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 B
Explanation
Choice A reason: Wearing an external collection bag is typically associated with other types of urinary diversions, such as an ileal conduit, not a neobladder.
Choice B reason: A neobladder involves the creation of an internal pouch from a segment of the intestine that stores urine and allows for more natural urination, similar to the function of a natural bladder. This option provides the ability to void through the urethra.
Choice C reason: While some initial incontinence can occur after neobladder surgery, the goal is to eventually have voluntary control over urination with time and practice.
Choice D reason: Having a stoma located in the abdomen is characteristic of an ileal conduit or urostomy, not a neobladder. The neobladder is designed to avoid the need for an external stoma.
Correct Answer is A
Explanation
Choice A reason: Cheddar cheese is high in fat, which can trigger pancreatitis flare-ups. People with pancreatitis are generally advised to follow a low-fat diet to avoid exacerbating their condition. Consuming high-fat foods like cheddar cheese can stimulate the pancreas to produce more digestive enzymes, which can lead to increased inflammation and pain.
Choice B reason: Vegetable soup, especially if it is broth-based and low in fat, is generally safe for individuals with pancreatitis. It provides essential nutrients without putting too much strain on the pancreas. However, it is essential to ensure that the soup does not contain any high-fat ingredients, such as cream or butter, which can aggravate the condition.
Choice C reason: Baked fish is typically a good choice for individuals with pancreatitis because it is low in fat and high in protein. The preparation method also matters; baking is a healthy cooking method that does not add extra fat to the dish. As long as the fish is not fried or cooked with high-fat sauces, it should be safe to consume.
Choice D reason: Noodles, particularly those made from refined flour, are generally low in fat and can be included in a pancreatitis-friendly diet. However, the overall meal should be balanced and low in fat to avoid triggering symptoms. Whole grain noodles might be a better option as they provide more fiber and nutrients.
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