Nursing Chapter 34 Rationale Cleaning The Perineal Area From Back

4. Wear goggles.

Question 18

Type: MCSA

A client is having a lumbar puncture. In which position should the nurse place the client?

1. Lateral with head bent toward the chest and knees flexed onto the abdomen

2. Lying prone, with the knees drawn up toward the abdomen

3. Sitting bent over from the waist with legs extended

4. Supine with knees pulled toward the chest

Question 19

Type: MCSA

A client is scheduled to have abdominal ascites fluid removed. What should the nurse instruct the client about this

procedure?

1. A catheter will be inserted into the bladder.

2. A liver biopsy will be done.

3. An abdominal paracentesis will be done.

4. A thoracentesis will be done.

Question 20

Type: MCMA

The nurse is providing care to a client during the posttest phase of diagnostic testing. What will the nurse do

during this phase?

Standard Text: Select all that apply.

1. Provide emotional and physical support to the client.

2. Compare the previous and current test results.

3. Prepare the client for the test.

4. Modify nursing interventions as necessary.

5. Report the results to appropriate health team members.

Question 21

Type: MCSA

The nurse needs to collect a specimen from a client; however, the nurse has never collected this type of specimen

in the past. What should the nurse do?

1. Notify the physician.

2. Ask another nurse to collect the specimen.

3. Consult the nursing procedure manual.

4. Delegate the collection of the specimen to unlicensed assistive personnel.

Question 22

Type: MCSA

An older client is having difficulty handling the specimen cup for a clean catch urine specimen. What can the

nurse do to help this client?

1. Provide a clean funnel to pour the urine into the specimen cup.

2. Document that the specimen could not be obtained.

3. Catheterize the client for the specimen.

4. Ask the physician to obtain the specimen.

Question 23

Type: MCSA

A client is scheduled for a nuclear imaging test. What should the nurse instruct the client about this test?

1. It is the use of a magnetic field to produce an image of a body part or organ.

2. A radioisotope will be injected to determine organ functioning as being either hot or cold.

3. It produces a three-dimensional image of an organ.

4. It is more sensitive than an x-ray image.

Question 24

Type: MCMA

The nurse is instructing a female client on how to cleanse the perineum before collecting a clean catch urine

specimen for culture and sensitivity. What should the nurse instruct this client to do?

Standard Text: Select all that apply.

1. Clean the perineal area using a circular motion.

2. Use all towelettes provided.

3. Use each towelette once, and discard.

4. Clean the perineal area from back to front.

5. Clean the perineal area from front to back.

Question 25

Type: MCMA

Unlicensed assistive personnel (UAP) will be conducting a test on a client’s urine. What should the nurse instruct

the UAP about the test?

Standard Text: Select all that apply.

1. Nothing, because the UAP can perform urine testing.

2. Remind the UAP to tell the client the results of the test.

3. Notify the physician with the results of the test.

4. Report the results of the test to the nurse.

5. Save the urine, in case the nurse wants to repeat the test.

Question 26

Type: MCSA

A client is having a timed urine collection done. The unlicensed assistive personnel does not save one specimen.

What should the nurse do?

1. Continue with the test, and document that one specimen is missing.

2. End the test immediately, and send what is collected to the laboratory.

3. Document that the test cannot be completed.

4. Start the test over.

Question 27

Type: MCMA

The nurse is caring for a client who has just had a lumbar puncture. What should the nurse document about this

client’s procedure?

Standard Text: Select all that apply.

1. Date and time performed

2. The physician’s name

3. The client’s ability to void after the procedure

4. The color, character, and amount of cerebrospinal fluid withdrawn

5. The client’s status after the procedure

Question 28

Type: MCMA

A client has just completed a bone marrow biopsy. What should the nurse document about the client at this time?

Standard Text: Select all that apply.

1. Client’s tolerance of the procedure

2. Bowel sounds

3. The site for bleeding

4. Status of deep tendon reflexes

5. Presence of pain and any pain medication received

Question 29

Type: MCMA

A client is scheduled for a bronchoscopy. What should the nurse instruct the client about this procedure?

Standard Text: Select all that apply.

1. Tissue samples may be taken for biopsy.

2. Eating will not be permitted for 12 hours.

3. A local anesthetic is sprayed on the throat.

4. Bed rest for 8 hours is necessary after the test.

5. Informed consent is required for this procedure.

Question 30

Type: MCMA

The nurse needs to obtain a urine specimen from a client with an indwelling urinary catheter. What should the

nurse do when collecting this specimen?

Standard Text: Select all that apply.

1. Withdraw 30 mL of urine for a routine urinalysis.

2. Perform catheter care before obtaining the specimen.

3. Apply sterile gloves before retrieving the urine specimen.

4. Send the specimen immediately or refrigerate it for later pickup.

5. Clamp the drainage tubing for 30 minutes if there is no urine in the catheter.