A nurse is assessing an older adult client.
Which of the following findings should the nurse expect?

Choice A rationale:

Discard the client's last void at the end of the collection time period. This choice is not appropriate. When conducting a 24-hour urine collection, it's essential to include all urine produced during the specified time frame. Discarding the last void would result in an incomplete and inaccurate collection.

Choice B rationale:

Include toilet paper with the collected urine. This choice is also incorrect. Toilet paper is not typically included in a 24-hour urine collection. The purpose of this collection is to accurately measure substances excreted by the kidneys over a specific time period. Toilet paper is not part of this measurement and should not be included.

Choice D rationale:

This helps prevent the breakdown of certain substances and ensures the sample's accuracy. Failure to refrigerate the urine can lead to inaccurate test results. Now, let's discuss the rationale for the correct answer, choice C:

Choice C rationale:

The first void at the beginning of the collection period is typically discarded, as it represents the urine that was in the bladder before the timed collection started. This helps ensure that the collection is accurate and only includes urine produced during the specified 24-hour period. It's important to follow this protocol to obtain reliable test results.

Choice A rationale:

The statement, "Depression," does not align with the client's promise to go to church every day if they get better. Depression is one of the Kubler-Ross stages of grief, but it does not reflect the client's behavior of making promises to engage in specific activities if they improve. Therefore, this choice does not represent the client's current stage of grief accurately.

Choice B rationale:

The client's statement, "If I get better, I promise to go to church every day," indicates that the client is in the bargaining stage of grief. During this stage, individuals often make deals or promises in an attempt to reverse or delay the terminal diagnosis or adverse outcome. This response reflects the typical behavior associated with the bargaining stage, making it the correct choice.

Choice C rationale:

The statement, "Denial," is not consistent with the client's promise to go to church every day. Denial is a stage in which individuals may refuse to accept the reality of their situation and may not engage in making promises or deals. Therefore, this choice does not accurately represent the client's current stage of grief.

Choice D rationale:

The statement, "Anger," does not align with the client's promise to go to church every day. Anger is another stage of grief, characterized by frustration and resentment, but it does not correspond to the client's behavior of making promises. This choice does not accurately reflect the client's current stage of grief.