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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 B

Explanation

Choice A reason: Obesity is a risk factor for various cancers but is not specifically a primary risk factor for prostate cancer. It can contribute to overall health problems that indirectly affect cancer risk.
Choice B reason: Being male is a primary risk factor for prostate cancer, as this type of cancer affects the prostate gland, which is present only in men. The risk increases significantly with age and other factors.
Choice C reason: Age is a significant risk factor, with the incidence of prostate cancer increasing in men over 50. However, the most defining factor is being male.
Choice D reason: Moderate alcohol use is not specifically linked to an increased risk of prostate cancer. While excessive alcohol consumption can affect overall health, it is not a primary risk factor for prostate cancer.

A. Decreased potassium level B. Decreased chloride level C. Decreased phosphate level D. Decreased sodium level

Correct Answer is D

Explanation

Choice A reason: Spironolactone is a potassium-sparing diuretic, so it is more likely to cause elevated potassium levels rather than decreased levels.
Choice B reason: Chloride levels are not typically affected in a predictable pattern with the use of spironolactone or in liver failure with ascites.
Choice C reason: Phosphate levels are not commonly altered by spironolactone or in ascites, and any changes would depend on other metabolic factors.
Choice D reason: Spironolactone can lead to decreased sodium levels due to its action as a diuretic that promotes sodium excretion while retaining potassium. This is particularly relevant in clients with liver failure and ascites, where fluid and electrolyte management is crucial.

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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 screening a client for cancer risk factors. The nurse records that the client is a 65-year-old male, clinically obese with a BMI of 31, has a history of past smoking, and drinks moderately. Which of the following is a primary risk factor for prostate cancer?

Correct Answer is B

Explanation

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect?

A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect?

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?

Which condition causes the formation of biliary sludge?

A nurse is admitting a client to the surgical unit from the PACU following a cholecystectomy. Which of the following assessments is the nurse's priority?

A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching?

A nurse is caring for a client who is 5 hours postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?

Which finding in the patient's history increases the risk for acute pancreatitis?