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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
Percussion between the iliac crest and ribs at the midaxillary line is not the standard method for assessing flank tenderness associated with pyelonephritis. This technique may not elicit the characteristic pain of kidney inflammation.

Choice B rationale
Pushing fingers upward into the two lowest intercostal spaces is not a specific test for flank tenderness and may not accurately assess for pyelonephritis. This action is more related to assessing the integrity of the rib cage and intercostal muscles.

Choice C rationale
Palpating along both sides of the lumbar vertebral column is not the correct method for assessing flank tenderness due to pyelonephritis. This approach is more suited for assessing the musculoskeletal structure rather than the kidneys.

Choice D rationale
Striking a flat hand over the costovertebral angle is the correct method for assessing flank tenderness in cases of suspected pyelonephritis. This technique, known as costovertebral angle tenderness, elicits pain when the kidneys are inflamed, which is a common sign of pyelonephritis.

A. Increasing hemoglobin level B. Decreasing serum amylase level C. Falling serum bilirubin level D. Increasing serum alkaline phosphatase level

Correct Answer is B

Explanation

Choice A reason: An increasing hemoglobin level does not indicate the resolution of acute pancreatitis. Hemoglobin levels can fluctuate due to various factors, including hydration status and blood loss, but are not directly related to the resolution of pancreatitis.

Choice B reason:A decreasing serum amylase level is indicative of the resolution of acute pancreatitis. Amylase is an enzyme that helps digest carbohydrates and is released in large amounts when the pancreas is inflamed. As the inflammation resolves, amylase levels decrease.

Choice C reason: A falling serum bilirubin level may indicate improvement in liver function but is not a specific indicator of the resolution of acute pancreatitis. Bilirubin levels can be affected by conditions other than pancreatitis, such as bile duct obstruction or liver disease.

Choice D reason:An increasing serum alkaline phosphatase level is generally associated with bile duct obstruction or bone disease and does not indicate the resolution of acute pancreatitis. This enzyme is found in several tissues throughout the body, including the liver and bones.

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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

How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?

Correct Answer is D

Explanation

Which laboratory finding indicates the resolution of a patient's acute pancreatitis?

Correct Answer is B

Explanation

Which finding in the patient's history increases the risk for acute pancreatitis?

A nurse is caring for a client who has end-stage kidney disease and will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact their quality of life? (Select all that apply.)

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A nurse is developing a plan of care for a client who has a new ileal conduit. Which of the following should the nurse include as risks for the client? (Select all that apply.)

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?

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

A patient who has is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the acute glomerulonephritis prescribed calcium gluconate IV?