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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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: The use of a colostomy bag is expected following surgery for colorectal cancer that involves the creation of a stoma. This does not indicate a complication.
Choice B reason: A loss of appetite is common after major surgery and can be managed with nutritional support and gradual reintroduction of food.
Choice C reason: Absent bowel sounds in the lower abdominal quadrants could indicate a paralytic ileus or bowel obstruction, which are serious complications requiring immediate intervention to prevent further issues such as bowel ischemia.
Choice D reason: Mild pain at the surgical site is expected and can be managed with prescribed pain medications. It does not indicate a serious complication.

A. Increased glomerular filtration rate (GFR) B. Decreased creatinine level C. Hypomagnesemia D. Hyperkalemia

Correct Answer is D

Explanation

Choice A reason: Increased glomerular filtration rate (GFR) would indicate improved kidney function, which is not expected in the oliguric phase of acute kidney injury. Instead, GFR is typically reduced during this phase.
Choice B reason: Decreased creatinine level suggests better kidney function and is not consistent with acute kidney injury, where creatinine levels are usually elevated due to impaired filtration.
Choice C reason: Hypomagnesemia, or low magnesium levels, is not a typical finding in acute kidney injury. Electrolyte imbalances more commonly include elevated levels of potassium and phosphorus.
Choice D reason: Hyperkalemia, or elevated potassium levels, is a common finding in the oliguric phase of acute kidney injury due to the kidneys' inability to excrete potassium effectively. This can lead to serious complications such as cardiac arrhythmias.

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You are working in a urologist's office. When you return from lunch, you have the following phone messages. Which one requires immediate attention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has colorectal cancer and is recovering from surgery to redirect intestinal contents out of the body. Which of the following post-surgical manifestations require nursing intervention to avoid a serious complication?

Correct Answer is C

Explanation

A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse is caring for a client who has suspected cholecystitis. The nurse should expect the client's urine to appear which of the following colors?

A nurse is providing preoperative teaching to a client who is to undergo an open bowel resection at 1300 next week. Which of the following statements by the client indicates the need for further teaching?

After a patient has undergone cholecystectomy, for which immediate complication would the nurse monitor?

A nurse is caring for a client who has prostate cancer and had a prostatectomy. Which of the following should the nurse understand is a potential complication of prostate surgery?

A nurse is teaching a client who is preoperative for a neobladder urinary diversion. Which of the following statements should the nurse make?

A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level?

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