A nurse is reinforcing teaching with a client about how to collect a stool specimen. Which of the following instructions should the nurse include?
Urinate after the specimen collection.
Keep the specimen in a warm area.
Place 1.3 cm (0.5 in) of formed stool into a culture tube.
Avoid placing toilet tissue in the bedpan after defecation.
The Correct Answer is D
Choice A reason: This is incorrect because the client should urinate before the specimen collection to avoid contaminating the stool with urine.
Choice B reason: This is incorrect because the specimen should be kept in a cool area to prevent bacterial growth and decomposition.
Choice C reason: This is incorrect because the client should place at least 2.5 cm (1 in) of formed stool or 15 to 30 mL of liquid stool into a culture tube.
Choice D reason: This is correct because the client should avoid placing toilet tissue in the bedpan after defecation to prevent interfering with the laboratory analysis of the stool.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is incorrect because suggesting a feeding tube is premature and may alarm the son without knowing the cause of the client's poor appetite.
Choice B reason: This is incorrect because asking why the son thinks the client is not eating may imply that the son is responsible or has the answer, which may make him feel defensive or guilty.
Choice C reason: This is incorrect because dismissing the son's concern as nothing serious may make him feel unheard or invalidated, and may also delay seeking appropriate help for the client.
Choice D reason: This is correct because asking the son to tell more about what happens at mealtime is an open-ended question that shows interest and empathy, and may elicit more information about the client's condition and preferences.
Correct Answer is B
Explanation
Choice A reason: Client instructed on self-care needs is not a specific or accurate documentation. The nurse should include the details of the instruction, such as the topics covered, the teaching methods used, the client's response, and the evaluation of learning.
Choice B reason: Oral temperature elevated at 0800 is a specific and accurate documentation. The nurse should include the vital signs and any abnormal findings, such as fever, in the client's health record. The nurse should also report the elevation to the provider and monitor the client for signs of infection.
Choice C reason: Episiotomy approximated, 3 cm (1.18 in) in length is not a specific or accurate documentation. The nurse should include the type, location, and degree of the episiotomy, as well as the condition of the wound, the presence of edema, erythema, or drainage, and the interventions performed.
Choice D reason: Client drank adequate amounts of fluid with meals is not a specific or accurate documentation. The nurse should include the exact amount and type of fluid intake, as well as the output, in the client's health record. The nurse should also assess the client for signs of dehydration or fluid overload.
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