A 55-year-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which statement should the nurse include in her teaching about this medication?

"This medication will need to be stored at room temperature."

"This medication is being given because your kidneys are not properly producing erythropoietin."

"This medication will delay your need for dialysis as long as you take it."

"This medication will help prevent your AV fistula from clotting."

Answer and Explanation

The Correct Answer is B

Choice A rationale
Storing the medication at room temperature is a practical instruction but does not explain the therapeutic purpose of the medication, which is essential for patient understanding.

Choice B rationale
Epoetin alfa (Procrit) is used to treat anemia associated with chronic kidney disease by supplementing erythropoietin, a hormone the damaged kidneys can no longer produce effectively. This is the most informative statement for the patient's understanding of the medication's purpose.

Choice C rationale
While epoetin alfa can improve anemia and potentially improve quality of life, it does not directly delay the need for dialysis, which is determined by overall kidney function and not solely by the presence of anemia.

Choice D rationale
Epoetin alfa does not have a role in preventing AV fistula clotting. It is specifically used to stimulate red blood cell production and has no direct effect on clotting mechanisms.

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Correct Answer is B

Explanation

Choice A rationale
Potassium levels are not directly affected by lactulose. While cirrhosis can lead to imbalances in electrolytes, including potassium, lactulose is not used to manage potassium levels in the bloodstream.

Choice B rationale
Ammonia is produced by the breakdown of proteins in the intestines and is normally processed by the liver. In cirrhosis, the liver's ability to convert ammonia to urea is impaired, leading to increased levels in the blood. Lactulose helps reduce blood ammonia levels by converting it into ammonium, which is then excreted.

Choice C rationale
Bicarbonate levels are related to the body's pH balance and are not the target of lactulose treatment. Cirrhosis does not typically result in bicarbonate imbalances that would be treated with lactulose.

Choice D rationale
Glucose levels are managed by insulin and other metabolic processes, not lactulose. While cirrhosis can affect overall metabolism, lactulose does not have a direct effect on blood glucose levels.

A. Tell the patient to clean the urethral area, void a small amount into the toilet, then void directly into a sterile container. B. Have the patient empty the bladder completely; then obtain the next urine specimen that the patient is able to void. C. Clean the area around the patient's meatus with a povidone-iodine (Betadine) swab and then have the patient void into a sterile specimen cup. D. Insert a short sterile "mini" catheter attached to a collecting container into the urethra and bladder to obtain the specimen.

Correct Answer is A

Explanation

Choice A rationale
This method is the standard procedure for obtaining a clean-catch midstream urine specimen. The initial voiding washes away organisms near the meatus, and the midstream urine is less likely to be contaminated by bacteria from the skin or urethral area, providing a sample that more accurately represents the bacteria in the bladder.

Choice B rationale
Having the patient empty the bladder completely and then obtaining the next specimen does not ensure a clean-catch sample. This method could lead to contamination of the specimen with bacteria from the skin or urethral area.

Choice C rationale
Cleaning the area with povidone-iodine is not recommended for routine urine culture as it may kill some of the bacteria, leading to a false-negative result. The standard practice is to clean the area with mild soap and water.

Choice D rationale
Inserting a catheter is an invasive procedure and is not the first choice for obtaining a urine specimen. It is used when a patient is unable to provide a clean-catch specimen or if there are specific medical indications.

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A 55-year-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which statement should the nurse include in her teaching about this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A female patient with a suspected urinary tract infection is to provide a clean-catch midstream urine specimen for culture and sensitivity testing. What should the nurse do to obtain the specimen?

Correct Answer is A

Explanation

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