You arrive for your morning 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 with complaints of severe hip pain and anorexia. His lab tests were normal with the exception of elevated liver enzymes. After an initial dose of Dilaudid 1 mg, he reports his pain as 2 on a 0 to 10 scale and has slept fitfully overnight.
Mr. Bradford, 5 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 three years ago, was admitted via the ER overnight with complaints 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 C
Choice A reason: Mr. Dominic's pain has been controlled to a manageable level, and although he experienced elevated liver enzymes, there are no acute symptoms requiring immediate intervention. He has been able to sleep, indicating that his current condition is stable.
Choice B reason: Mr. Bradford, although experiencing discomfort and blood-tinged urine, is post-surgical, and his condition is stable with managed output. Ambulating is a positive sign post-surgery, indicating recovery. His condition needs monitoring but is not the most urgent.
Choice C reason: Mr. Jennings, who had a TURBT yesterday, is experiencing bladder spasms and high volume irrigation. The output is almost equivalent to the input, which is a positive sign, but bladder spasms can indicate irritation, infection, or a blockage that needs prompt assessment and intervention to prevent further complications.
Choice D reason: Ms. Griffiths presents a similar case to Mr. Dominic, with controlled pain and elevated liver enzymes. She is stable overnight, and her pain level is low after medication, indicating her condition is currently managed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: The phrase "Achent has control rion" is incorrect and unclear. It seems to be a typographical error and does not convey any meaningful information about an ileal conduit.
Choice B reason: Stool is not passed through an ileal conduit. An ileal conduit is a type of urinary diversion, where urine is diverted from the kidneys to an external pouch through a segment of the ileum, not for stool passage.
Choice C reason: An ileal conduit does not directly connect the kidney to an external pouch. It involves the use of a segment of the small intestine (ileum) to create a passageway for urine to be collected in an external pouch.
Choice D reason: This is the correct explanation. An ileal conduit involves attaching the ureters to a segment of the small intestine (ileum) to divert urine to an external pouch, bypassing the bladder.
Correct Answer is A
Explanation
Choice A reason: Dumping syndrome is a common complication after a gastroduodenostomy, where food moves too quickly from the stomach to the small intestine. Symptoms such as weakness, sweating, palpitations, and dizziness shortly after eating are typical indicators of this condition. This happens because the rapid passage of food causes fluid shifts in the body and a release of gut hormones that can lead to the symptoms experienced.
Choice B reason: Bile reflux gastritis involves the backflow of bile into the stomach, which can cause inflammation and discomfort. However, it does not typically present with the acute symptoms described in this scenario, such as weakness and dizziness shortly after eating. Symptoms of bile reflux gastritis usually include chronic pain, nausea, and vomiting.
Choice C reason: Postprandial hypoglycemia occurs when blood sugar levels drop significantly after eating. While it can cause symptoms like dizziness and weakness, it typically occurs a few hours after a meal, not 15 minutes post-consumption. The timing of the symptoms described aligns more with dumping syndrome.
Choice D reason: Malnutrition refers to the lack of proper nutrition caused by not having enough food or not eating the right things. It does not typically present with acute symptoms like those described in the question. Chronic symptoms of malnutrition include weight loss, fatigue, and weakness over a longer period.
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