chapter 7
5. _______________ organisms grow in superficial wounds exposed to the air.
ANS: Aerobic
2. A common test performed on fecal material is the ________ test for fecal occult blood.
ANS: Guaiac
3. ______________ is often indicated to collect sputum from patients unable to spontaneously produce a sample for laboratory analysis.
ANS: Suctioning
1. 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 unique chemical properties.
ANS: change in color
6. The least traumatic method of obtaining a blood specimen is known as __________.
ANS: skin puncture
4. Localized inflammation, tenderness, warmth at the wound site, and purulent drainage usually signify _______________.
ANS: wound infection
1. How should the nurse identify a patient before obtaining a laboratory specimen? a. Use at least two patient identifiers. b. Look at the chart before entering the room. c. Ask the patient his name. d. Check the patient's armband twice.
ANS: A
16. A nurse suspects that the patient may have tuberculosis (TB). 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 (AFB) b. General cytology c. Chemical analysis d. Culture and sensitivity
ANS: A
20. The nurse has delegated activities of daily living (ADL) care of a patient with a large wound that is draining. Which of the following should the nurse instruct the nurse assistant to report back to her? a. The wound has a foul odor. b. Drainage is decreased. c. The patient's temperature is slightly below normal. d. The patient does not complain of discomfort.
ANS: A
27. The nurse is drawing blood from a patient to determine the 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.
ANS: A
31. Which of the following is the site of choice for obtaining samples for an arterial blood gas (ABG)? a. Radial artery b. Brachial artery c. Femoral artery d. Popliteal artery
ANS: A
32. An appropriate technique for the nurse to implement when obtaining an arterial blood gas (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 blood after the puncture.
ANS: A
33. What should the nurse do after obtaining a sample for an arterial blood gas (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.
ANS: A
5. 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 the infant sit facing the back of the toilet. d. Catheterize the infant and collect the urine using sterile procedure.
ANS: A
2. 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.
ANS: A, B
3. 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
ANS: A, B
6. 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. Bacteria accumulate as secretions pool. d. Specimens should be obtained at bedtime.
ANS: A, B, C
1. 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.
ANS: A, B, C, D
4. Hemoccult testing 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. Large polyps
ANS: A, B, C, D
5. 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
ANS: A, B, C, D
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
ANS: B
12. The nurse evaluates that an expected outcome for analysis of gastric secretions is: a. inability of the patient to discuss the rationale for the test. b. negative occult blood. c. the presence of clumps or clots. d. the presence of brown, "coffee-ground" secretions.
ANS: B
13. An appropriate technique for the nurse to implement when obtaining throat cultures is to: a. have the patient lie 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.
ANS: B
18. An appropriate technique that the nurse can 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.
ANS: B
25. 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 the fist. d. Do not use veins that rebound.
ANS: B
26. An appropriate technique for the nurse to implement when preparing for a venipuncture is to: a. tie the tourniquet in a knot. b. tie the tourniquet, so it can be easily removed. c. place the tourniquet 6 to 8 inches above the selected site. d. make the tourniquet tight enough to occlude the distal pulse.
ANS: B
3. 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 to obtain the specimen? a. Obtain the urine from the drainage bag. b. Clamp the drainage tubing for 10 to 15 minutes. c. Draw urine using a 20-mL syringe. d. Insert the needle into the silicone catheter.
ANS: B
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.
ANS: B
10. 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.
ANS: C
15. 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.
ANS: C
17. 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. Acid-fast bacilli (AFB) c. Cytology d. Chemical analysis
ANS: C
19. 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.
ANS: C
2. 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.
ANS: C
21. An appropriate technique for the nurse to use when culturing wound drainage that is suspected to contain 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.
ANS: C
22. 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 blood from the patient's intravenous (IV) catheter.
ANS: C
23. When blood specimens are drawn, which of the following statements 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.
ANS: C
29. 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.
ANS: C
30. 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.
ANS: C
4. 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.
ANS: C
6. What should the nurse do when a patient is required to provide a timed urine specimen? a. Save all urine from the time the test began. b. Leave the collection bottle on the floor near the patient's bed. c. Send notices along with the patient when leaving the unit 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.
ANS: C
7. 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 voiding and the 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.
ANS: C
9. 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.
ANS: C
14. 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.
ANS: D
24. 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 pre-warmed test tubes. b. Keep the specimen out of the light. c. Avoid use of a tourniquet during the procedure. d. Place the samples on ice before sending them to the lab.
ANS: D
28. 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 cordlike, 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.
ANS: D
