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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Cleaning the inside of the container with a wipe is not a part of the standard procedure for collecting a midstream urine sample. The focus should be on maintaining external cleanliness to avoid contamination of the sample, rather than cleaning the container itself.
Choice B reason: Urinating a little then stopping, while part of the process, is not enough information to indicate a complete understanding of the procedure. The more critical aspect is how the client cleans and collects the sample to ensure it is not contaminated.
Choice C reason: Using the cleansing wipe from front to back is the correct procedure for collecting a midstream urine sample. This method helps prevent contamination from bacteria that could be present around the genital area, ensuring a more accurate sample for analysis.
Choice D reason: Using each cleansing wipe twice is not advised. It can lead to contamination as the same wipe might transfer bacteria instead of eliminating them. It is essential to use a new wipe for each part of the cleaning process to maintain hygiene and ensure the accuracy of the urine sample.
Correct Answer is C
Explanation
Choice A reason: Having a glass of juice the morning of surgery may not be allowed, depending on the preoperative fasting guidelines. This statement could indicate a need for further clarification on preoperative instructions, but it is less critical than the misconception about eating solid food postoperatively.
Choice B reason: Taking time to relax if nervous the night before surgery is a healthy coping mechanism and does not indicate a lack of understanding about the surgery.
Choice C reason: The belief that the client will be able to eat solid food immediately after waking up from anesthesia is incorrect and indicates a need for further teaching. Postoperative dietary restrictions are typically in place, starting with clear liquids and gradually progressing to solid foods as tolerated.
Choice D reason: Understanding the risks associated with the surgery indicates that the client has received and comprehended the relevant information about the procedure.
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