A nurse is preparing to collect a sputum specimen from a client. Which of the following actions should the nurse take?

Use sterile gloves to obtain the sputum specimen.

Place the sputum specimen in a clean container.

Collect the sputum specimen in the morning.

Obtain the sputum specimen after the client uses mouthwash.

Answer and Explanation

The Correct Answer is C

A.   Sterile gloves are not necessary for collecting sputum specimens. Clean gloves are typically sufficient.

B.   Sputum specimens should be collected in a sterile container to prevent contamination.
C.   Early morning specimens are preferred due to increased sputum production from the overnight accumulation of secretions.
D.   Mouthwash may contain substances that interfere with sputum culture results, so specimens should be collected before mouthwash use.

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Correct Answer is B

Explanation

A. Extracellular fluid volume deficit (dehydration) typically leads to decreased venous return and reduced preload, resulting in flat or collapsed neck veins, rather than distended ones.
B. In extracellular fluid volume deficit, there is a decrease in blood volume, which can result in postural hypotension when the client changes positions, due to inadequate fluid volume to maintain blood pressure.
C. Extracellular fluid volume deficit is characterized by decreased fluid volume, which leads to decreased tissue perfusion and fluid shifts out of the interstitial spaces, resulting in reduced or absent edema.
D. Bradycardia is not typically associated with extracellular fluid volume deficit.

Instead, tachycardia may occur as a compensatory mechanism to maintain cardiac output in response to decreased blood volume.

A. The client's pupils constrict in response to light. B. The client's tongue is in a midline position: C. The client has a symmetrical smile. D. The client turns their head against resistance.

Correct Answer is C

Explanation

A. This response is associated with cranial nerve II, the optic nerve.

B. Tongue position is associated with cranial nerve XII, the hypoglossal nerve.

C. A symmetrical smile is indicative of cranial nerve VII, the facial nerve.

D. This action is associated with cranial nerve XI, the accessory nerve.

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A nurse is preparing to collect a sputum specimen from a client. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an extracellular fluid volume deficit. Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

A nurse is assessing a client's cranial nerve VII. Which of the following responses should the nurse expect?

Correct Answer is C

Explanation

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A nurse is caring for a client who is 6 hr postoperative following abdominal surgery and is having difficulty voiding. Which of the following actions should the nurse take?

A nurse is preparing to collect a sputum specimen from a client. Which of the following actions should the nurse take?

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