Nokea
Which of the following is inappropriate in collecting midstream clean-catch urine specimen for urine analysis?
- A. Collect early in the morning, first voided specimen
- B. Do perineal care before specimen collection
- C. Collect 5 to 10 ml of urine
- D. Discard the first flow of urine
Correct Answer: C
Rationale: The inappropriate action in collecting a midstream clean-catch urine specimen for urine analysis is to collect only 5 to 10 ml of urine. Adequate urine volume of 30 to 60 ml is required for accurate testing. Collecting a small amount like 5 to 10 ml may lead to inaccurate results due to insufficient sample size. It is crucial to follow proper collection techniques, such as discarding the first flow of urine, performing perineal care, and collecting an adequate volume, to ensure reliable test results.
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A nurse is caring for a client with a diagnosis of catatonic schizophrenia. What clinical finding does the nurse expect the client to exhibit?
- A. Crying
- B. Self-mutilation
- C. Immobile posturing
- D. Repetitive activities
Correct Answer: C
Rationale: In catatonic schizophrenia, clients commonly exhibit immobile posturing, where they may maintain a fixed position for extended periods. This could include holding rigid poses or remaining motionless. Choice A, 'Crying,' is not typically associated with catatonic schizophrenia. Choice B, 'Self-mutilation,' refers to a different behavior seen in some mental health conditions but is not a characteristic feature of catatonic schizophrenia. Choice D, 'Repetitive activities,' does not align with the typical presentation of catatonic schizophrenia, which is characterized by motor abnormalities such as immobility rather than engaging in purposeful repetitive movements.
Which electrolyte imbalance is a potential side effect of diuretics?
- A. Hyperkalemia
- B. Hypercalcemia
- C. Hypomagnesemia
- D. Hypokalemia
Correct Answer: D
Rationale: The correct answer is D, Hypokalemia. Diuretics commonly cause hypokalemia due to increased urinary excretion of potassium. Hyperkalemia (Choice A) is the opposite, characterized by high potassium levels and is not typically associated with diuretics. Hypercalcemia (Choice B) is an elevated calcium level, which is not a common side effect of diuretics. Hypomagnesemia (Choice C) is low magnesium levels, which can be a side effect of diuretics, but the most common electrolyte imbalance associated with diuretics is hypokalemia.
The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?
- A. Discontinue the heparin drip prior to initiating the Coumadin
- B. Check the client's INR prior to beginning Coumadin
- C. Clarify the order with the health care provider as soon as possible
- D. Administer the Coumadin along with the heparin drip as ordered
Correct Answer: D
Rationale: The correct action for the nurse to take is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip prior to initiating Coumadin could leave the patient without anticoagulation coverage during the period when warfarin's effects are not yet established. Checking the client's INR prior to beginning Coumadin is important but not the immediate action to take when both medications are ordered together. Clarifying the order with the health care provider is unnecessary in this scenario as it is common practice to give heparin and warfarin concurrently in the transition period.
People who use monoamine oxidase inhibitors for the treatment of depression need to avoid foods high in:
- A. Folate
- B. Tyramine
- C. Potassium
- D. Vitamin K
Correct Answer: B
Rationale: The correct answer is B: Tyramine. Tyramine can interact with monoamine oxidase inhibitors, leading to hypertensive crises. Folate (choice A) is not contraindicated with monoamine oxidase inhibitors. Potassium (choice C) is an essential mineral and not specifically contraindicated with these medications. Vitamin K (choice D) is not a concern for interactions with monoamine oxidase inhibitors.
What is the mission of the Army Medical Department?
- A. Ensure that each soldier receives a physical examination annually
- B. Deliver healthcare to regions of the U.S. designated as disaster areas by the President
- C. Maintain the health of the Army and preserve its combat effectiveness
- D. Offer medical, dental, and veterinary education and training
Correct Answer: C
Rationale: The correct answer is C: 'Maintain the health of the Army and preserve its combat effectiveness.' This mission statement reflects the primary goal of the Army Medical Department, which is to ensure that military personnel remain healthy and fit for duty to preserve the Army's fighting strength. Choices A, B, and D are incorrect because they do not capture the core purpose of the Army Medical Department, which is focused on the health and readiness of the military forces, rather than performing annual physical examinations, responding to disasters, or providing education and training.