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 D

Explanation

A. Inserting an indwelling urinary catheter may be considered if the client is unable to urinate or if precise measurement of urine output is crucial for assessing fluid status. However, in this context, the immediate concern is more likely related to the client's cardiovascular status and respiratory symptoms rather than urinary output.
B. Serum cardiac enzymes (such as troponin, CK-MB) are important for diagnosing acute myocardial infarction or myocardial injury. While this is relevant for assessing cardiac damage, the elevated BNP level and current symptoms suggest that heart failure or fluid overload might be more pressing concerns.

C. Emotional support is important for any patient, especially those dealing with significant health issues. However, in this situation, the priority should be on addressing the immediate physiological concerns related to the client's symptoms and laboratory findings. Emotional support can be provided alongside other clinical interventions but should not be the primary action in this acute setting.
D. Fine rales (or crackles) in the lung fields are often associated with pulmonary congestion or fluid
overload, which are common in heart failure. Given the elevated BNP level and the client’s symptoms of
shortness of breath and fatigue, assessing the lung fields for rales is crucial.

A. An adolescent who drinks a minimum of four diet drinks daily. B. A client who is too busy at work to void when the urge occurs. C. A multipara who had pyelonephritis during her last pregnancy. D. An older adult who is usually incontinent of urine during the night

Correct Answer is C

Explanation

A. While excessive consumption of certain beverages can potentially affect urinary health, diet drinks are generally not a primary risk factor for UTIs. The key risk factors for UTIs typically involve issues related to urinary retention, hygiene, and anatomical predispositions rather than beverage consumption alone.
B. Not voiding when the urge occurs, also known as urinary retention, can increase the risk of UTIs. When urine is retained in the bladder for extended periods, it can provide an environment where bacteria can proliferate, leading to infections. This behavior is a significant risk factor for developing UTIs, as it contributes to urinary stasis.
C. A multipara with a history of pyelonephritis is at increased risk for future UTIs. A history of pyelonephritis indicates that the client has experienced a serious urinary infection in the past, which could make her more susceptible to recurrent infections. This is a significant risk factor for developing UTIs again.
D. Urinary incontinence, especially in older adults, can be associated with increased risk for UTIs due to factors like poor hygiene, the presence of residual urine, and possible skin breakdown. While incontinence is a risk factor, it is often considered less directly related to recurrent UTIs compared to issues like urinary retention or a history of severe infections.

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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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