A nurse is obtaining a 24-hour urine specimen collection from the patient. Which action should the nurse take?
Testing the urine sample with a reagent strip by dipping in the urine
Withholding all patient medications for the day
Asking the patient to void and discarding that urine to start the collection
Irrigating the sample as needed with sterile solution
The Correct Answer is C
Choice A reason: Testing the urine sample with a reagent strip is not a standard procedure for a 24-hour urine collection. This method is used for spot urine tests to assess parameters like glucose or protein but does not ensure accurate measurement of total urine output or analytes over 24 hours. It introduces potential contamination and is irrelevant to the collection process, which focuses on volume and composition over time.
Choice B reason: Withholding all patient medications is unnecessary and potentially harmful for a 24-hour urine collection. Medications may influence urine composition, but the collection aims to reflect the patient’s normal physiological state, including medication effects. Disrupting medication schedules could alter metabolic or renal function, skewing results and compromising patient health.
Choice C reason: Asking the patient to void and discard the initial urine marks the start of the 24-hour collection period. This ensures all subsequent urine reflects the exact 24-hour timeframe, providing accurate data on volume, electrolytes, and other analytes. This step establishes a clear baseline, preventing inclusion of urine from an undefined prior period.
Choice D reason: Irrigating the sample with sterile solution is inappropriate for a 24-hour urine collection. Adding any solution would dilute the sample, altering its concentration and volume, thus invalidating results for tests like creatinine clearance or protein excretion. The collection requires untouched urine to maintain analytical integrity.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: A negative fecal occult blood test suggests no gastrointestinal bleeding, reducing the urgency for a colonoscopy. Black stool can result from benign causes like iron supplements, so immediate invasive procedures are not warranted without further history or symptoms.
Choice B reason: Assuming a false negative without evidence is premature. Fecal occult blood tests are reliable for detecting bleeding. Black stool may stem from non-bleeding causes like medications or diet, and suggesting a false result could unnecessarily alarm the patient.
Choice C reason: Stress does not directly cause black stool. While stress can exacerbate gastrointestinal issues, black stool is more likely due to dietary factors, medications, or rare conditions. This question is vague and less relevant to the symptom’s likely etiology.
Choice D reason: Iron supplements commonly cause black stool due to the oxidation of iron in the gastrointestinal tract, a benign side effect. Given the negative fecal occult blood test, asking about iron supplements is the most appropriate, targeted response to identify a likely cause.
Correct Answer is C
Explanation
Choice A reason: Antibiotic-associated diarrhea is common due to gut flora disruption, often benign or linked to Clostridium difficile. This statement aligns with expected side effects, requiring monitoring but not immediate further questioning compared to persistent symptoms.
Choice B reason: Green colostomy output can result from dietary changes (e.g., green vegetables) or medications. This is a normal variation and does not warrant urgent questioning unless accompanied by systemic symptoms like fever or pain.
Choice C reason: Strong-smelling liquid stool for several days suggests potential infection, malabsorption, or inflammatory conditions (e.g., C. difficile, colitis). Persistent symptoms warrant further questioning to assess duration, associated symptoms, and risk factors for serious pathology.
Choice D reason: Black, thick stool is a known side effect of ferrous sulfate due to iron oxidation in the gut. This is benign and expected, not requiring further questioning unless other symptoms like bleeding are present.
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