The healthcare provider prescribes a 24-hour urine specimen to be collected for creatinine clearance. The client is eager to go home and tells the nurse that the first sample was put in the urinal 2 hours ago. Which action should the nurse implement?

Start collecting the specimen with the next void.

Begin the collection the next day.

Observe the sample for sediment.

Empty the sample into the 24-hour container.

Answer and Explanation

The Correct Answer is A

The correct answer is A. Start collecting the specimen with the next void.

Choice A reason: The 4-hour urine collection for creatinine clearance should start with an empty bladder. The first urine of the day is discarded and the time is noted. All subsequent urine for the next 4 hours, including the first urine the following day, should be collected. If the first sample was put in the urinal hours ago and was not collected, the nurse should start collecting the specimen with the next void.

Choice B reason: Beginning the collection the next day would delay the test and may not be necessary. The test should ideally start after the first urine of the day is discarded.

Choice C reason: Observing the sample for sediment is not typically part of the procedure for a 4-hour urine collection for creatinine clearance. The focus is on collecting all urine for a specified period, not on the physical characteristics of the sample.

Choice D reason: Emptying the sample into the 4-hour container would be incorrect if the sample was the first urine of the day, which should be discarded. The collection should start with the next void.

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Correct Answer is C

Explanation

Choice A reason: Offering reassurance that she is not alone is not the best action to take first. It may sound dismissive of her feelings and make her feel more isolated.

Choice B reason: Explaining that alternative treatment options may be helpful is not the best action to take first. It may give false hope or imply that the wife is not accepting the reality of her husband's condition.

Choice C reason: Encouraging the wife to share her feelings is the best action to take first. It shows empathy and respect for her emotional state. It also allows the nurse to assess her coping skills and provide appropriate support.

Choice D reason: Reminding her that her husband may still live a long time is not the best action to take first. It may contradict the medical prognosis and make the wife feel more confused and anxious.

A. Obtain the specimen from the client's current bowel movement. B. Contact the healthcare provider before obtaining the specimen. C. Withhold specimen collection until tarry black stool is observed. D. Wait to obtain the specimen until observable blood is present.

Correct Answer is A

Explanation

Choice A reason: This is the correct action because the nurse should obtain the specimen as soon as possible to avoid delays in diagnosis and treatment. The color and consistency of the stool do not affect the test for occult blood.

Choice B reason: This is not necessary because the nurse does not need to obtain a prescription or approval from the healthcare provider to collect a stool specimen for occult blood. The nurse should follow the standard protocol for specimen collection and labeling.

Choice C reason: This is incorrect because withholding specimen collection until tarry black stool is observed would delay the detection of occult blood. Tarry black stool indicates a bleeding source in the upper gastrointestinal tract, while occult blood can be present in any part of the gastrointestinal tract.

Choice D reason: This is also incorrect because waiting to obtain the specimen until observable blood is present would also delay the detection of occult blood. Observable blood indicates a bleeding source in the lower gastrointestinal tract, while occult blood can be present in any part of the gastrointestinal tract.

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The healthcare provider prescribes a 24-hour urine specimen to be collected for creatinine clearance. The client is eager to go home and tells the nurse that the first sample was put in the urinal 2 hours ago. Which action should the nurse implement?

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Naxlex Comprehensive Predictor Exams

A client's wife has just learned that her husband is terminally ill. She is sitting in the corner of the client's room crying, and says to the nurse, "I feel as if I'm already so alone." Which action should the nurse take first?

Correct Answer is C

Explanation

While preparing to obtain a stool specimen for occult blood, the nurse observes that the client's feces is soft, solid, and light brown. Which action should the nurse implement?

Correct Answer is A

Explanation

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