The nurse is collecting a urine specimen for a client with symptoms related to urethritis. Which collection method should the nurse implement?

First voided specimen in the morning.

A clean catch specimen.

Any specimen voided after drinking adequate fluids.

A 24-hour specimen.

Answer and Explanation

The Correct Answer is B

A.   A first voided morning specimen is often used for detecting conditions such as urinary tract infections (UTIs) or pregnancy because it is more concentrated and may provide a clearer result. However, for diagnosing urethritis specifically, a clean catch or midstream specimen is generally preferred to minimize contamination and better identify pathogens.
B.   A clean catch urine specimen is the most appropriate method for diagnosing urethritis. This method reduces the risk of contamination from bacteria that may be present in the initial or final part of the urine stream, providing a more accurate representation of the urine coming directly from the bladder.
C.   Collecting any specimen after drinking fluids is not a standardized method for diagnosing urethritis. While adequate fluid intake is generally important for urine production and can help dilute the urine, the quality and accuracy of the specimen are more reliably ensured through specific collection techniques such as a clean catch.
D.   A 24-hour urine collection is used for assessing the overall function of the kidneys and measuring substances that vary in concentration throughout the day, such as proteins or electrolytes. It is not typically used for diagnosing urethritis, which is usually evaluated with a clean catch specimen for a more immediate assessment of infection or inflammation.

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Correct Answer is A

Explanation

A. This calcium level is below the normal reference range (8.4 to 10.6 mg/dL or 2.10 to 2.50 mmol/L), indicating hypocalcemia. Calcium plays a crucial role in cardiac muscle contraction and electrical conduction. Low calcium levels can lead to various cardiac dysrhythmias, including prolonged QT intervals and increased risk of ventricular arrhythmias.

B. This potassium level falls within the normal range (3.5 to 5.0 mEq/L or 3.5 to 5.0 mmol/L). Potassium is essential for maintaining normal cardiac rhythm, but a level of 3.8 mg/dL is not abnormal and, therefore, is less likely to be the cause of a dysrhythmia compared to abnormal levels.
C. This sodium level is within the normal reference range (136 to 145 mEq/L or 136 to 145 mmol/L). Sodium levels typically do not directly cause dysrhythmias unless they are extremely high or low, which is not the case here. Thus, a sodium level of 140 mEq/L is not likely to be the primary contributor to the dysrhythmia.
D. This oxygen saturation level is considered normal (95% to 100%). While oxygenation is critical for overall heart function and can influence cardiac health, a saturation level of 97% is not likely to be a direct cause of a dysrhythmia, especially if it falls within the normal range.

A. Schedule a portable chest x-ray per PRN protocol. B. Maintain the current IV antibiotic schedule. C. Obtain a specimen of the drainage for culture. D. "Milk" the tube to remove any clots.

Correct Answer is C

Explanation

A. A chest x-ray can be useful to assess for complications or changes in lung status, such as pneumothorax, pleural effusion, or changes in lung volume. However, the change in drainage color from viscous green to clear watery fluid may not immediately warrant an x-ray unless there are additional clinical concerns or symptoms suggesting a need for imaging.
B. Continuing the IV antibiotic schedule is important if there is an ongoing infection that needs treatment. However, if the change in drainage is significant and suggests a potential change in the underlying condition or complication, it’s important to evaluate the cause of the change rather than solely relying on antibiotics.
C. Obtaining a specimen of the drainage for culture is a valuable action if there is concern about infection or if the drainage characteristics have changed unexpectedly. Clear, watery fluid could indicate the presence of serous fluid or a change in the nature of the drainage, potentially due to infection or resolution of an infection.
D. “Milking” or stripping the chest tube is not recommended as a routine practice because it can create negative pressure and potentially damage the pleural tissues or exacerbate issues. Additionally, the change in the drainage from viscous green to clear watery fluid does not necessarily indicate that clots are present or that tube milking would be helpful.

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The nurse is collecting a urine specimen for a client with symptoms related to urethritis. Which collection method should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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