The nurse is instructing a patient on collecting a sputum sample. ...

[aabwk4]

The nurse is instructing a patient on collecting a sputum sample. What is the best time for the nurse to collect this specimen?
 
  1. after a meal
  2. upon awakening from a nap
  3. before a meal
  4. upon awakening in the morning

Question 2

Upon auscultation of the chest, the nurse reports to the preceptor what is heard. What statement should cause the preceptor to be most concerned?
 
  1. I heard crackles earlier, but now I am not able to hear anything.
  2. I hear wheezing in the right lobes, but clear on the left.
  3. There are coarse crackles that clear with coughing.
  4. The patient was clear, but now there are scattered wheezes bilaterally.

[potomatos]

Answer to Question 1

Correct Answer: 4
There is the greatest opportunity to obtain a sputum specimen in the morning. Respiratory secretions pool more during sleep. Patients with respiratory illness cough more when awakening, so sputum collection would be best before daily activities are initiated. There might not be the same opportunity after a nap due to the shortened time frame. Before a meal would not produce the same results, and can tire a patient. Collecting a specimen after a meal would not produce a specimen, and could induce vomiting.

Answer to Question 2

Correct Answer: 1
The preceptor would be most concerned about the nurse not hearing anything. This statement needs immediate follow-up assessment as to whether the nurse hears nothing, or no adventitious breath sounds. The other options indicate adventitious breath sounds, but none is indicative of the need for immediate action.

[aabwk4]

Excellent

[parshano]

Thanks for the timely response, appreciate it