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 B
Explanation
Choice A reason: Increasing the intake of raw vegetables is not typically recommended immediately after colostomy surgery due to the potential for causing gas and irritation in the bowel. A more balanced diet should be gradually introduced.
Choice B reason: It is common to experience a small amount of bleeding around the stoma initially as it heals. This is normal and should subside as the healing process continues.
Choice C reason: Fecal output usually begins within 2-4 days after surgery, not necessarily within 24 hours. The bowel needs time to adjust and start functioning properly after the operation.
Choice D reason: The stoma should be pink to red and moist, indicating healthy tissue. A purplish color may indicate compromised blood flow and requires immediate medical attention.
Correct Answer is C
Explanation
Choice A reason: Red urine can indicate the presence of blood, which is not typically associated with cholecystitis. This finding might be more related to urinary tract issues or hematuria.
Choice B reason: Greenish-brown urine is not a common description for urine changes associated with cholecystitis. It does not reflect the typical bilirubin-induced color changes.
Choice C reason: Dark and foamy urine is associated with cholecystitis due to the presence of excess bilirubin in the urine. The dark color indicates the liver's bile is backing up due to the inflamed gallbladder, and the foaminess can result from high bilirubin levels.
Choice D reason: Pale yellow urine is normal and does not indicate cholecystitis. It suggests proper hydration and normal urine function.
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