A nurse is preparing to obtain a catheterized urine sample from a toddler who is uncircumcised. The nurse is using a commercially prepared catheterization kit. Identify the sequence in which the nurse should plan to obtain the urine sample. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Obtaining a sterile urine sample via catheterization in an uncircumcised toddler requires knowledge of sterile technique and anatomical considerations. Proper sequencing ensures the meatus is adequately exposed and cleaned while maintaining the sterility of the catheter before insertion. Choice A rationale Retracting the foreskin is necessary to expose the urinary meatus in an uncircumcised male. This step must occur before cleansing to ensure the antiseptic solution reaches the area where the catheter will enter the body. Choice B rationale Cleansing the meatus with antiseptic from the kit reduces the bacterial load at the entry point. This step is vital to prevent the introduction of skin flora into the sterile bladder, which prevents infections. Choice C rationale Lubricating the catheter tip is the first step in preparing the equipment. Reducing friction is critical to minimize urethral trauma and discomfort in a toddler, who has a very narrow and sensitive urinary tract. Choice D rationale Advancing the catheter into the urethra is the final step once the area is prepared and sterile. The nurse must insert it gently until urine flow is visualized, confirming the tip has reached the bladder.