Which is the most appropriate action by the nurse when obtaining a clean catch urine from a patient?
Collect the second voided specimen of the day.
Collect the specimen after the initial stream of urine.
Restrict fluids before the specimen collection.
Place the specimen in a clean urinalysis container.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
As individuals age, the kidneys' ability to concentrate urine declines due to structural and functional changes in the renal tubules and collecting ducts, including decreased response to antidiuretic hormone. This diminished concentrating ability often leads to an increased excretion of dilute urine, rather than enhanced concentration.
Choice B rationale
Normal physiological changes of aging affecting the urinary system include decreased bladder capacity, decreased bladder muscle tone, and increased involuntary bladder contractions. These changes often result in symptoms such as urinary frequency (more frequent voiding), urgency (sudden strong urge to void), and nocturia (waking up at night to urinate).
Choice C rationale
In healthy adults, the kidneys are typically not easily palpable unless they are enlarged due to pathology, such as polycystic kidney disease or hydronephrosis. Normal kidneys are protected by the lower ribs and posterior abdominal muscles, making deep palpation challenging for identification of normal size.
Choice D rationale
While some older adults may experience increased urinary incontinence due to age-related changes or comorbidities, it is not an inevitable outcome of aging that all patients will require wearing a brief at all times. Many older adults maintain continence with proper management, exercise, and lifestyle modifications, thus avoiding dependence on briefs.
Correct Answer is B
Explanation
Choice A rationale
Ciprofloxacin absorption can be significantly impaired by antacids containing aluminum, magnesium, or calcium. These antacids bind to ciprofloxacin, forming insoluble complexes that reduce the antibiotic's bioavailability, thus diminishing its effectiveness in treating the infection.
Choice B rationale
Ciprofloxacin, a fluoroquinolone antibiotic, carries a black box warning for increased risk of tendinitis and tendon rupture. Patients should be instructed to monitor for tendon pain, especially in the Achilles tendon, and report it immediately to prevent severe and permanent injury.
Choice C rationale
Limiting fluid intake is contraindicated when taking ciprofloxacin for a UTI. Adequate hydration is crucial to help flush bacteria from the urinary tract and prevent crystalluria, a potential side effect where drug crystals form in the urine, which can lead to kidney damage.
Choice D rationale
Ciprofloxacin does not typically cause urine to turn dark orange. This side effect is more commonly associated with other medications, such as rifampin or phenazopyridine (a urinary analgesic), and is not an expected or normal finding when taking ciprofloxacin.
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