Nokea
A nurse teaches a client who has been prescribed a 24-hour urine collection to measure excreted hormones. The client asks, Why do I need to collect urine for 24 hours instead of providing a random specimen? How should the nurse respond?
- A. The hormone is secreted on a circadian rhythm.
- B. The hormone is diluted in urine, therefore, we need a large volume.
- C. We are assessing when the hormone is secreted in large amounts.
- D. To collect the correct hormone, you need to urinate multiple times.
Correct Answer: A
Rationale: Hormones are secreted in a pulsatile or circadian cycle. A 24-hour urine collection provides a more accurate reflection of hormone secretion over time compared to a random specimen.
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A nurse plans care for an older adult who is admitted to the hospital for pneumonia. The client has no known drug allergic status nor a significant medical history. Which action should the nurse include in this clients plan of care?
- A. Initiate Airborne Precautions.
- B. Offer fluids every hour or two.
- C. Administer broad-spectrum antibiotics.
- D. Palpate the clients thyroid gland.
Correct Answer: B
Rationale: Decreased antidiuretic hormone (ADH) production is a normal age-related change, leading to increased urine output and risk of dehydration. Offering fluids regularly helps prevent dehydration in older adults.
A nurse cares for a client with a hypofunctioning anterior pituitary gland. Which hormones should the nurse expect to be affected by this condition? (Select all that apply.)
- A. Thyroid-stimulating hormone
- B. Vasopressin
- C. Follicle-stimulating hormone
- D. Calcitonin
- E. Growth hormone
Correct Answer: A,C,E
Rationale: The anterior pituitary gland secretes thyroid-stimulating hormone, follicle-stimulating hormone, and growth hormone, which would be affected by hypofunction. Vasopressin and calcitonin are secreted by the posterior pituitary and thyroid gland, respectively.
A nurse cares for a client who is prescribed a serum catecholamine test. Which action should the nurse take?
- A. Discard the first sample and then begin the collection.
- B. Draw the blood sample after the client eats breakfast.
- C. Place the sample on ice and send to the laboratory immediately.
- D. Add preservatives before sending the sample to the laboratory.
Correct Answer: C
Rationale: Serum catecholamine samples must be placed on ice and sent to the laboratory immediately to maintain sample integrity and ensure accurate results.
A nurse cares for a client who has excessive catecholamine release. Which assessment finding should the nurse correlate with this condition?
- A. Decreased blood pressure
- B. Increased pulse
- C. Decreased respiratory rate
- D. Increased urine output
Correct Answer: B
Rationale: Catecholamines activate the sympathetic nervous system, leading to tachycardia (increased pulse) as part of the fight-or-flight response.
A nurse teaches an older adult with a decreased production of estrogen. Which statement should the nurse include in this clients teaching to decrease injury?
- A. Drink at least 2 liters of fluids each day.
- B. Walk daily as a weight-bearing exercise.
- C. Bathe your perineal area twice a day.
- D. You should check your blood glucose before meals.
Correct Answer: B
Rationale: Decreased estrogen in older adults increases the risk of osteoporosis and fractures. Weight-bearing exercises like walking help maintain bone density and reduce injury risk.