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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A rationale

Breads are generally well-tolerated and do not contain substances known to irritate the bladder. They are composed primarily of carbohydrates and are not acidic or caffeinated, making them a safe dietary choice for individuals with a urinary tract infection.

Choice B rationale

While some fresh fruits are acidic, many are not strong bladder irritants and contribute to overall hydration and nutrient intake. The impact of specific fruits can vary among individuals, but generally, fresh fruits are not a universal avoidance recommendation for UTIs.

Choice C rationale

Caffeine acts as a diuretic and a bladder irritant. It can increase urinary frequency, urgency, and may exacerbate bladder discomfort and inflammation in individuals with a urinary tract infection by stimulating the bladder detrusor muscle. Therefore, it should be avoided.

Choice D rationale

Cheeses, particularly aged cheeses, do not typically contain compounds that directly irritate the bladder. They are a source of protein and fat, and generally do not contribute to urinary symptoms in the context of a urinary tract infection.

A. "I can stop using the medication if my skin looks worse.”. B. "I need to avoid being in the sun while on this medication.”. C. "I will apply the medication only to the affected areas.”. D. "I will wash my hands before and after applying the medication.”.

Correct Answer is A

Explanation

Choice A rationale

Stopping topical fluorouracil when the skin appears worse is incorrect. The medication often causes an inflammatory reaction, including erythema, crusting, and erosion, which indicates the drug is working by causing cellular necrosis of abnormal cells. Premature discontinuation compromises treatment efficacy and may lead to inadequate destruction of cancerous cells, necessitating prolonged or alternative therapies.

Choice B rationale

Avoiding sun exposure while using topical fluorouracil is crucial due to the medication's photosensitizing properties. Fluorouracil enhances the skin's sensitivity to ultraviolet radiation, increasing the risk of severe sunburn, erythema, and blistering. This phototoxicity can exacerbate local inflammatory reactions and compromise treatment outcomes, necessitating strict photoprotection.

Choice C rationale

Applying topical fluorouracil only to affected areas is essential to minimize systemic absorption and reduce adverse effects on healthy skin. Fluorouracil is a cytotoxic agent that nonspecifically inhibits DNA and RNA synthesis, leading to cell death. Accidental application to unaffected skin can cause unnecessary irritation, inflammation, and discomfort without therapeutic benefit.

Choice D rationale

Washing hands before and after applying topical fluorouracil is a fundamental infection control and safety measure. Handwashing before application prevents the introduction of microbes to the treatment site, reducing infection risk. Post-application handwashing removes residual medication, preventing accidental transfer to other body parts or individuals, minimizing systemic exposure.

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Which is the most appropriate action by the nurse when obtaining a clean catch urine from a patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse educates a patient diagnosed with a UTI. Which diet choices should be avoided to prevent bladder irritation?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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