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.
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.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is an incorrect statement as it implies that breaking eye contact is beneficial for the client. In fact, breaking eye contact may reduce the client's trust and rapport with the nurse. The nurse should maintain eye contact as much as possible and use verbal and nonverbal cues to show active listening.
Choice B reason: This is an incorrect statement as it implies that electronic documentation is mandatory for all interviews. In fact, electronic documentation is not a legal obligation, but a preferred method of recording the assessment data. The nurse should follow the facility's policy and procedure for electronic documentation and ensure the accuracy, completeness, and confidentiality of the record.
Choice C reason: This is the correct statement as it acknowledges the challenge of electronic documentation during an interview. The nurse may miss some important nonverbal cues from the client, such as facial expressions, gestures, or posture, while typing on the computer. The nurse should balance the time spent on the computer and the time spent on the client and use open-ended questions and reflective statements to elicit more information.
Choice D reason: This is an incorrect statement as it implies that electronic documentation is beneficial for the interview process. In fact, electronic documentation may interfere with the flow and quality of the interview. The client may feel rushed or ignored by the nurse's attention to the computer. The nurse should pace the interview according to the client's needs and preferences and use electronic documentation as a tool, not a barrier.
Correct Answer is D
Explanation
Choice A reason: Reviewing the chart for number of voids over the last 24 hours is not the best action to evaluate the client for urinary retention. It may provide some information about the client's urinary pattern, but it does not indicate the amount of urine left in the bladder after voiding.
Choice B reason: Palpating the suprapubic region for distention is a useful action to assess the client for urinary retention, but it is not the most accurate or reliable method. It may be difficult to palpate the bladder if the client is obese, has abdominal pain, or has bowel distention.
Choice C reason: Evaluating the client for urinary incontinence is not relevant to the assessment of urinary retention. Urinary incontinence is the involuntary loss of urine, while urinary retention is the inability to empty the bladder completely.
Choice D reason: Scanning the client's bladder after voiding is the best action to evaluate the client for urinary retention. It is a noninvasive and precise technique that measures the post-void residual urine volume. A normal post-void residual is less than 50 mL, while a high post-void residual indicates urinary retention.

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