Question 1

The nurse is assessing a wound that may need to be cultured.Which of the following should be reported to the physician?

Accepted Answer

Report foul odor,increase in drainage,and increase in temperature or complaint of discomfort.

Question 2

When using a commercially prepared tube to collect a culture,the nurse should:

Accepted Answer

Immediately squeeze the end of the tube to crush the ampule,and push tip of swab into fluid medium.

Question 3

What must the nurse do to collect a midstream urine sample from an infant?

Accepted Answer

Use a sterile plastic urine collecting bag that adheres to the perineum of a non-toilet-trained child.Special considerations for boys: Place penis and scrotum inside the bag.Diapers may be contaminated.Seating on a toilet is generally not realistic for an infant.Catheterization should be used as a last resort only.

Question 4

An appropriate technique for the nurse to tell the patient to implement before obtaining a sputum specimen is to:

Accepted Answer

If patient has a surgical incision or localized area of discomfort,have the patient place hands firmly over affected area,or place a pillow over area.Splinting of painful area minimizes muscular stretching and discomfort during coughing and thus makes cough more productive.
Patient should not use mouthwash or toothpaste because it may decrease viability of microorganisms and culture results.Have the patient wait 1 to 2 hours after eating.After a series of deep breaths,ask the patient to cough after full inhalation.

Question 5

When teaching a patient about home testing for occult blood,the nurse instructs the patient that:

Accepted Answer

Specimens will be positive if contaminated by menstrual blood or hemorrhoidal blood or povidone-iodine.A single positive test result does not confirm bleeding or indicate colorectal cancer.Diets rich in meats; green,leafy vegetables; poultry; and fish may produce false-positive results.Obtain second fecal specimen from different portion of stool.

Question 6

During a sputum collection,the patient becomes hypoxic.What action should the nurse take?

Accepted Answer

If the patient becomes hypoxic,discontinue the procedure until stable and provide oxygen therapy as needed,if ordered.Suctioning can decrease usable oxygen to the patient.

Question 7

A nurse suspects that the patient may have tuberculosis.She sends a sputum sample to the lab for testing.When the following tests are compared,which will best support the diagnosis of possible tuberculosis?

Accepted Answer

Three major types of sputum specimens are sputum for cytology,culture and sensitivity,and acid-fast bacilli.The acid-fast bacilli (AFB)smear is used to support the diagnosis of tuberculosis.
Cytological or cellular examinations of sputum may identify aberrant cells or cancer.Chemical analysis would indicate chemicals within the blood,not sputum.Sputum collected for culture and sensitivity testing is used to identify specific microorganisms and determine which antibiotics are most sensitive.A definitive diagnosis of TB also requires a sputum culture and sensitivity.

Question 8

An appropriate procedure for urine testing with reagent strips for chemical properties of the sample is to:

Accepted Answer

Immerse the strip briefly in the urine sample,remove and tap gently on side of container,prolonged exposure to excess urine can dilute reagents.
Stagnant urine stored in bladder overnight or for long periods does not reveal quantities of glucose and ketones excreted by kidney at time of testing. Kits containing tablets do not also utilize strips,the tablet contains the reagent and changes color to indicate chemical properties of urine.
Tap strip gently against side of container to shed excess urine,do not wipe it.

Question 9

What step should the nurse take to obtain a vaginal specimen for a culture?

Accepted Answer

Gently insert swabs ½ to 1 inch into vaginal orifice and rotate before removal.Apply clean disposable gloves.Patient should be in dorsal recumbent position.If discharge near vagina appears different from discharge along perineum,collect separate specimens from each area.

Question 10

How should the nurse identify the patient before obtaining a laboratory specimen from Mr.Smith?

Accepted Answer

Before obtaining a laboratory specimen,use at least two identifiers such as the identification number on the admission arm band and asking the patient's name.Patients who are confused or who have a language barrier may smile and not understand the question.The patient could also have the wrong arm band on; checking it twice would not change that.

Question 11

A patient asks what food may be eaten before a stool specimen is obtained for occult blood.What food should the nurse allow the patient to eat?

