Which of the following would interfere with the collection of a good sputum sample for Gram stain?
1. Contamination of the sample with oral secretions
2. Lack of productive cough
3. Prior antibiotic therapy
4. Rinsing with mouthwash prior to sputum collection
a. 1, 2, and 3 only
b. 2 and 4 only
c. 3 only
d. 1 and 4 only
ANS: A
Factors that contribute to a poor Gram stain specimen include: lack of productive cough, prior antibiotic therapy, and contamination by oral secretions as specimens contaminated with oropha-ryngeal epithelial cells are unsatisfactory for analysis.
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