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A patient with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine specimen that is an orange colour. Which of the following actions should the nurse take first?
- A. Notify the patient's health care provider.
- B. Ask the patient about use of any medications.
- C. Question the patient about any UTI risk factors.
- D. Teach about the correct procedure for midstream urine collection.
Correct Answer: B
Rationale: An orange colour in the urine is normal with some medications such as sulfasalazine. The colour would not be expected with urinary tract infection, is not a sign that poor technique was used in obtaining the specimen and does not need to be communicated to the health care provider until further assessment is done.
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The nurse is preparing a patient with a decreased glomerular filtration rate for an intravenous pyelogram (IVP). Which of the following actions should be included in the plan of care?
- A. Monitor the urine output after the procedure.
- B. Assist with monitored anesthesia care (MAC).
- C. Give oral contrast solution before the procedure.
- D. Insert a large size urinary catheter before the IVP.
Correct Answer: A
Rationale: Patients with impaired renal function are at risk for decreased renal function after IVP because the contrast medium used is nephrotoxic, so the nurse should monitor the patient's urine output. MAC sedation and retention catheterization are not required for the procedure. The contrast medium is given intravenously, not orally.
The nurse is preparing a patient for an intravenous pyelogram (IVP) and obtains the following information. Which information has the most immediate implications for the patient's care?
- A. The patient describes allergies to shellfish and penicillin.
- B. The patient has not had anything to eat or drink for 8 hours.
- C. The patient complains of costovertebral angle (CVA) tenderness.
- D. The patient used a bisacodyl tablet the previous night.
Correct Answer: A
Rationale: Iodine-based contrast dye is used during IVP and for many computed tomography (CT) scans. The nurse will need to notify the health care provider before the procedures so that the patient can receive medications such as antihistamines or corticosteroids before the procedures are started. The other information also is important to note and document but does not have immediate implications for the patient's care during the procedures.
The nurse is reviewing the results of a patient's urinalysis. Which of the following information indicates that the nurse should notify the health care provider?
- A. pH 6.2
- B. Trace protein
- C. WBC: 20-26/hpf
- D. Specific gravity: 1.021
Correct Answer: C
Rationale: The increased number of white blood cells (WBCs) indicates the presence of urinary tract infection or inflammation. Normal WBC result in a urinalysis report is 0-5/hpf. The other findings are normal.
Which of the following actions should the nurse plan to take first when admitting a patient who has a history of neurogenic bladder as a result of a spinal cord injury?
- A. Ask about the usual urinary pattern and any measures used for bladder control.
- B. Assist the patient to the toilet at scheduled times to help ensure bladder emptying.
- C. Check the patient for urinary incontinence every 2 hours to maintain skin integrity.
- D. Use intermittent catheterization on a regular schedule to avoid the risk of infection.
Correct Answer: A
Rationale: Before planning any interventions, the nurse should complete the assessment and determine the patient's normal bladder pattern and the usual measures used by the patient at home. All the other responses may be appropriate, but until the assessment is complete, an individualized plan for the patient cannot be developed.
The nurse is reviewing the result of a patient's creatinine clearance test which is 60 mL/minute. Which of the following values is the patient's glomerular filtration rate (GFR) in mL/minute?
- A. 30
- B. 60
- C. 120
- D. 240
Correct Answer: B
Rationale: The creatinine clearance approximates the GFR. The other responses are not accurate.