A nurse on a medical unit is planning the shift assignments. The nurse may delegate collection of which of the following specimens to an assistive personnel (AP)? (Select all that apply.)

A. "This medication does not prevent sexually transmitted infections.": While it is important for clients to understand that sildenafil does not provide protection against STIs, this information is educational rather than immediately safety-related. It is important but not the highest priority.

B. "Take the medication before you plan to engage in sexual intercourse.": Proper timing of sildenafil is necessary for efficacy, but incorrect timing does not pose an immediate life-threatening risk. This instruction focuses on therapeutic effectiveness rather than urgent safety.

C. "This medication can cause a headache.": Headache is a common side effect due to vasodilation, but it is generally mild and self-limiting. Although clients should be aware, it is not a priority safety concern.

D. "If you have an erection for more than four hours, seek emergency treatment.": Priapism is a rare but serious adverse effect of sildenafil that can cause permanent tissue damage and erectile dysfunction if not treated promptly. Educating the client about this risk is the highest priority because it involves immediate, potentially irreversible harm.

A. Instruct the client to remain NPO 8 hr before the procedure: Kidney biopsies are typically performed under local anesthesia with sedation, not general anesthesia, so strict NPO status is usually unnecessary unless sedation is planned. Routine NPO for 8 hours is not a standard requirement for all clients.

B. Review the coagulation studies before the procedure: Kidney biopsy involves inserting a needle into highly vascular renal tissue, which carries a significant risk of bleeding. Reviewing coagulation studies (e.g., PT, INR, platelet count) ensures that the client’s blood clotting ability is adequate and minimizes the risk of post-procedure hemorrhage, making this a priority action.

C. Inform the client that the biopsy is performed while lying supine during the procedure: Kidney biopsies are usually performed with the client lying prone, often with a pillow under the abdomen to better expose the kidney.

D. Administer a cleansing enema before the procedure: A cleansing enema is not required for a kidney biopsy because the procedure does not involve the gastrointestinal tract. Administering one is unnecessary and does not affect the safety or success of the biopsy.