A nurse is providing instructions about a 24-hour urine collection to an adolescent client. Which of the following should the nurse include in the teaching?
Discard the first voided specimen.
Void every hour.
Save the final specimen in a separate container.
Cleanse the perineum with a povidone-iodine solution prior to voiding.
The Correct Answer is A
Choice A rationale
The first voided specimen is discarded to ensure that the 24-hour urine collection starts with an empty bladder and accurately reflects the urine produced over the entire period.
Choice B rationale
Voiding every hour is not necessary and may not be practical for a 24-hour urine collection.
Choice C rationale
The final specimen should be included in the same container as the rest of the 24-hour urine collection.
Choice D rationale
Cleansing the perineum with a povidone-iodine solution is not required for a 24-hour urine collection.
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Correct Answer is C
Explanation
Choice A rationale
A hemoglobin level of 6.8 g/dL is significantly lower than the normal range (9.5 to 14 g/dL) and indicates anemia. This finding does not suggest that the treatment for acute lymphoblastic leukemia is having a therapeutic effect.
Choice B rationale
An RBC count of 5/mm³ is within the normal range (4 to 5.5/mm³) but does not specifically indicate that the treatment for acute lymphoblastic leukemia is having a therapeutic effect.
Choice C rationale
A WBC count of 15,000/mm³ is higher than the normal range (5,000 to 10,000/mm³) but can indicate that the treatment is having a therapeutic effect. In the context of acute lymphoblastic leukemia, an elevated WBC count can be a sign that the body is responding to treatment.
Choice D rationale
A platelet count of 98,000/mm³ is lower than the normal range (150,000 to 400,000/mm³) and does not indicate that the treatment for acute lymphoblastic leukemia is having a therapeutic effect.
Correct Answer is D
Explanation
Choice A rationale
Rotavirus vaccination is typically administered in infancy, not at 5 years of age. The rotavirus vaccine is given to infants to protect against rotavirus infections, which can cause severe diarrhea and dehydration in young children. By the age of 5, children have usually completed the rotavirus vaccination series.
Choice B rationale
Hepatitis B vaccination is also typically completed in infancy. The hepatitis B vaccine is given to infants to protect against hepatitis B virus infection, which can cause chronic liver disease and liver cancer. By the age of 5, children who are up-to-date with their immunizations have usually completed the hepatitis B vaccination series.
Choice C rationale
Haemophilus influenzae type b (Hib) vaccination is typically completed by 15 months of age. The Hib vaccine protects against infections caused by Haemophilus influenzae type b, such as meningitis, pneumonia, and epiglottitis. By the age of 5, children who are up-to-date with their immunizations have usually completed the Hib vaccination series.
Choice D rationale
The second dose of the varicella vaccine is usually given at 4-6 years of age. The varicella vaccine protects against chickenpox, a highly contagious viral infection that causes an itchy rash and fever. Administering the second dose of the varicella vaccine at this age helps ensure that the child has adequate immunity against chickenpox.