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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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: The use of a colostomy bag is expected following surgery for colorectal cancer that involves the creation of a stoma. This does not indicate a complication.
Choice B reason: A loss of appetite is common after major surgery and can be managed with nutritional support and gradual reintroduction of food.
Choice C reason: Absent bowel sounds in the lower abdominal quadrants could indicate a paralytic ileus or bowel obstruction, which are serious complications requiring immediate intervention to prevent further issues such as bowel ischemia.
Choice D reason: Mild pain at the surgical site is expected and can be managed with prescribed pain medications. It does not indicate a serious complication.

A. Dumping syndrome B. Bile reflux gastritis C. Postprandial hypoglycemia D. Malnutrition

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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You are working in a urologist's office. When you return from lunch, you have the following phone messages. Which one requires immediate attention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

Explanation

The patient is having a gastroduodenostomy (Billroth I operation) for stomach cancer. Which complication is occurring when the patient reports generalized weakness, sweating, palpitations, and dizziness 15 minutes after eating?

Correct Answer is A

Explanation

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