Nokea
The nurse preceptor observes a graduate practical nurse collecting a urine sample for urinalysis and culture as pictured in the exhibit. What is the preceptor's best action?
- A. Advise the graduate nurse to discard the collected urine specimen and record the output
- B. Advise the graduate nurse to use a sterile specimen cup rather than a graduated container for collection
- C. Explain to the graduate nurse that midstream clean catch or straight catheterization is required
- D. Remind the graduate nurse that the specimen should be kept cool until it is sent to the laboratory
Correct Answer: C
Rationale: Urine for culture requires a midstream clean catch or catheterization (C) to avoid contamination. A graduated container (B) is acceptable if sterile. Discarding (A) is unnecessary, and cooling (D) is secondary.
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The mother of a newborn asks why the nurse is checking the baby's nose. The nurse replies that it is important to check nasal patency because the newborn:
- A. does not have the ability to sneeze.
- B. must breathe through his nose.
- C. is subject to periods of apnea.
- D. has rapid respirations.
Correct Answer: B
Rationale: Newborns are obligate nose breathers, making nasal patency critical to prevent respiratory distress. Sneezing ability, apnea, or rapid respirations are unrelated.
The nurse is screening clients for those at risk of developing nephrolithiasis. Which of the following factors would increase a client's risk of developing nephrolithiasis?
- A. gout
- B. dehydration
- C. hypokalemia
- D. thrombocytopenia
- E. hyperparathyroidism
Correct Answer: A,B,E
Rationale: Gout (A), dehydration (B), and hyperparathyroidism (E) increase nephrolithiasis risk due to uric acid, concentrated urine, and calcium imbalances, respectively. Hypokalemia (C) and thrombocytopenia (D) are unrelated.
The nurse is caring for a newborn who has a large myelomeningocele. It would be a priority for the nurse to
- A. check the newborn's anus for muscle tone
- B. cover the area with a sterile, moist dressing
- C. measure the occipital frontal circumference
- D. place the newborn in the supine position
Correct Answer: B
Rationale: A myelomeningocele requires a sterile, moist dressing (B) to prevent infection and drying. Checking anus tone (A), measuring head circumference (C), and supine positioning (D) are secondary or contraindicated.
The nurse is reinforcing teaching on self-administering ophthalmic lubricating ointment medication to a client with newly diagnosed Sjogren's syndrome. Which client statement indicates the need for further teaching?
- A. After applying the ointment, I'll close my eyes tightly and rub the lid for 2-3 minutes.
- B. I'll squeeze a thin strip of ointment on my lower eyelid, from the inner to the outer edge.
- C. I'll tilt my head back, pull my lower lid down, and look upward when administering the ointment.
- D. I'll use my ointment at bedtime and my eyedrops during the day.
Correct Answer: A
Rationale: Rubbing the eyes after applying ointment (A) can cause irritation or displace the medication, indicating a need for further teaching. The other statements (B, C, D) reflect correct administration techniques.
A 2-year-old who swallowed an overdose of adult cough syrup is being discharged from the emergency department. The parent says to the nurse, 'From now on, I'm going to store all medicines in my top dresser drawer.' Which is the best response by the nurse?
- A. Can you lock your dresser drawer?
- B. Make sure all of your medicines have childproof caps.
- C. That sounds like a safe plan.
- D. You need to keep an eye on your child at all times.
Correct Answer: A
Rationale: A locked drawer (A) ensures safety. Childproof caps (B) are helpful but insufficient alone. The plan (C) is unsafe without a lock, and constant supervision (D) is unrealistic.