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Questions 163

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Question 1 of 5

The physician has ordered a sterile urine specimen to be collected from a client who has a Foley catheter. To obtain a sterile urine specimen, the nurse should:

Correct Answer: D

Rationale: Withdrawing from the catheter port with a syringe ensures a sterile specimen. Other methods risk contamination.

Question 2 of 5

An adult client in an acute care setting asks the nurse to show him his hospital records. The nurse's response should reflect which understanding?

Correct Answer: C

Rationale: HIPAA grants clients the right to access their medical records and receive explanations, ensuring transparency. Court orders, physician approval, or committees are not required.

Question 3 of 5

The nurse is collecting data from a client who had a transurethral resection of the prostate 10 hours ago and is receiving continuous bladder irrigation. Which of the following findings would require follow-up?

Correct Answer: D

Rationale: A 200 mL discrepancy between irrigation input and output suggests possible catheter obstruction or absorption, requiring follow-up. Normal vitals , spasm relief , and light pink urine are expected post-TURP.

Question 4 of 5

A client asks the nurse to explain the basic ideas of homeopathic medicine. The response that best explains this approach is that such remedies

Correct Answer: C

Rationale: boost the immune system. The practitioner treats with minute doses of plant, mineral or animal substances which provide a gentle stimulus to the body's own defenses.

Question 5 of 5

In response to a call for assistance by a client in labor, the nurse notes that a loop of the umbilical cord protrudes from the vagina. What is the priority nursing action?

Correct Answer: C

Rationale: Immediate action is needed to relieve pressure on the cord, which puts the fetus at risk due to hypoxia. The knee-chest position accomplishes this. The exposed cord is covered with saline-soaked gauze, not reinserted.

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