A nurse is teaching an adolescent about the procedure for completing a 24-hr urine test. Which of the following statements by the adolescent indicates an understanding of the teaching?
"I will include toilet paper that falls into the urine as part of the collected sample."
"I will throw out my first urine sample when I start the urine collection."
"I can stop the urine test earlier than 24 hours if I fill up the collection container."
"I can discard urine while I am at school if I keep track of the number of times I void."
The Correct Answer is B
A. "I will include toilet paper that falls into the urine as part of the collected sample.": Contamination of the urine specimen with toilet paper or other foreign material can alter test results and compromise accuracy. The collection container should receive urine only, and any contaminated sample should be discarded and reported.
B. "I will throw out my first urine sample when I start the urine collection.": A 24-hour urine collection begins after discarding the first void to ensure the bladder is empty at the start time. All urine produced after that point, including the final void at 24 hours, is collected to provide an accurate measurement.
C. "I can stop the urine test earlier than 24 hours if I fill up the collection container.": Stopping the collection early results in incomplete data and invalid test results. If the container becomes full, an additional container should be obtained so the full 24-hour collection can be completed.
D. "I can discard urine while I am at school if I keep track of the number of times I void.": Every void during the 24-hour period must be collected regardless of location. Missing any urine output makes the test inaccurate, even if the number of voids is recorded.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["15"]
Explanation
- Calculate the total daily dose based on weight
Total Daily Dose = 50 mg/kg × 30 kg
= 1,500 mg/day
- Divide the total daily dose by the number of doses per day
Doses per day = every 6 hours → 24 ÷ 6
= 4 doses/day
Dose per administration = 1,500 ÷ 4
= 375 mg per dose
- Calculate the volume to administer per dose
Available Concentration: 125 mg/5 mL → 125 mg in 5 mL
Volume to administer = (Dose per Administration ÷ Available Dose) × Volume
= (375 ÷ 125) × 5
= 3 × 5
= 15 mL
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Rationale for correct choices
• Hydromorphone: The child reports severe pain increasing from 7/10 to 10/10 in the right knee, indicating a vaso-occlusive crisis typical of sickle cell disease. Hydromorphone, a potent opioid analgesic, is appropriate for managing severe pain unrelieved by milder medications. Prompt administration improves comfort, reduces physiological stress, and prevents complications from prolonged pain.
• Pain: The child’s pain is the direct result of ischemia caused by sickled red blood cells obstructing blood flow to the extremity. Pain intensity and the presence of swelling and warmth support the need for opioid analgesia. Managing pain effectively is a priority to reduce the risk of further complications such as joint damage or prolonged hospitalization.
Rationale for incorrect choices
• Antibiotics: The child’s WBC count is within normal limits, and there are no signs of infection such as fever, purulent drainage, or systemic symptoms. Antibiotics are not indicated for vaso-occlusive crisis unless a concurrent infection is suspected. Empiric antibiotic use without evidence of infection is unnecessary.
• IV fluids: While hydration is important in sickle cell disease, the primary issue in this scenario is acute pain. There is no evidence of dehydration, and vital signs and skin turgor are within normal limits. IV fluids may be considered adjunctively, but the immediate anticipated prescription is for pain management.
• Dehydration: The child’s assessment does not indicate dehydration; vital signs are stable, mucous membranes are not dry, and capillary refill is normal. Addressing dehydration is not the priority at this time compared with pain control.
• WBC levels: The WBC count is 9,500/mm³, within normal limits, and does not necessitate intervention. Elevated WBC levels would indicate infection risk, but in this case, WBC monitoring is routine and not the reason for opioid administration.
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