to the lungs. It's generally not a routine action to clamp the tube without proper instruction.
Choice C Reason:
Pin the tubing to the client's bed sheets is incorrect. Pinning the tubing to the bed sheets can cause tension on the chest tube, leading to accidental dislodgment or obstruction. The tubing should be secured but not pinned to prevent inadvertent movement.
Choice D Reason:
Monitor for at least 150 mL of drainage every hour is incorrect. There isn't a standard or prescribed amount of drainage that should occur hourly. The nurse should monitor the drainage rate and characteristics but shouldn't expect a specific volume within a set timeframe. Monitoring for excessive or decreased drainage and changes in characteristics is crucial, but an hourly volume expectation isn't appropriate.
Correct Answer is D
Explanation
Choice A Reason:
3 oz chicken breast is incorrect. Chicken breast contains iron, but its iron content is generally lower compared to red meats like beef. It contains less heme iron, which is more readily absorbed by the body, compared to the iron in red meats.
Choice B Reason:
3 oz canned tuna is incorrect. Tuna is a good source of protein but doesn't contain as much iron as red meats. While it does have some iron content, it's generally lower compared to red meats like ground beef.
Choice C Reason:
3 oz pork roast is incorrect. Pork contains iron, but its iron content might not be as high as that found in red meats like ground beef. The specific cut and preparation method can also affect the iron content, but generally, pork might not provide as much iron as beef.
Choice D Reason:
3 oz ground beef is correct. Red meat, like ground beef, generally contains higher amounts of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based sources. This makes ground beef a good source of iron for individuals with iron-deficiency anemia.
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