Deck 43: Specimen Collection

Question 1

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

A) Foul odor
B) Decreased drainage
C) Decreased temperature
D) Denial of discomfort

Answer 1

Foul odor

Question 2

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

A) Take the swab and mix it in the reagent to check for color changes
B) Place the swab into the culture tube and then add a special reagent to the tube
C) Crush the ampule at the end of the tube and put the tip of the swab into the solution
D) Place the swab into the tube, close it securely, and keep it warm until it is sent to the laboratory

Answer 2

Crush the ampule at the end of the tube and put the tip of the swab into the solution

Question 3

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

A) Apply a sterile plastic collection bag to the perineum
B) Wring out diapers and collect the urine in a specimen container
C) Have infant sit facing the back of the toilet
D) Catheterize the infant and collect the urine using sterile procedure

Answer 3

Apply a sterile plastic collection bag to the perineum

Question 4

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

A) Use mouthwash before the collection
B) Splint the surgical incision before coughing
C) Try to obtain a sample immediately after eating
D) Take a deep breath, cough hard, and expectorate

Question 5

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

A) Positive results are indicative of bleeding
B) Poultry and fish should be eaten before testing
C) Testing should be done carefully during the menstrual cycle
D) Two samples should be obtained from the same part of the stool specimen

Question 6

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

A) Suction the patient thoroughly
B) Continue to complete the procedure quickly
C) Stop the procedure and provide oxygen, if ordered
D) Have the patient lie down and take deep breaths before continuing with the specimen collection

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?

A) Acid-fast bacilli
B) General cytology
C) Chemical analysis
D) Culture and sensitivity

Question 8

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

A) Obtain the first voided specimen in the morning
B) Immerse the test strip in the urine and remove immediately
C) Add a chemically active tablet to the urine and then test it with a reagent strip
D) Wipe the strip with a sterile gauze after dipping

Question 9

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

A) Apply sterile gloves
B) Assist the patient to a side-lying position
C) Collect discharge from the perineum on the same swab
D) Insert the swab to 1 inch into the orifice and rotate before removal

Question 10

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

A) Using at least two patient identifiers
B) Looking at the chart before entering the room
C) Asking the patient if he is Mr. Smith
D) Checking the patient's arm band twice

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?

A) Fish
B) Apples
C) Red meats
D) Green, leafy vegetables

Question 12

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

A) Perform Credé's procedure for the suprapubic area
B) Catheterize the patient to obtain the specimen
C) Offer fluids, if allowed, and wait about 30 minutes
D) Notify the physician that the test cannot be completed

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?

A) Obtain the urine from the drainage bag
B) Clamp the drainage tubing for 30 minutes
C) Draw urine using a 20-mL syringe
D) Insert the needle into the silicone catheter

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?

A) Culture and sensitivity
B) AFB
C) Cytology
D) Chemical analysis

Question 15

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

A) Save all urine from the time that the test began
B) Leave the collection bottle on the floor near the patient's bed
C) Send notices along with the patient to have all urine saved and returned to the unit
D) Remove contaminants such as toilet paper from the urine before transferring it to the collection bottle

Question 16

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

A) Inability of patient to discuss rationale for test
B) Negative occult blood
C) The presence of clumps or clots
D) The presence of brown, "coffee-ground" secretions

Question 17

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

A) Have the patient lay flat in the bed
B) Do the culture before meals or an hour after meals
C) Avoid touching the swab to any of the inflamed areas
D) Place pressure on the tongue blade along the back of the tongue

Question 18

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

A) Use a clean specimen cup
B) Collect 100 to 150 mL of urine for testing
C) Void some urine first and then collect the sample
D) Wash the perineal area with soap and water immediately before voiding

Question 19

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

A) Save two separate specimens from the first voiding in the morning
B) Add two specimens together from the morning and evening voiding
C) Discard the first sample, then wait a half hour and void again
D) Void first and then self-catheterize to obtain the specimens

Question 20

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

A) The patient probably has colorectal cancer
B) The test needs to be repeated after she eats some red meat
C) The test needs to be repeated at least 3 times
D) The patient needs a low-residue diet to reduce intestinal abrasions

Question 21

The guaiac test helps to reveal blood that is visually undetectable.This test is a useful diagnostic tool for which of the following conditions? (Select all that apply.)

