When initiating a 24 hour urine collection, which action should the practical nurse (PN) take?

Maintain sterile technique during specimen collection.

Assist the client to cleanse the perineal area prior to voiding.

Instruct the client to discard the first voided specimen.

Insert an indwelling urinary catheter.

Answer and Explanation

The Correct Answer is C

A. Maintain sterile technique during specimen collection: Sterile technique is required for urine cultures, not for 24-hour urine collections. For a timed urine collection, clean collection techniques are sufficient to accurately measure excretion over a full day.
B. Assist the client to cleanse the perineal area prior to voiding: While perineal hygiene is important, it is not the primary step when starting a 24-hour urine collection. The critical action is ensuring that the first void is discarded to properly begin timing the collection period.
C. Instruct the client to discard the first voided specimen: The first void is discarded to ensure the collection accurately measures substances excreted during the full 24-hour period. Timing officially starts after discarding the initial urine, and every subsequent void must be collected.
D. Insert an indwelling urinary catheter: Inserting an indwelling catheter is unnecessary unless the client is unable to void independently. Most 24-hour urine collections are performed using normal voiding and collection into a clean container.

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Correct Answer is B

Explanation

A. Show the UAP how to use a transfer belt to safely move the client: A transfer belt is useful for clients who can bear some weight and follow instructions. Since the client is confused and cannot bear weight, using a transfer belt is unsafe and increases the risk of injury.
B. Work with the UAP to use a mechanical lift and sling for the transfer: A mechanical lift provides the safest method for transferring a confused, non-weight-bearing client. It minimizes the risk of injury to both the client and staff while ensuring the transfer is done safely and correctly.
C. Instruct the UAP to use a pivot technique when moving the client: Pivot techniques require the client to bear weight and follow simple directions, neither of which is appropriate given the client's confusion and inability to bear weight.
D. Notify the charge nurse that the client cannot be transferred: While updating the charge nurse may eventually be needed, the immediate action is to modify the transfer method to ensure the client's needs are safely met using appropriate equipment.

A. Synergistic actions. B. Cumulative effects. C. Idiosyncratic responses. D. Antagonistic reactions.

Correct Answer is B

Explanation

A. Synergistic actions: Synergistic effects occur when two drugs enhance each other’s action, but they are not the primary concern after one week of stable medication use. While important to monitor, they are less critical than cumulative effects in older adults who have slower drug metabolism.
B. Cumulative effects: Cumulative effects are the most important to assess in an older adult because aging decreases liver and kidney function, slowing drug metabolism and excretion. This can lead to drug buildup in the body, increasing the risk of toxicity even when medications have been taken as prescribed.
C. Idiosyncratic responses: Idiosyncratic reactions are unpredictable and not dose-dependent. They are important but tend to occur early in therapy rather than after a week of consistent medication use, making them less of a focus at this stage.
D. Antagonistic reactions: Antagonistic reactions, where drugs block each other's effects, are possible but would generally present early during therapy. After a week of stable use without new drugs added, cumulative buildup remains the greater priority for safe ongoing care.

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When initiating a 24 hour urine collection, which action should the practical nurse (PN) take?

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Naxlex Comprehensive Predictor Exams

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Explanation

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