The nurse is obtaining a sputum specimen from a patient without using suction. What should the nurse have the patient do to produce enough sputum for a sample?
a. Instruct the patient to obtain specimens over 4 hours.
b. Try to obtain a sample immediately after eating.
c. Rinse the mouth with water to loosen the mucus.
d. Take several deep breaths and forcefully cough into a sterile container.
D
The nurse instructs the patient to take three to four deep breaths before expectorating; the series of deep breaths helps to mobilize secretions and increases the chance of obtaining sputum in a sufficient quantity. The nurse instructs the patient to produce 5 to 10 mL of sputum and sends the specimen directly to the laboratory before potential degradation. A specimen obtained imme-diately after a meal is likely to be contaminated with food or saliva. The nurse offers clear water for oral rinsing before asking the patient to provide a sputum specimen because toothpaste or mouthwash potentially kills pathogens that cause infection and skews the results of the culture.
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Which question or command is a part of the Geriatric Depression Scale (GDS)?
a. "Who was the president just before Bill Clinton?" b. "How often does your family provide support for you?" c. "Do you prefer to stay at home rather than go out and do things?" d. "Please repeat the three words I asked you to remember."
An Emergency Department nurse has agreed to testify as an expert witness in a lawsuit involving a child. The opposing attorney questions the nurse's qualifications as a pediatric nurse. Which type of law does this scenario reflect?
1. Procedural law 2. Substantive law 3. Due process of law 4. Private law
The patient's initial vital signs immediately on return from surgery are BP, 140/90; P, 80; R, 14; T, 98° F. One hour later the vital signs are BP, 130/84; P, 72; R, 16; T, 96.8° F. Based on these assessments, the nurse should:
a. add a blanket for warmth to the patient. b. notify the charge nurse of probable he-morrhage. c. raise the head of the bed 45 degrees. d. note the assessment as normal postopera-tive recovery.
A patient receiving treatment for severe burns over more than half the body has an indwelling urinary catheter. When evaluating the patient's intake and output, what should the nurse take into consideration?
1. Urine output will be reduced in the first 24–48 hours and will then increase. 2. Urine output will be greatest in the first 24 hours after the burn injury. 3. Urine output will be reduced during the first 8 hours and will then increase as diuresis begins. 4. Urine output will be elevated due to the amount of intravenous fluids administered during the initial phases of treatment.