The nurse plans to collect a 24 hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the adult male client?

Urinate immediately into a urinal, and the laboratory will collect the specimen every 6 hours, for the next 24 hours.

Cleanse around the meatus, discard first portion of voiding, and collect the rest in a sterile bottle.

For the next 24 hours, notify nurse when the bladder is full, and the nurse will collect catheterized specimens.

Urinate at a specified time, discard this urine, and collect all subsequent urine during the next 24 hours.

Answer and Explanation

The Correct Answer is D

A. Urinate immediately into a urinal, and the laboratory will collect the specimen every 6 hours, for the next 24 hours: Intermittent collection is not used for a 24-hour urine test; continuous collection of all urine after the start time is required to accurately measure creatinine clearance.

B. Cleanse around the meatus, discard first portion of voiding, and collect the rest in a sterile bottle: This procedure is for a clean-catch or midstream urine specimen, not a 24-hour collection, and does not provide the total volume needed for creatinine clearance.

C. For the next 24 hours, notify nurse when the bladder is full, and the nurse will collect catheterized specimens: Catheterization is unnecessary for routine 24-hour urine collection and increases infection risk. The client can collect urine in a provided container.

D. Urinate at a specified time, discard this urine, and collect all subsequent urine during the next 24 hours: Discarding the first void establishes the start of the collection period, and collecting all urine for the next 24 hours ensures accurate measurement of creatinine clearance.

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Correct Answer is B

Explanation

A. Polydipsia and polyuria: These symptoms are more commonly associated with uncontrolled diabetes mellitus rather than hypertension. They are not direct complications of elevated blood pressure.

B. Elevated blood urea nitrogen: Hypertension can damage renal blood vessels, leading to impaired kidney function and elevated BUN levels. This is a significant complication that indicates progressive end-organ damage.

C. Dry and irritated skin: This is a nonspecific symptom that may result from dermatologic conditions, dehydration, or environmental factors. It is not typically associated with hypertension complications.

D. New onset of bradycardia: Bradycardia is not a usual complication of hypertension itself, though it may occur as a side effect of certain antihypertensive medications such as beta-blockers. It is not a primary complication to anticipate.

A. Prone. B. Sims. C. Supine. D. Fowlers.

Correct Answer is C

Explanation

A. Prone: Prone positioning limits assessment of spinal curvature, extremity alignment, and body symmetry because the client is lying on the abdomen, which can obscure certain postural deviations.

B. Sims: Sims position is primarily used for rectal or vaginal procedures and does not provide a full view of overall body alignment, making it less ideal for assessment purposes.

C. Supine: Supine position allows the client to lie flat on the back with the body fully supported. This position provides the best view of the head, neck, spine, shoulders, hips, and extremities for a comprehensive assessment of body alignment.

D. Fowlers: Fowlers position elevates the head and torso, which may alter natural spinal alignment and obscure an accurate assessment of posture and symmetry compared with a flat, supine position.

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The nurse plans to collect a 24 hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the adult male client?

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