The healthcare provider prescribes a 24-hour urine specimen to be collected for creatinine clearance. The client is eager to go home and tells the nurse that the first sample was put in the urinal 2 hours ago. Which action should the nurse implement?

Start collecting the specimen with the next void.

Begin the collection the next day.

Observe the sample for sediment.

Empty the sample into the 24-hour container.

Answer and Explanation

The Correct Answer is A

The correct answer is A. Start collecting the specimen with the next void.

Choice A reason: The 4-hour urine collection for creatinine clearance should start with an empty bladder. The first urine of the day is discarded and the time is noted. All subsequent urine for the next 4 hours, including the first urine the following day, should be collected. If the first sample was put in the urinal hours ago and was not collected, the nurse should start collecting the specimen with the next void.

Choice B reason: Beginning the collection the next day would delay the test and may not be necessary. The test should ideally start after the first urine of the day is discarded.

Choice C reason: Observing the sample for sediment is not typically part of the procedure for a 4-hour urine collection for creatinine clearance. The focus is on collecting all urine for a specified period, not on the physical characteristics of the sample.

Choice D reason: Emptying the sample into the 4-hour container would be incorrect if the sample was the first urine of the day, which should be discarded. The collection should start with the next void.

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Correct Answer is A

Explanation

Choice A reason: Smoking cessation is the most important lifestyle modification for the nurse to encourage. Smoking is a major risk factor for cardiac disease, as it increases blood pressure, heart rate, and oxygen demand, and damages the blood vessels and the heart muscle. Quitting smoking can reduce the risk of cardiac disease by 50% within one year.

Choice B reason: Regular exercise is a beneficial lifestyle modification for the nurse to encourage, but not the most important one. Exercise can improve cardiovascular fitness, lower blood pressure, and reduce body weight, but it does not eliminate the harmful effects of smoking on the heart and blood vessels.

Choice C reason: A low-fat diet is a helpful lifestyle modification for the nurse to encourage, but not the most important one. A low-fat diet can lower cholesterol levels and prevent atherosclerosis, but it does not reverse the damage caused by smoking to the heart and blood vessels.

Choice D reason: Stress reduction is a useful lifestyle modification for the nurse to encourage, but not the most important one. Stress can trigger the release of hormones that increase blood pressure, heart rate, and oxygen demand, and can also lead to unhealthy behaviors such as smoking, overeating, and alcohol abuse. However, stress reduction alone does not address the direct effects of smoking on the heart and blood vessels.

A. Apply lubricant to the cannula tubing. B. Place padding around the cannula tubing. C. Decrease the flow rate to 1 L/minute. D. Discontinue the use of the nasal cannula.

Correct Answer is B

Explanation

Choice A reason: Applying lubricant to the cannula tubing is not the best intervention as it may cause irritation or infection of the nasal mucosa. The nurse should use water-soluble gel or saline spray to moisten the nasal passages if needed.

Choice B reason: Placing padding around the cannula tubing is the best intervention as it prevents friction and pressure on the skin. The nurse should use soft materials such as gauze or foam to cushion the tubing and check the skin integrity frequently.

Choice C reason: Decreasing the flow rate to 1 L/minute is not an appropriate intervention as it may compromise the client's oxygenation. The nurse should maintain the prescribed flow rate and monitor the client's vital signs and oxygen saturation.

Choice D reason: Discontinuing the use of the nasal cannula is not an option as it may endanger the client's life. The nurse should continue the oxygen therapy as ordered and provide comfort measures and education to the client.

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The healthcare provider prescribes a 24-hour urine specimen to be collected for creatinine clearance. The client is eager to go home and tells the nurse that the first sample was put in the urinal 2 hours ago. Which action should the nurse implement?

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Naxlex Comprehensive Predictor Exams

A client with a family history of cardiac disease is seeking information to control risk factors. Which lifestyle modification is most important for the nurse to encourage?

Correct Answer is A

Explanation

The nurse observes that there are reddened areas on the cheekbones of a client receiving oxygen per nasal cannula at 3 L/minute, and the client's oxygen saturation level is 92%. Which intervention would the nurse implement?

Correct Answer is B

Explanation

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