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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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason: A serum creatinine level of 6 mg/dL is significantly elevated and indicates impaired kidney function, which is a hallmark of acute kidney injury (AKI). Normal creatinine levels are typically around 0.6 to 1.2 mg/dL for adults, so this level suggests severe kidney impairment.
Choice B reason: A serum potassium level of 4.5 mEq/L is within the normal range (3.5-5.0 mEq/L) and does not indicate acute kidney injury. Elevated potassium can be seen in AKI but is not the most specific indicator without other abnormal values.
Choice C reason: A hemoglobin level of 16 g/dL is within the normal range for adults (approximately 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women). It does not indicate acute kidney injury.
Choice D reason: A BUN level of 15 mg/dL is within the normal range (7-20 mg/dL) and does not indicate acute kidney injury on its own. Elevated BUN in conjunction with elevated creatinine would be more indicative of AKI.

A. Question-and-answer B. Discussion C. Role play D. Return demonstration

Correct Answer is B

Explanation

Choice A reason: A question-and-answer session might provide information but does not specifically encourage the client to share their feelings and concerns about the colostomy. It's more about imparting knowledge rather than addressing emotional needs.
Choice B reason: Discussion is an effective strategy to encourage the client to share their feelings about the colostomy. It creates an open environment for expressing concerns, asking questions, and receiving emotional support.
Choice C reason: Role play can be useful in teaching new skills or preparing for specific situations, but it might not be the best initial approach for someone struggling to accept a new colostomy. Emotional readiness and comfort should be addressed first.
Choice D reason: Return demonstration is a method to confirm the client's understanding of a procedure by having them perform it. It is more appropriate for assessing practical skills rather than addressing emotional concerns and readiness to engage with the stoma.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?

Correct Answer is A

Explanation

A nurse is caring for a client who has a new colostomy and states they are not ready to look at the stoma. Which of the following teaching strategies is helpful and encourages the client to share their feelings about the colostomy?

Correct Answer is B

Explanation

The nurse is involved in a health promotion program for teenagers related to the prevention of oral cancer. Which behaviors would the nurse explain as increasing the risk for oral cancer? Select all that apply.

An acute pancreatitis patient who complains of muscle cramping. The nurse explains to the patient that is the typical sign and symptom of? Select best answer.

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 planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan?

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?

A nurse is teaching a client who has a new colostomy. Which of the following outcomes should the nurse expect?

A nurse is preparing to obtain a 24-hour urine collection from a client. Which of the following actions should the nurse plan to take?