Accepted Answer

Diets rich in meats; green,leafy vegetables; poultry; and fish may produce false-positive results.

Question 12

What should the nurse do first if a patient is unable to void on demand for a clean-voided specimen?

Accepted Answer

If patient is unable to urinate on demand,offer fluids if permitted.Allow more time for urine to accumulate in bladder.Try obtaining specimen after 30 minutes.
If the patient has no urine in the bladder,Credé would not be useful.The risk for infection precludes the use of catheterization simply to obtain a specimen.If patient is unable to void after several hours,the physician may need to be called to obtain an order for catheterization.

Question 13

The nurse needs to obtain a sterile urine specimen for culture and sensitivity (C&S)from a patient who has an indwelling catheter.The catheter was placed the night before.What must the nurse do in order to obtain the specimen?

Accepted Answer

Clamp drainage tubing with clamp or rubber band for 30 minutes to permit collection of
fresh,sterile urine in catheter tubing rather than draining into bag.
Do not collect a urine specimen for culture tests from a urine drainage bag unless it is the first urine to drain into a new sterile bag.Draw urine into 3-mL syringe (for culture),or draw urine into 20 mL-syringe (for routine urinalysis).Proper volume is needed to perform test.
Do not puncture Silastic,silicone,or plastic catheters.These are not self-sealing.

Question 14

The patient has come to the emergency department complaining of coughing up bloody sputum.The patient has a 30-year history of smoking and has lost 15 pounds in the last month.What will the nurse expect the sputum specimen to be evaluated for?

Accepted Answer

The patient is showing signs of cancer.Cytological or cellular examinations of sputum may identify aberrant cells or cancer.
Sputum collected for culture and sensitivity testing is used to identify specific microorganisms.The AFB is used to support the diagnosis of tuberculosis.Chemical analysis would indicate chemicals within the blood,not sputum.

Question 15

What should the nurse do when a patient is required to provide a timed urine specimen?

Accepted Answer

Place signs on the patient's door and toileting area,indicating that a timed urine specimen
collection is in progress.If patient leaves the unit for a test or procedure,be sure that personnel in that area collect and save all urine.
The nurse discards the first specimen and then collects every successive specimen until the time period has ended.Place specimen collection container in the bathroom and,if indicated,in a pan of ice.Urine specimen is not to be contaminated with feces or toilet tissue.

Question 16

The nurse evaluates that an expected outcome for the analysis of gastric secretions is:

Accepted Answer

Expected outcome following completion of procedure is the test for occult blood.If frank red blood is observed or coffee-ground materials are seen,report these findings immediately.This is an unexpected finding.

Question 17

An appropriate technique for the nurse to implement when obtaining throat cultures is to:

Accepted Answer

Plan to do the culture before mealtime or at least 1 hour after eating.Procedure often induces gagging; timing will decrease patient's chances of vomiting.Ask patient to sit erect in bed or on chair facing nurse.Gently but quickly swab tonsillar area side to side,making contact with inflamed or purulent sites.Depress anterior third of tongue only; placement of tongue blade along back of tongue is more likely to initiate gag reflex.

Question 18

When discussing the collection of a clean-voided urine specimen,it is important for the nurse to instruct the patient to:

Accepted Answer

After patient has initiated urine stream,pass urine specimen container into stream and collect 30 to 60 mL of urine.A sterile specimen container is used.Pour antiseptic solution over cotton balls.Cotton ball or gauze is used to cleanse perineum.

Question 19

What instructions does the nurse provide to the patient to obtain a double-voided urine specimen?

Accepted Answer

A fresh specimen should be used because stagnant urine that has been in the bladder for several hours will not accurately reflect serum glucose level at time of testing.Ask patient to collect random urine specimen and discard,drink a glass of water,and collect another specimen 30 to 45 minutes later.

Question 20

A patient is concerned because her first guaiac test is positive.What information should the nurse share with the patient?

Accepted Answer

A single positive test result does not confirm bleeding or indicate colorectal cancer.For confirmed positive results,the test must be repeated at least three times while patient is on meat-free,high-residue diet.More in-depth diagnosis is needed with positive result.

Quiz 43: Specimen Collection