Fecal Occult Blood Testing

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Percentage Correct: 100%
1. What is the initial step in preparing a fecal occult blood test?
A. Determine the patient’s ability to help obtain a sample.
B. Gather both a Hemoccult slide and developing solution.
C. Provide the patient with a specimen hat or bedpan.
D. Perform hand hygiene and apply treatment gloves.

Rationale: Completing this action will determine the extent of the

nurse’s involvement in collecting the required sample. Gathering a
Hemoccult slide and developing solution is appropriate, this would not
be the initial step in preparing a fecal occult blood test. Providing the
patient with a specimen hat or bedpan, performing hand hygiene and
applying treatment gloves are appropriate, but this would not be the
initial step in preparing a fecal occult blood test.
2. The nurse has delegated to nursing assistive personnel (NAP) the task
of performing fecal occult blood tests on the stool of a patient with a
history of positive results. Which instruction is most relevant to
performing this test in this particular patient?
A. “Notify me only if the test is positive.”
B. “Save the stool sample so that I can retest it if it is positive.”
C. “Remind the patient that we test one section of the bowel movement.”
D. “Use Gastroccult developer with Hemoccult developer.”
Rationale: The nurse is likely to give NAP this instruction, because any
sample from which NAP obtains a positive result must be retested.
Asking the NAP to notify the nurse if the test is positive is appropriate for
all patients being tested for fecal occult bleeding, but the NAP would
report a negative finding as well. The sample should be taken from
different sections of the stool. Hemoccult developer would be used, not
Gastroccult developer.
3. Which instruction to nursing assistive personnel (NAP) is most
relevant to the proper performance of a fecal occult blood test using a
Hemoccult slide?
A. “Be sure to wear sterile gloves.”
B. “Reinforce with the patient the need to use the hat.”
C. “Is the patient capable of assisting with the collection?”
D. “Remember to take samples from two different areas of the
specimen.”

Rationale: Reminding the NAP to take samples from two different areas
of the specimen is the most relevant instruction, because stool samples
must be taken from two different areas and placed on the slide. Sterile
gloves are not needed when testing a stool specimen for occult blood.
Reinforcing with the patient the need to use the hat pertains and asking
if the patient is capable of assisting with the collection pertain to
obtaining the sample, not to testing the sample.
4. Which statement indicates proper interpretation of the results of a
positive fecal occult blood test?
A. “If the sample turns blue, it is positive for bleeding.”
B. “The sample turned blue after about 45 seconds.”
C. “The results were positive both times the sample was tested.”
D. “Because it was positive, the patient must be asked when he or she
last ate red meat.”
Rationale: Asking the patient when he or she last ate read meat
indicates the nurse’s awareness that a positive result does not
necessarily indicate gastrointestinal bleeding. The sample turning blue
after 45 seconds and the results were positive both times the sample was
tested indicate an understanding of proper technique, not proper
interpretation of positive test results.
5. Which of the following nursing actions addresses the risk for infection
related to fecal occult blood testing?
A. Maintaining aseptic technique while performing the test
B. Performing the fecal occult blood testing in the patient’s bathroom
C. Wearing clean gloves while testing
D. Assessing the patient’s ability to provide an uncontaminated fecal
specimen

Rationale: Wearing clean gloves is the most effective way to minimize

the risk for infection. Fecal occult blood testing procedure does not
require aseptic technique. Although performing the fecal occult blood
testing in the patient’s bathroom would not be inappropriate, other
locations (such as a dirty utility room) would be acceptable. Although it
would be appropriate to assess the patient’s ability to provide an
uncontaminated fecal specimen, doing so does not pertain to the risk for
infection.