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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 A

Explanation

Choice A reason: A purplish-colored stoma indicates compromised blood flow, which is a medical emergency that requires immediate attention to prevent tissue necrosis.
Choice B reason: A rosebud-like stoma orifice is a normal appearance for a healthy stoma and does not need to be reported.
Choice C reason: Some oozing of red drainage from a new stoma can be expected postoperatively and is generally not alarming unless it is excessive or persistent.
Choice D reason: A shiny, moist stoma indicates a healthy stoma and is expected; no need to report this finding.

A. Red B. Greenish-brown C. Dark and foamy D. Pale yellow

Correct Answer is C

Explanation

Choice A reason: Red urine can indicate the presence of blood, which is not typically associated with cholecystitis. This finding might be more related to urinary tract issues or hematuria.
Choice B reason: Greenish-brown urine is not a common description for urine changes associated with cholecystitis. It does not reflect the typical bilirubin-induced color changes.
Choice C reason: Dark and foamy urine is associated with cholecystitis due to the presence of excess bilirubin in the urine. The dark color indicates the liver's bile is backing up due to the inflamed gallbladder, and the foaminess can result from high bilirubin levels.
Choice D reason: Pale yellow urine is normal and does not indicate cholecystitis. It suggests proper hydration and normal urine function.

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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 in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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