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 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.
Correct Answer is A
Explanation
Choice A reason: Reducing the client's intake of protein can help decrease the production of ammonia, which is a byproduct of protein metabolism. High ammonia levels contribute to hepatic encephalopathy, so a lower protein diet can be beneficial.
Choice B reason: Administering vitamin K is important for managing bleeding risks associated with cirrhosis, but it does not specifically address ammonia levels.
Choice C reason: Restricting fluid intake may be necessary for managing ascites and edema in cirrhosis but does not directly impact ammonia levels.
Choice D reason: Administering diuretics is often necessary to manage fluid retention and ascites, but it does not affect ammonia production or levels in the blood.
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