The nurse is examining an adult patient after removal of a urinary catheter.
For what purpose would the nurse use palpation?

Choice A rationale

Collecting the second voided specimen of the day is not the standard procedure for a clean-catch urine sample. A clean-catch specimen aims to collect urine mid-stream after initial flushing, regardless of the time of day, to minimize contamination from the urethra and external genitalia.

Choice B rationale

When obtaining a clean-catch urine specimen, the patient should void a small initial amount into the toilet. This initial stream helps to flush out microorganisms from the distal urethra and periurethral area, reducing contamination of the collected specimen and ensuring a more accurate representation of bladder urine.

Choice C rationale

Restricting fluids before specimen collection is generally contraindicated for a clean-catch urine. Adequate hydration ensures sufficient urine volume for collection and can help to dilute contaminants, making it easier to obtain a clean mid-stream sample. Fluid restriction may lead to a concentrated, insufficient sample.

Choice D rationale

Placing the specimen in a clean urinalysis container is insufficient; the container must be sterile. A non-sterile container can introduce external contaminants into the urine sample, leading to inaccurate laboratory results, potentially causing misdiagnosis or inappropriate treatment for a urinary tract infection.

Choice A rationale

Acyclovir is an antiviral drug primarily active against herpes viruses. Respiratory syncytial virus (RSV) is typically treated with ribavirin, a guanosine analog, which interferes with RNA synthesis and viral replication. Acyclovir's mechanism of action, involving thymidine kinase phosphorylation, is not effective against RSV.

Choice B rationale

Influenza is caused by influenza viruses (A, B, C) and is typically treated with neuraminidase inhibitors like oseltamivir or zanamivir, which prevent viral release from infected cells. Acyclovir's antiviral spectrum does not include influenza viruses, as their replication cycle and enzymatic targets differ significantly.

Choice C rationale

Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV), an RNA virus. Treatment for hepatitis A is primarily supportive, as there is no specific antiviral medication. Acyclovir is not effective against hepatitis A virus; its mechanism of action is specific to DNA polymerase inhibition in herpesviruses.

Choice D rationale

Acyclovir is a highly effective antiviral agent specifically indicated for the treatment of herpes zoster, commonly known as shingles. It works by inhibiting viral DNA synthesis after being phosphorylated by viral thymidine kinase, thereby impairing the replication of the varicella-zoster virus (VZV) that causes herpes zoster.