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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 D

Explanation

Choice A reason: The statement that the tube is a routine standard following this type of surgery is too vague and does not provide the client with specific information about the purpose of the NG tube. Providing clear and specific reasons for medical interventions helps improve client understanding and comfort.
Choice B reason: While NG tubes can be used for nutritional support, this is not typically their primary purpose in the immediate postoperative period for colectomy patients. The main purpose is usually decompression, not nutrition.
Choice C reason: Telling the client that the tube can be explained once they are stable after surgery does not adequately address the client's need for information before the procedure. It is essential to provide clear and accurate information beforehand to reduce anxiety and promote informed consent.
Choice D reason: This is the correct answer because it clearly explains the primary purpose of a large-bore NG tube after a colectomy, which is to remove gas and fluid from the stomach to prevent distension and complications such as nausea, vomiting, and aspiration.

A. uOP of 350 ml/day B. uOP of 450 ml/day C. uOP of 550 ml/day D. uOP of 650 ml/day

Correct Answer is A

Explanation

Choice A reason: Oliguria is defined as a significantly reduced urine output, typically less than 400-500 ml per day in adults. A urinary output of 350 ml/day falls well below this threshold, indicating a condition of oliguria. This reduced output can be a sign of underlying issues such as dehydration, renal failure, or urinary tract obstructions. It is essential for healthcare providers to identify and address the cause of oliguria to prevent further complications.
Choice B reason: A urinary output of 450 ml/day is also indicative of oliguria but is closer to the higher end of the threshold for this condition. However, the specified definition usually considers less than 400 ml/day as oliguria, making 350 ml/day a more definitive example. While 450 ml/day is still reduced and warrants attention, it is slightly above the typical clinical cutoff for oliguria.
Choice C reason: A urinary output of 550 ml/day is above the typical threshold for oliguria. It indicates reduced urine output but does not meet the clinical definition of oliguria. Such output may still require monitoring, but it does not classify as oliguria, which is generally defined as less than 400-500 ml per day.
Choice D reason: A urinary output of 650 ml/day is well above the threshold for oliguria. This output is closer to normal daily urine output, which typically ranges from 800 to 2000 ml/day, depending on fluid intake and other factors. Therefore, it does not indicate oliguria and would be considered within normal limits or slightly reduced, depending on the clinical context.

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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 teaching a client who is preoperative for a colectomy. The client asks the nurse why he needs a large-bore NG tube. Which of the following statements should the nurse make?

Correct Answer is D

Explanation

The nurse determines that a patient is experiencing oliguria based on which amount of urinary output?

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?

A nurse is providing teaching to a client who has a history of pancreatitis. Which of the following food choices should the nurse instruct the client to avoid?

Which subjective description of pain would the nurse expect from a patient who has cholecystitis?

A nurse instructs a female client about collecting a midstream urine sample. Which of the following client statements indicates an understanding of the procedure?

A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level?

A nurse is developing a plan of care for a client who has a new ileal conduit. The nurse should include that the client is at risk for which of the following?

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?

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