A) Colon cancer
B) Upper gastrointestinal (GI) ulcers
C) Localized gastric parasites
D) Detection of large polyps
E) None of above

Question 22

When teaching about the procedure for capillary puncture,the nurse instructs a patient to:

A) Hold the finger upright
B) Use the central tip of the finger
C) Allow the antiseptic to dry completely
D) Vigorously squeeze the end of the finger

Question 23

The patient asks why he has to obtain a "clean catch" urine specimen.The nurse explains that the purpose of the "clean catch" is to obtain a culture and sensitivity measurement that will tell: (Select all that apply.)

A) The amount of protein in the urine
B) Whether bacteria are present
C) The color of the urine
D) Which antibiotics will be effective

Question 24

Which of the following is the site of choice for obtaining samples for ABG?

A) Radial artery
B) Brachial artery
C) Femoral artery
D) Popliteal artery

Question 25

The nurse is drawing blood from a patient to determine blood alcohol level.Which step is an appropriate action for the nurse to take?

A) Swab the area with an antiseptic swab
B) Swab the area with an alcohol swab
C) Do not swab the area at all
D) Apply the tourniquet for 5 minutes

Question 26

The nurse is preparing to perform a venipuncture on a patient.Which of the following is an appropriate action for the nurse to take?

A) Apply the tourniquet until the distal pulse is no longer felt
B) Remove the tourniquet after 1 minute
C) Instruct the patient to vigorously open and close fist
D) Do not use veins that rebound

Question 27

When collecting specimens,the nurse should: (Select all that apply.)

A) Wear gloves and perform hand hygiene
B) Handle excretions discreetly
C) Explain the procedure to the patient
D) Allow patients to collect their own urine specimens
E) None of above

Question 28

A patient is to have a venipuncture to obtain a blood sample to check ammonia levels.What should the nurse do when given this information?

A) Use prewarmed test tubes
B) Keep the specimen out of the light
C) Do not use a tourniquet during the procedure
D) Place the samples on ice before sending them to the lab

Question 29

An appropriate technique for the nurse to use when culturing wound drainage that is suspected to have anaerobic bacteria is to:

A) Use older secretions for the specimen
B) Add exudate from the skin to the wound specimen
C) Aspirate 5 to 10 mL of exudate from a deep cavity wound
D) Swab carefully and slowly in a back-and-forth motion across the wound

Question 30

When obtaining a venipuncture sample for a blood culture,the nurse should:

A) Recap the needles
B) Shake the culture bottles well
C) Use two different sites to draw samples
D) Inoculate the aerobic culture bottle first

Question 31

What should the nurse do after obtaining a sample for ABG?

A) Maintain pressure over the site for 3 to 5 minutes
B) Check the artery proximal to or above the puncture site
C) Place the syringe into a plastic bag, and send it to the lab
D) Apply a cool compress to hematoma formation at the puncture site

Question 32

An appropriate technique for the nurse to implement when preparing for a venipuncture is to:

A) Tie the tourniquet in a knot
B) Leave the tourniquet on no longer than 1 minute
C) Place the tourniquet 6 to 8 inches above the selected site
D) Make the tourniquet tight enough to occlude the distal pulse

Question 33

When blood specimens are drawn,which of the following is true?

A) Draw cryoglobulin levels using test tubes placed on ice
B) To test ammonia and ionized calcium levels, warm the test tubes
C) To draw for lactic acid levels, do not use a tourniquet
D) To draw for vitamin levels, use light to determine density

Question 34

A timed urine collection can be used for which of the following? (Select all that apply.)

A) Glucose
B) Adrenocorticosteroids
C) Bacteria count
D) Color

Question 35

When obtaining laboratory specimens,the nurse needs to be aware that: (Select all that apply.)

