Specimen Collection - NCLEX Pn

1. Which information must match between the specimen label and the requisition form?

   Patient identifiers, date/time, specimen source, and ordered test. Matching details prevent errors in processing and ensure accurate test results linked to the correct patient.

2. What is the correct urine specimen type for a $24$-hour urine collection test?

   All urine for $24$ hours, stored as directed, with timed start and stop. Comprehensive collection over $24$ hours accurately measures substances excreted throughout the day.

3. What is the correct action if a stool specimen for culture cannot be transported immediately?

   Place in appropriate transport medium and send promptly per policy. Transport medium preserves microbial viability, ensuring reliable culture results despite delays.

4. What is the priority action before collecting any specimen from a patient?

   Perform hand hygiene and verify the patient using two identifiers. Ensures correct patient identification and reduces infection risk, adhering to standard safety protocols in specimen collection.

5. What is the most important principle when collecting a wound culture?

   Collect from viable tissue after cleansing; avoid surface exudate when possible. Sampling viable tissue after cleansing isolates wound pathogens without interference from debris or dead cells.

6. What is the correct storage requirement for many $24$-hour urine collections?

   Keep the collection container refrigerated or on ice as ordered. Cool storage preserves specimen stability and prevents degradation of analytes like proteins or hormones.

7. What is the correct order of action when a specimen is time-sensitive (for example, blood gases)?

   Collect, label at bedside, and transport immediately per protocol. Prompt handling preserves analyte stability, preventing degradation in sensitive tests like blood gases.

8. What is the preferred specimen for sputum culture to evaluate lower respiratory infection?

   Early-morning deep-cough sputum, not saliva. Deep-cough sputum from lower airways provides a representative sample for detecting respiratory pathogens.

9. What is the correct specimen site for a throat culture when testing for streptococcal infection?

   Swab tonsillar pillars and posterior pharynx; avoid tongue and cheeks. Targeting the posterior pharynx captures streptococcal organisms while avoiding non-pathogenic oral flora.

10. Which stool specimen is required for fecal occult blood testing (FOBT)?

    Small stool sample applied to FOBT card per kit instructions. Kit-specific application detects hidden blood accurately, aiding in early gastrointestinal disorder screening.

11. Which urine specimen is preferred for pregnancy testing and why?

    First-morning urine because it is most concentrated for hCG detection. Concentration of hCG is highest in first-morning urine, improving test sensitivity and accuracy.

12. Identify the correct step before obtaining urine from a catheter sampling port.

    Clamp tubing briefly and disinfect the port with antiseptic. Clamping allows fresh urine accumulation, and disinfection prevents introducing contaminants during collection.

13. What is the correct patient instruction for a clean-catch midstream urine specimen?

    Cleanse meatus, start voiding, collect midstream without touching inside. Proper technique minimizes contamination, ensuring the specimen accurately reflects urinary tract conditions.

14. What is the correct action if a specimen arrives unlabeled or mislabeled?

    Reject per policy and recollect; do not relabel from memory. Relabeling from memory risks errors, so rejection ensures specimen accuracy and patient safety per lab policies.

15. Identify the correct action when a specimen is designated as biohazard.

    Place in leak-proof container and biohazard bag with separate requisition. Proper containment and separation prevent exposure and cross-contamination during transport.

16. What is the correct action for urine collected from an indwelling catheter for culture?

    Collect from the sampling port using aseptic technique, not the bag. Sampling from the port yields fresh, uncontaminated urine, unlike the bag which may harbor bacteria.

17. What is the correct action if a patient misses a void during a $24$-hour urine collection?

    Restart the $24$-hour collection per policy and notify the provider/lab. Missing a void invalidates the total volume, requiring a restart to ensure accurate quantitative results.

18. Which PPE is required at minimum when handling any specimen with potential body fluid exposure?

    Gloves; add gown, mask, and eye protection if splash risk exists. Gloves provide barrier protection against biohazards, with additional PPE for higher exposure risks as per infection control standards.

19. Which action helps obtain an adequate sputum specimen when the patient cannot expectorate?

    Encourage fluids, deep breathing, and cough; use humidification if ordered. These interventions loosen secretions, facilitating expectoration of adequate lower respiratory material.

20. What is the correct stool specimen for ova and parasite testing?

    Fresh stool in a clean container; avoid urine or toilet water contamination. Fresh, uncontaminated stool ensures detection of viable parasites or ova without dilution or interference.

21. What is the correct timing for labeling a specimen container to prevent errors?

    Immediately at the bedside after collection, before leaving the patient. Labeling at the point of collection minimizes the risk of misidentification and maintains specimen integrity.

22. What is the purpose of using a sterile container for urine culture collection?

    To prevent contamination and false-positive culture results. Sterile containers maintain specimen purity, avoiding external bacteria that could skew microbial analysis.

23. Which option is correct for collecting a blood culture to reduce contamination?

    Use strict aseptic technique and disinfect skin; obtain before antibiotics. Aseptic methods and timing minimize skin flora contamination and improve pathogen detection accuracy.

24. What is the correct urine specimen for routine urinalysis in most outpatient settings?

    Clean-catch midstream urine in a clean container. Clean-catch method reduces bacterial contamination from skin or urethra, providing a reliable sample for analysis.

25. What is the correct disposal method for used specimen-collection sharps (for example, lancets)?

    Dispose immediately in an approved puncture-resistant sharps container. Sharps containers prevent needlestick injuries and comply with biohazard waste regulations.

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