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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
A) Observe the client's skin integrity every 2 hr. - Regular skin assessments are essential to monitor for any signs of skin breakdown or injury related to the use of restraints.
B) Use a square knot to secure the client's restraint to the bed. - A quick-release knot, not a square knot, should be used to secure restraints for easy removal in case of an emergency.
C) Ensure that 2 fingers can be placed between the restraint and the client. - This ensures that the restraint is not too tight, allowing for circulation and preventing injury.
D) Tie the ends of the restraint to the client's bed rail. - Restraints should not be tied to the bed rail as it can increase the risk of injury and entrapment.
E) Pad bony prominences before applying a restraint. - Padding bony prominences helps prevent pressure injuries and discomfort for the client.
Correct Answer is A
Explanation
A) Unequal height of the shoulders - This finding is characteristic of scoliosis, as the curvature of the spine may cause one shoulder to appear higher than the other.
B) Expansion of the upper intercostal spaces - Expansion of the intercostal spaces is not a typical finding in scoliosis and may indicate other respiratory or musculoskeletal conditions.
C) Increased convex curve of the cervical spine - While scoliosis can affect the entire spine, an increased convex curve in the cervical spine is not typically associated with scoliosis.
D) Increased concave curve of the thoracic spine - While scoliosis often involves a lateral curvature of the spine, an increased concave curve of the thoracic spine alone may not be indicative of scoliosis.
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