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Which is the most appropriate action when obtaining a sterile urine specimen from an indwelling urinary catheter?

Swab the collection port of the catheter with an antiseptic swab. Insert a sterile needle and aspirate 3 to 5 mL of urine into the syringe.

Immediately clamp the catheter tubing.

Return one hour later and empty 3 to 5 mL of urine from the drainage bag into a sterile specimen container.

Flush the catheter with 10 mL of sterile water.

Answer and Explanation

The Correct Answer is A

Insert a sterile needle and aspirate 3 to 5 mL of urine into the syringe. This is the best technique for obtaining a sterile urine specimen from an indwelling urinary catheter because it ensures that microorganisms in the specimen are from the urine, and not the result of contamination.

Choice B is wrong because it does not use sterile technique and it does not collect fresh urine. The urine in the drainage bag may have been sitting there for a long time and may not reflect the current condition of the patient’s urinary tract.

Choice C is wrong because it does not use sterile technique and it flushes the catheter with sterile water, which may dilute the urine and alter its composition.

Choice D is wrong because it does not use sterile technique and it collects urine from the drainage bag, which may be contaminated or stale.

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Correct Answer is D

Explanation

This is because diminished breath sounds indicate poor oxygenation and ventilation, which can lead to respiratory failure and hypoxia. The healthcare provider should be notified immediately to assess the client and provide appropriate interventions.

Choice A is wrong because joint pain is a common side effect of some arthritis medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs). It does not require immediate attention unless it is severe or accompanied by other symptoms, such as swelling, redness, or fever.

Choice B is wrong because decreased appetite and difficulty sleeping are normal responses to grief and loss. They do not indicate a medical emergency, but rather a need for emotional support and counseling.

Choice C is wrong because a weight loss of two pounds in a client admitted with congestive heart failure is a positive sign that indicates fluid removal and improved cardiac function. It does not require immediate reporting, but rather ongoing monitoring and evaluation.

Normal ranges for vital signs are as follows :

Blood pressure: 90/60 mm Hg to 120/80 mm Hg
Breathing: 12 to 18 breaths per minute
Pulse: 60 to 100 beats per minute
Temperature: 97.8°F to 99.1°F (36.5°C to 37.3°C); average 98.6°F (37°C)

A. I usually fall asleep after about 15 minutes. B. I wake up to urinate once each night. C. I often wake up feeling tired in the morning. D. I have a regular nighttime routine.

Correct Answer is C

Explanation

This statement requires further follow-up because it indicates that the client may have poor sleep quality or quantity, which can affect their health and well-being. According to, the main components of the sleep history include defining the specific sleep problem, assessing the disorder’s clinical course, differentiating between sleep disorders, evaluating the sleep-wakefulness patterns, questioning the bed partner, and obtaining a family history of sleep disorders.

Choice A is wrong because falling asleep after about 15 minutes is normal and indicates good sleep hygiene.

Choice B is wrong because waking up to urinate once each night is not uncommon in older adults and does not necessarily disrupt their sleep continuity.

Choice D is wrong because having a regular nighttime routine is beneficial for promoting relaxation and preparing for sleep.

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Which is the most appropriate action when obtaining a sterile urine specimen from an indwelling urinary catheter?

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