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Correct Answer: papanicolaou testing
when conducting an obstetric and gynecologic examination, the order in which specimens are collected is crucial to prevent contamination and to ensure the accuracy of test results. each type of specimen has a specific purpose and requires particular collection methods.
among the options listed—voided urine, vaginal swab for ph, saline, or koh, endocervical swab for naat or culture, and papanicolaou (pap) testing—papanicolaou testing is indeed typically the last specimen collected.
voided urine is generally collected first. this is because it's a non-invasive procedure and involves the patient providing a sample of urine. collecting this specimen first minimizes the risk of contamination from other gynecological procedures. the urine sample can be used for various tests, including pregnancy tests, urinalysis, or culture, which help in diagnosing urinary tract infections or other conditions.
following the collection of the urine sample, a vaginal swab for ph, saline, or koh might be taken. this involves swabbing the vagina to collect cells or discharge for testing. these tests can help diagnose infections like bacterial vaginosis or yeast infections. the saline or koh tests involve preparing the samples with saline or potassium hydroxide to better view the cells or pathogens under a microscope.
an endocervical swab for nucleic acid amplification tests (naat) or culture usually follows. this procedure involves collecting cells from the cervix, which can be sensitive to contamination. the samples collected are used to test for sexually transmitted infections such as chlamydia or gonorrhea. these tests require specific collection techniques to ensure that the results are accurate and free from contamination from other sources.
lastly, papanicolaou testing, commonly known as a pap smear, is performed. during this test, cells are collected from the cervix to check for the presence of precancerous or cancerous cells. it is vital to perform this test last to avoid any potential contamination from previous examinations, which could affect the accuracy of the cytological examination. the pap smear requires a sterile environment and specific collection techniques, which is why it is strategically positioned at the end of the examination process.
in conclusion, the sequence of specimen collection during an obstetric and gynecologic examination is designed to prevent cross-contamination and ensure the reliability of test results, with papanicolaou testing correctly positioned as the last specimen collected.
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