A) Specimen collection may cause anxiety and embarrassment
B) Sociocultural variations may affect a patient's compliance
C) Contact isolation precautions are required for collection of blood
D) Two identifiers, including room number, must be used

Question 36

When evaluating who may have a sample taken immediately for arterial blood gases (ABG),the nurse selects the patient who:

A) Has been asleep
B) Has just been suctioned
C) Has been on continuous oxygen
D) Had ventilator settings changed more than 2 hours ago

Question 37

An appropriate technique for the nurse to implement when obtaining an ABG specimen is to:

A) Insert the needle at a 45 degree angle
B) Use a 19-gauge, 1-inch needle
C) Leave 0.5 mL of heparin in the syringe
D) Aspirate the blood after the puncture

Question 38

Which is an appropriate site for the nurse to select for a venipuncture?

A) Right arm of a patient near the IV site
B) Right arm of a patient with a left-sided cerebral vascular accident (CVA)
C) Left arm of a patient with a left arteriovenous (AV) shunt
D) Right arm of a patient with a right mastectomy

Question 39

When performing a venipuncture,the nurse should:

A) Inject with the needle at a 45-degree angle
B) Select a vein that is rigid and cord-like, and that rolls when palpated
C) Perform the needle insertion immediately after cleansing the skin with alcohol
D) Place the thumb of the nondominant hand about 1 inch below the site and pull the skin taut

Question 40

The patient is diagnosed with suspected bacteremia.The physician has ordered blood cultures from two different sites.The patient is complaining of chills and has an elevated temperature.What action should the nurse take in the presence of these symptoms?

A) Delay drawing the blood cultures until symptoms subside
B) Draw blood from only one site to prevent further discomfort
C) Draw the blood cultures as ordered
D) Draw the blood from the patient's intravenous (IV) catheter

Question 41

In explaining to the patient about obtaining a sputum specimen to diagnose tuberculosis,the nurse explains which of the following? (Select all that apply.)

A) Specimens are best obtained in the early morning
B) Acid-fast bacilli (AFB) smears require three consecutive morning samples
C) Cultures can take up to 8 weeks to yield results
D) Specimens should be obtained at bedtime

Question 42

The most common method of obtaining blood samples that involves inserting a hollow-bore needle into the lumen of a large vein is known as ___________.

Question 43

A common test performed on fecal material is the ________ test for fecal occult blood.

Question 44

The nurse is preparing to obtain a blood specimen via capillary puncture.Which site(s)below would be appropriate for the procedure? (Select all that apply.)

A) Finger
B) Earlobe
C) Toe
D) Heel
E) None of above

Question 45

Localized inflammation,tenderness,warmth at the wound site and purulent drainage usually signify _______________.

Question 46

_________________ is the release of chemical substances manufactured by cells of glandular organs.

Question 47

_____________________is a term that means that the patient is positively identified before the procedure.

Question 48

Assessment of the chemical properties of urine is done by immersing a special,chemically prepared strip of paper into a clean urine specimen,or by combining drops of urine with chemically prepared tablets.The _____________ of the strip or tablet indicates the presence of any of these substances.

Question 49

The nurse is caring for a patient who has had a craniotomy.The patient appears to need endotracheal suctioning.The nurse is aware that this can be of concern because suctioning can cause which of the following? (Select all that apply.)

A) Violent coughing
B) Aspiration of stomach contents
C) Increased intracranial pressure
D) Bradycardia or tachycardia
E) None of above

Question 50

__________________ is the process by which the body eliminates or sheds substances by organs or tissues.

Question 51

______________ is often indicated to collect sputum from patients unable to spontaneously produce a sample for laboratory analysis.

Question 52

_________________organisms grow deep within body cavities where oxygen is not normally present.

Question 53

The least traumatic method of obtaining a blood specimen is known as __________.

Question 54

_______________ organisms grow in superficial wounds exposed to the air.