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 A

Explanation

A. Notify the unit charge nurse of the client's reported symptoms immediately: Tingling and numbness can be signs of hyperkalemia, a serious and potentially life-threatening complication from potassium supplementation. Immediate reporting is necessary for prompt evaluation and intervention to prevent cardiac or neuromuscular complications.
B. Reassure the client that the supplement will soon relieve those symptoms: Symptoms like tingling and numbness are not expected side effects of potassium therapy. Reassurance without investigation could delay necessary medical treatment and worsen the client’s condition.
C. Explain that a calcium supplement may be necessary: Calcium supplementation is not the standard response to symptoms of potassium imbalance. Without a clear diagnosis, recommending additional supplements could complicate the clinical situation further.
D. Encourage the client to decrease the intake of dietary sodium: Although reducing sodium is generally beneficial for health, it does not address the acute issue of possible potassium imbalance causing neuromuscular symptoms. Immediate clinical evaluation takes priority.

A. Place the suppository high in the rectum. B. Allow the suppository to soften before insertion. C. Freeze the suppository prior to insertion. D. Avoid use of a lubricant with insertion of the suppository.

Correct Answer is A

Explanation

A. Place the suppository high in the rectum: Inserting the suppository high in the rectum ensures that it is positioned beyond the anal sphincter, where it can be effectively absorbed. Proper placement maximizes the medication's effect and prevents expulsion, which is critical for achieving pain relief and antispasmodic benefits after prostate surgery.
B. Allow the suppository to soften before insertion: Allowing the suppository to soften may make it difficult to insert and can result in incomplete delivery of the medication. A firm suppository is easier to insert properly and ensures accurate medication placement and effectiveness.
C. Freeze the suppository prior to insertion: Freezing the suppository is not recommended because it can make it too hard and sharp, potentially causing trauma to delicate rectal tissues, especially in a postoperative client who may already have increased sensitivity and healing tissues.
D. Avoid use of a lubricant with insertion of the suppository: Using a water-soluble lubricant is important during suppository insertion to minimize mucosal trauma and facilitate smoother placement. Avoiding lubrication can cause unnecessary discomfort and increase the risk of rectal injury.

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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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