A nurse is providing instruction to a client about obtaining a clean-catch urine specimen. Which of the following instructions should the nurse provide?

"Catch the urine that initially comes out."

"Spread your labia with your nondominant hand."

Wash your perineum in a circular motion."

"Cleanse the perineum from back to front."

Answer and Explanation

The Correct Answer is B

A. "Catch the urine that initially comes out." The initial stream may contain contaminants from the urethra or perineum. For a clean-catch specimen, the first portion should be voided into the toilet, and the midstream should be collected in the container.

B. "Spread your labia with your nondominant hand." Spreading the labia exposes the urethral opening and helps prevent contamination of the urine sample from surrounding tissues. It is an essential step in proper clean-catch technique.

C. "Wash your perineum in a circular motion." The recommended cleaning motion is front to back, not circular. Circular motion does not ensure proper directionality to avoid contamination from the anal area.

D. "Cleanse the perineum from back to front." Cleaning from back to front increases the risk of introducing fecal organisms into the urethra and should be avoided. Proper hygiene involves cleansing from front to back.

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Correct Answer is ["A","B","C","F","G"]

Explanation

A. Assist the client to the left lateral position: Repositioning improves uteroplacental perfusion, especially in the presence of variable decelerations. The left lateral position relieves pressure on the inferior vena cava, promoting fetal oxygenation.

B. Administer oxygen at 10 L/min via nonrebreather face mask: Oxygen is indicated to improve fetal oxygenation during nonreassuring FHR patterns like recurrent variable decelerations and minimal variability, both of which are present in this scenario.

C. Notify the provider of the client's condition: The combination of recurrent variable decelerations, minimal variability, and a history of meconium-stained fluid warrants immediate provider notification to assess further interventions and potential fetal compromise.

D. Request a prescription for oxytocin: Oxytocin stimulates uterine contractions and may worsen fetal distress in the presence of variable decelerations or minimal variability. It is contraindicated until the fetal status is stabilized.

E. Request a prescription for hydralazine: Hydralazine is used to treat hypertension. The client’s blood pressure is within normal range and does not require antihypertensive management at this time.

F. Prepare to administer an amnioinfusion: Amnioinfusion is indicated to dilute meconium-stained amniotic fluid and relieve cord compression, both of which are suggested by the variable decelerations and green-stained fluid earlier.

G. Initiate a bolus of IV fluid: IV fluid bolus improves maternal blood volume and uteroplacental perfusion, which can help resolve variable decelerations and increase fetal oxygenation during nonreassuring FHR patterns.

A. Whole wheat pasta B. Strawberries C. Rye toast D. Brussels sprouts

Correct Answer is B

Explanation

A. Whole wheat pasta: Whole wheat products are high in insoluble fiber, which can exacerbate symptoms of irritable bowel syndrome (IBS) like bloating and cramping. Clients with IBS often tolerate soluble fiber better than insoluble fiber.

B. Strawberries: Strawberries are a low- (Fermentable Oligo-, Di-, Mono-saccharides And Polyols) FODMAP fruit and generally well tolerated in IBS. They contain soluble fiber, which can help regulate bowel movements without worsening gas or bloating, making them a suitable choice.

C. Rye toast: Rye contains high levels of fructans, a type of fermentable carbohydrate that can trigger IBS symptoms such as gas, bloating, and discomfort, especially in clients sensitive to FODMAPs.

D. Brussels sprouts: These are known to cause gas and bloating due to their high content of fermentable carbohydrates. They are often poorly tolerated by individuals with IBS and should be limited or avoided.

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A nurse is providing instruction to a client about obtaining a clean-catch urine specimen. Which of the following instructions should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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