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A healthcare professional has a prescription to collect a 24-hour urine specimen from a client. Which of the following measures should the healthcare professional take during this procedure?
- A. Keeping the specimen chilled
- B. Saving the first urine specimen collected at the start time
- C. Discarding the last voided specimen at the end of the collection time
- D. Asking the client to void, discarding the specimen, and noting the start time
Correct Answer: D
Rationale: The correct answer is asking the client to void, discarding the specimen, and noting the start time. During a 24-hour urine collection, the first voided urine is discarded to ensure the test starts with an empty bladder. The specimen should be kept chilled, not at room temperature, to prevent bacterial growth. The last voided specimen is not discarded because it contributes to the total volume collected, so choice C is incorrect. Discarding the specimen and noting the start time is essential for accurate results in a timed quantitative determination like a 24-hour urine collection.
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A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection is being taught by a nurse. Which statement should the nurse include in this client's teaching?
- A. Use a second form of birth control while taking this medication.
- B. You will experience increased menstrual bleeding while on this medication.
- C. You may experience an irregular heartbeat while on this medication.
- D. Watch for blood in your urine while taking this drug.
Correct Answer: A
Rationale: The correct statement for the nurse to include in the teaching is to advise the client to use a second form of birth control while taking amoxicillin. Penicillin, like amoxicillin, may reduce the effectiveness of estrogen-containing contraceptives, making it important to use additional contraceptive measures. The incorrect choices are B, C, and D. Increased menstrual bleeding, irregular heartbeat, or blood in the urine are not common side effects associated with amoxicillin use for a urinary tract infection.
A client has pyelonephritis and expresses embarrassment about discussing symptoms. How should the nurse respond?
- A. Assure the client that their symptoms will be kept confidential.
- B. Acknowledge the client's discomfort and avoid discussing elimination topics.
- C. Encourage the use of familiar language and assure the client they can take their time.
- D. Offer the client a nurse of the same gender to provide care.
Correct Answer: C
Rationale: When a client expresses embarrassment or discomfort in discussing symptoms related to sensitive topics like elimination and the genitourinary area, the nurse should respond by encouraging the client to use words they are comfortable with. This helps the client feel more at ease and opens up communication. Offering a nurse of the same gender may not address the client's discomfort with discussing symptoms. Assuring confidentiality is important, but it should not be promised in a way that may not be fulfilled. Avoiding the topic of elimination entirely does not address the client's feelings or promote effective communication.
The nurse is caring for a patient who is receiving isotonic intravenous (IV) fluids at an infusion rate of 125 mL/hour. The nurse performs an assessment and notes a heart rate of 102 beats per minute, a blood pressure of 160/85 mm Hg, and crackles auscultated in both lungs. Which action will the nurse take?
- A. Decrease the IV fluid rate and notify the provider.
- B. Increase the IV fluid rate and notify the provider.
- C. Request an order for a colloidal IV solution.
- D. Request an order for a hypertonic IV solution.
Correct Answer: A
Rationale: The patient is showing signs of fluid volume excess, indicated by crackles in both lungs, increased heart rate, and elevated blood pressure. To address this, the nurse should decrease the IV fluid rate and notify the provider. Increasing the IV fluid rate would worsen fluid overload. Requesting colloidal or hypertonic IV solutions would exacerbate the issue by pulling more fluids into the intravascular space, leading to further volume overload.
A client recovering from a urologic procedure is being assessed by a nurse. Which assessment finding indicates an obstruction of urine flow?
- A. Severe pain
- B. Overflow incontinence
- C. Hypotension
- D. Blood-tinged urine
Correct Answer: B
Rationale: The correct answer is 'B: Overflow incontinence.' The most common manifestation of urethral stricture after a urologic procedure is obstruction of urine flow. This obstruction can lead to overflow incontinence, which is the involuntary loss of urine when the bladder is distended. Severe pain is not typically associated with an obstruction of urine flow. Hypotension is unrelated to this issue. Blood-tinged urine is not a direct indication of an obstruction of urine flow but may indicate other conditions like trauma or infection.
What should the nurse do before an echocardiogram for a client who has had a myocardial infarction?
- A. Ensuring no food or drink for 4 hours before the procedure
- B. Obtaining informed consent from the client
- C. Assessing for any history of iodine or shellfish allergies
- D. Informing the client about the painless nature and duration of the procedure
Correct Answer: D
Rationale: The correct answer is to inform the client that the echocardiogram is a painless procedure that usually takes 30 to 60 minutes to complete. Echocardiography is a noninvasive, risk-free, and pain-free test that uses ultrasound to evaluate the heart's structure and motion. There is no need for special preparation before the procedure. Choices A, B, and C are incorrect because imposing nothing-by-mouth status, obtaining informed consent, and assessing for allergies to iodine or shellfish are not necessary steps before an echocardiogram.