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The nurse instructs a female client about collecting a midstream urine sample for culture and sensitivity. Which should the nurse include in client teaching?
- A. Bathe before collecting the specimen.
- B. Cleanse the perineum from front to back.
- C. Label specimen with the provider's name.
- D. Collect urine at the beginning of urination.
Correct Answer: B
Rationale: To prepare properly for collection of a sterile urine specimen, the client cleanses the perineum from front to back using antiseptic swabs. Bathing before a midstream urine collection is unnecessary; however, proper specimen handling is critically important because improper specimen handling can yield inaccurate test results. The specimen should be labeled with the client's name, date, time, and medical record number in addition to the provider's name. The client should begin the flow of urine and collect the sample after starting the flow of urine, and then send the specimen to the laboratory as soon as possible.
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A client is scheduled for an intravenous pyelogram (IVP). Which of the following questions would be most important for the nurse to ask the client in preparation for the procedure?
- A. Have you ever had an IVP before?'
- B. Do you have any allergies to shellfish?'
- C. When was your last bowel movement?'
- D. Have you ever experienced urinary incontinence?'
Correct Answer: B
Rationale: Shellfish allergies may indicate a risk for contrast dye reactions, critical for IVP safety.
A client with a history of peptic ulcer disease is prescribed ranitidine (Zantac). The nurse should instruct the client to take the medication:
- A. With meals
- B. At bedtime
- C. Before breakfast
- D. After exercise
Correct Answer: B
Rationale: Ranitidine, an H2 receptor blocker, is most effective when taken at bedtime to reduce nighttime acid production and promote ulcer healing.
A pregnant woman at 22 weeks' gestation is diagnosed with gonorrhea. The physician orders doxycycline (Vibramycin). The nurse should first:
- A. Inform the client about the effects of the drug.
- B. Make sure the record notes that the baby must receive eyedrops when born.
- C. Have the physician add a single dose of ceftriaxone (Rocephin).
- D. Discuss with the physician the need to change the order.
Correct Answer: D
Rationale: Doxycycline is contraindicated in pregnancy due to risks to the fetus. The nurse should discuss changing the order to a safer alternative, such as ceftriaxone, which is recommended for gonorrhea in pregnancy.
The nurse-manager on the medical unit is teaching the staff about the medication reconciliation policy. The nurse teaches the staff that reconciliation is needed to ensure that clients are on the correct medications in which situations? Select all that apply.
- A. Admission to the hospital.
- B. Transfer to the nursing home.
- C. Transfer of a client from surgery to the surgical unit.
- D. Admission to a home health agency from the hospital.
- E. Move from a double room to a single room on the same unit.
Correct Answer: A,B,C,D
Rationale: Medication reconciliation is required during transitions of care (admission, transfers, discharge to home health) to ensure accuracy. Moving rooms on the same unit does not typically require reconciliation.
You are going to perform gastric lavage for your adult client who was accidentally poisoned. How many mLs of irrigating solution would you instill after each suctioning?
- A. 100 mLs
- B. 250 mLs
- C. 400 mLs
- D. 500 mLs
Correct Answer: B
Rationale: Gastric lavage typically involves instilling 200-300 mL of solution (commonly 250 mL) per cycle to effectively wash out the stomach contents.