You are working in a urologist's office. When you return from lunch, you have the following phone messages. Which one requires immediate attention?
Mr. Smith, who has multiple sclerosis, has been managing his urinary retention with intermittent catheterization for several years. He has been depressed lately after losing his job and admitted at his last visit to having thoughts of self-harm. He left a message saying he had chills, fatigue, and an oral temperature of 103°F.
Ms. Jones, who has had urinary frequency and urgency for many years, started on Ditropan at her last office visit. She left a message saying her urinary frequency has improved, but her mouth was very dry.
Mr. Jones, a new patient expressing concerns over embarrassing symptoms of incontinence.
Ms. Smith, who is 18 years old, called to cancel her afternoon appointment for her initial incontinence evaluation. Her message said her symptoms weren't that bad and she would call to reschedule.
The Correct Answer is A
Choice A reason: Mr. Smith requires immediate attention due to his multiple sclerosis and severe symptoms of chills, fatigue, and a high fever (103°F). These symptoms could indicate a severe infection such as a urinary tract infection (UTI) or even sepsis, which can be life-threatening, especially in individuals with a compromised immune system or chronic conditions like multiple sclerosis.
Choice B reason: Ms. Jones's dry mouth is a common side effect of Ditropan (oxybutynin), which is used to treat urinary frequency and urgency. While it is uncomfortable, it is not an emergency and can be addressed at the next visit or over a phone consultation.
Choice C reason: Mr. Jones, being a new patient with incontinence concerns, does not present an immediate emergency. This issue, while significant for his quality of life, can be managed through a scheduled appointment.
Choice D reason: Ms. Smith's decision to cancel her appointment due to her symptoms not being severe does not require immediate attention. She can be rescheduled for a later date without risk to her health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Including foods high in fiber can be beneficial for overall digestive health, but it is not specifically targeted to managing biliary colic from chronic cholecystitis. The key dietary focus for these patients is to manage fat intake rather than fiber.
Choice B reason: Including foods high in starch and proteins does not directly address the dietary needs for managing biliary colic. While proteins and starches are part of a balanced diet, the critical factor for these patients is fat consumption.
Choice C reason: Avoiding foods high in sodium is generally good advice for cardiovascular health and can help reduce the risk of hypertension, but it is not specifically related to managing biliary colic.
Choice D reason: Avoiding foods high in fat is crucial for patients with chronic cholecystitis. High-fat foods can trigger biliary colic by stimulating the gallbladder to release bile, which can be painful when the bile ducts are inflamed or obstructed.
Correct Answer is A
Explanation
Choice A reason: Infection is a common immediate complication after any surgical procedure, including cholecystectomy. The nurse should monitor for signs of infection, such as fever, redness, swelling, or discharge at the surgical site, to ensure prompt intervention and treatment.
Choice B reason: The term "binding" is unclear and not typically used to describe a specific postoperative complication. This choice may be referring to issues such as adhesions or scar tissue, but these are not immediate concerns.
Choice C reason: Bowel obstruction can occur after abdominal surgery, but it is not the most immediate concern following cholecystectomy. It may develop later as a complication but is not the primary focus in the immediate postoperative period.
Choice D reason: Dehydration can be a concern if the patient is not taking in adequate fluids postoperatively, but it is not as immediate a concern as monitoring for infection.
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