PCT Non-Blood Specimen Collection 2 — Questions and Answers
Question 1: When collecting a midstream clean-catch urine specimen, the patient should:
- Collect the first portion of urine in the container
- Begin urinating into the toilet, then catch the middle portion in the container (Correct answer)
- Collect urine at any point during voiding
- Stop and start urination multiple times to fill the container
Correct answer: Begin urinating into the toilet, then catch the middle portion in the container
The midstream clean-catch method avoids contaminants from the initial urine stream, providing a specimen that accurately represents bladder urine.
A midstream clean-catch specimen requires the patient to first clean the urethral area with antiseptic wipes, begin voiding into the toilet to flush bacteria from the urethra, then collect the middle portion in a sterile container without stopping the stream. This technique reduces contamination and provides reliable culture results.
Question 2: A 24-hour urine collection requires the patient to:
- Save only the first morning void each day for 24 days
- Discard the first void, then save all urine for the next 24 hours (Correct answer)
- Collect every other void for 24 hours
- Save urine from three consecutive voids
Correct answer: Discard the first void, then save all urine for the next 24 hours
The first void is discarded to start timing, then every subsequent void is saved for exactly 24 hours to measure total daily output of specific substances.
The 24-hour collection begins by having the patient void and discard that specimen (noting the time). All subsequent urine for the next 24 hours is collected in a large container, usually kept refrigerated. The final specimen is collected at the same time the next day. Missing even one void invalidates the test.
Question 3: A stool specimen for occult blood testing should be collected:
- Only from liquid stools
- From the center of the stool using the collection device provided (Correct answer)
- By having the patient defecate directly into the specimen container
- From toilet water after the patient has voided
Correct answer: From the center of the stool using the collection device provided
Collecting from the center of the stool avoids surface contamination and toilet water contact, providing the most accurate sample for occult blood detection.
Stool specimens for guaiac-based occult blood testing (FOBT) should be collected from different areas of the stool using the wooden applicator or collection device. The stool should not contact toilet water (which may contain cleaning chemicals) or urine. Patients should avoid red meat, vitamin C supplements, and NSAIDs before testing as these affect results.
Question 4: When labeling a specimen, which information is ALWAYS required?
- The PCT's home address
- The patient's name, date of birth, date and time of collection, and collector's initials (Correct answer)
- Only the patient's room number
- The patient's diagnosis and insurance information
Correct answer: The patient's name, date of birth, date and time of collection, and collector's initials
Proper specimen labeling with patient identifiers, collection time, and collector information prevents misidentification and ensures accurate test results.
Specimen labeling requirements typically include: patient's full name, date of birth or medical record number, date and time of collection, type of specimen, and the collector's initials. Labels must be applied at the bedside immediately after collection. Mislabeled specimens are rejected by the laboratory, requiring recollection.
Question 5: A sputum specimen should ideally be collected:
- After the patient eats a full meal
- First thing in the morning before eating or drinking (Correct answer)
- Right before bedtime
- Immediately after brushing teeth with toothpaste
Correct answer: First thing in the morning before eating or drinking
Early morning collection before oral intake yields the most concentrated specimen with secretions that accumulated overnight in the respiratory tract.
Sputum specimens are best collected upon waking because respiratory secretions pool overnight, providing a concentrated sample. The patient should rinse their mouth with water (not mouthwash) to reduce oral flora contamination, then cough deeply to produce sputum from the lower respiratory tract—not saliva. Collect in a sterile container.
Question 6: What is the correct action if a urine specimen cannot be transported to the lab within 30 minutes?
- Leave it at room temperature and send it when convenient
- Discard it and collect a new specimen later
- Refrigerate the specimen until transport is available (Correct answer)
- Add tap water to keep the specimen fresh
Correct answer: Refrigerate the specimen until transport is available
Refrigeration slows bacterial growth and chemical changes that can alter test results when immediate transport is not possible.
Urine left at room temperature undergoes bacterial multiplication, pH changes, and breakdown of cellular components, all of which affect test accuracy. Refrigerating at 2-8°C preserves the specimen for up to 24 hours for most tests. Some tests require special preservatives—always check laboratory requirements.
PCT Non-Blood Specimen Collection 2
When collecting a midstream clean-catch urine specimen, the patient should: