Deck 5: Diagnostic Testing

Question 1

Which specimens could the nurse safely delegate to assistive personnel (AP) to collect? Select all that apply.

A) Wound culture
B) Routine urine specimen
C) Cerebrospinal fluid
D) Stool specimen
E) Sputum specimen

Answer 1

B, D, E
Explanation:1. AP may safely collect a routine urine specimen, stool specimen, and sputum specimen. Wound culture collection requires sterile technique, and so must be performed by the nurse. A lumbar puncture is performed by the primary care provider to collect cerebrospinal fluid, and the nurse should assist because sterile technique must be followed.
2. AP may safely collect a routine urine specimen, stool specimen, and sputum specimen. Wound culture collection requires sterile technique, and so must be performed by the nurse. A lumbar puncture is performed by the primary care provider to collect cerebrospinal fluid, and the nurse should assist because sterile technique must be followed.
3. AP may safely collect a routine urine specimen, stool specimen, and sputum specimen. Wound culture collection requires sterile technique, and so must be performed by the nurse. A lumbar puncture is performed by the primary care provider to collect cerebrospinal fluid, and the nurse should assist because sterile technique must be followed.
4. AP may safely collect a routine urine specimen, stool specimen, and sputum specimen. Wound culture collection requires sterile technique, and so must be performed by the nurse. A lumbar puncture is performed by the primary care provider to collect cerebrospinal fluid, and the nurse should assist because sterile technique must be followed.
5. AP may safely collect a routine urine specimen, stool specimen, and sputum specimen. Wound culture collection requires sterile technique, and so must be performed by the nurse. A lumbar puncture is performed by the primary care provider to collect cerebrospinal fluid, and the nurse should assist because sterile technique must be followed.

Question 2

The nurse is caring for several clients and has an unlicensed assistive personnel (AP) and LPN/LVN assisting. Which task would the nurse delegate to the LPN/LVN as opposed to the AP?

A) Assisting the health care provider with performance of a lumbar puncture
B) Collecting and testing a routine urine specimen for sugar, protein, and specific gravity
C) Testing stool for the presence of occult blood
D) Collecting a sterile urine specimen by straight-catheterizing the client

Answer 2

D
Explanation:1. The nurse can safely delegate performance of a straight catheterization to collect a sterile urine specimen to the LPN/LVN who is educated in the use of sterile technique. The nurse would delegate the routine urine specimen and stool specimen test to the AP. The nurse should assist the health care provider with collection of cerebrospinal fluid because the client must be assessed during this procedure, and only the RN can assess the client safely.
2. The nurse can safely delegate performance of a straight catheterization to collect a sterile urine specimen to the LPN/LVN who is educated in the use of sterile technique. The nurse would delegate the routine urine specimen and stool specimen test to the AP. The nurse should assist the health care provider with collection of cerebrospinal fluid because the client must be assessed during this procedure, and only the RN can assess the client safely.
3. The nurse can safely delegate performance of a straight catheterization to collect a sterile urine specimen to the LPN/LVN who is educated in the use of sterile technique. The nurse would delegate the routine urine specimen and stool specimen test to the assistive personnel. The nurse should assist the health care provider with collection of cerebrospinal fluid because the client must be assessed during this procedure, and only the RN can assess the client safely.
4. The nurse can safely delegate performance of a straight catheterization to collect a sterile urine specimen to the LPN/LVN who is educated in the use of sterile technique. The nurse would delegate the routine urine specimen and stool specimen test to the AP. The nurse should assist the health care provider with collection of cerebrospinal fluid because the client must be assessed during this procedure, and only the RN can assess the client safely.

Question 3

The nurse is preparing to collect a stool specimen. Place the steps involved in the procedure in the correct order.
Response 1. Provide for client privacy.
Response 2. Assist the clients who need help, either with bedside commode or a bedpan.
Response 3. Perform hand hygiene and observe other appropriate infection control procedures.
Response 4. Apply gloves to prevent contamination, and clean the client as required. Inspect the skin around the anus for any irritation, especially if the client defecates frequently and has liquid stools.
Response 5. Transfer the required amount of stool to the stool specimen container. Use tongue blades to transfer some or all of the stool specimen to the container, taking care not to contaminate the outside of the container.
Response 6. Prior to beginning of procedure, introduce self and verify the client's identity. Explain what is going to be done, why it is necessary, and how the client can help.

Answer 3

6, 3, 1, 2, 4, 5
Explanation:Rationale 1: Providing privacy occurs prior to starting the procedure in which to collect the stool specimen.
Rationale 2: Assisting the client to a bedside commode or a bedpan is done after hand hygiene and providing for client privacy.
Rationale 3: Performing hand hygiene and observing for other appropriate infection control measures is done immediately prior to starting the procedure of collecting a stool specimen.
Rationale 4: Applying gloves, cleaning the client, and inspecting the skin around the anus for irritation is done after performing hand hygiene but prior to obtaining the stool specimen.
Rationale 5: Transferring the correct amount of stool into the specimen container is the last step in stool specimen collection.

Question 4

The nurse has delegated the collection of a clean catch urine specimen to the assistive personnel (AP). Which statement by the AP indicates an appropriate understanding of the procedure?

A) "I will have the client urinate in the specimen container the next time he or she urinates."
B) "I will provide the client with sterile gloves for collecting the urine specimen."
C) "I will ask the client to cleanse the urethra to avoid contamination of the urine specimen."
D) "I will watch the client obtain the urine specimen to ensure correct obtainment."

Question 5

The nurse collects a urine specimen for culture and sensitivity from a client. Which information is essential for the nurse to document on the laboratory slip for this specific diagnostic test?

A) Date of admission
B) Medical diagnosis
C) Type of health insurance
D) Use of antibiotic therapy