You arrive for your 7 a.m. shift on the urology unit and the night nurse gives a report on the following patients who will be under your care. Which one would you see first?
Mr. Dominic, newly admitted for evaluation of bladder cancer.
Mr. Bradford is 3 days post-radical prostatectomy for invasive bladder cancer. His urine output overnight was 1200 mL of blood-tinged urine. He did not sleep well and ambulated twice overnight complaining of gas pains.
Mr. Jennings had a TURBT (transurethral resection of bladder tumor) yesterday. He is complaining of bladder spasms. He had 3000 mL of bladder irrigation in overnight and 2950 mL out.
Ms. Griffiths, who had a cystectomy for bladder cancer 3 years ago, was admitted via the ER overnight with a complaint of severe hip pain and anorexia. Her lab tests were normal with the exception of elevated liver enzymes. After an initial dose of Dilaudid 1 mg, she reports her pain as 2 on a 0 to 10 scale and has slept fitfully overnight.
The Correct Answer is B
Choice A reason: Mr. Dominic's evaluation for bladder cancer is important, but there are no acute symptoms reported that require immediate attention over the other patients listed.
Choice B reason: Mr. Bradford's condition is the most concerning. He is 3 days post-radical prostatectomy with significant blood-tinged urine output and complaints of gas pains, which could indicate complications such as bleeding or infection that need immediate assessment.
Choice C reason: Mr. Jennings’ condition is stable with an almost equal in-and-out bladder irrigation, though bladder spasms should be addressed, it is not as immediately critical as Mr. Bradford's symptoms.
Choice D reason: Ms. Griffiths is stable with managed pain levels and normal lab results except for elevated liver enzymes, which do not present an immediate threat compared to Mr. Bradford's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Encouraging increased fluid intake is not appropriate for clients with acute glomerulonephritis as it can exacerbate fluid retention and hypertension, worsening the condition.
Choice B reason: Frequent ambulation is generally beneficial for overall health but is not a specific intervention for managing acute glomerulonephritis.
Choice C reason: Administering antibiotics is essential if the acute glomerulonephritis is caused by a bacterial infection, such as post-streptococcal glomerulonephritis. Treating the underlying infection can help resolve the kidney inflammation.
Choice D reason: Obtaining weight weekly is insufficient for monitoring fluid balance in acute glomerulonephritis. Daily weights are more appropriate to closely monitor fluid retention and adjust treatment as needed.
Correct Answer is B
Explanation
Choice A reason: Hepatitis A primarily affects the liver, not the kidneys.
Choice B reason: The manifestations of hepatitis A are similar to flu-like symptoms, including fever, fatigue, nausea, and jaundice.
Choice C reason: The incubation period of hepatitis A is typically 15 to 50 days, not 5 days.
Choice D reason: A family history does not increase the risk of hepatitis A, which is transmitted through the ingestion of contaminated food and water.
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