You arrive for your 7 a.m. shift on the urology unit and the night nurse gives a report on the following patients who will be under your care. Which one would you see first?
Mr. Dominic, newly admitted for evaluation of bladder cancer.
Mr. Bradford is 3 days post-radical prostatectomy for invasive bladder cancer. His urine output overnight was 1200 mL of blood-tinged urine. He did not sleep well and ambulated twice overnight complaining of gas pains.
Mr. Jennings had a TURBT (transurethral resection of bladder tumor) yesterday. He is complaining of bladder spasms. He had 3000 mL of bladder irrigation in overnight and 2950 mL out.
Ms. Griffiths, who had a cystectomy for bladder cancer 3 years ago, was admitted via the ER overnight with a complaint of severe hip pain and anorexia. Her lab tests were normal with the exception of elevated liver enzymes. After an initial dose of Dilaudid 1 mg, she reports her pain as 2 on a 0 to 10 scale and has slept fitfully overnight.
The Correct Answer is B
Choice A reason: Mr. Dominic's evaluation for bladder cancer is important, but there are no acute symptoms reported that require immediate attention over the other patients listed.
Choice B reason: Mr. Bradford's condition is the most concerning. He is 3 days post-radical prostatectomy with significant blood-tinged urine output and complaints of gas pains, which could indicate complications such as bleeding or infection that need immediate assessment.
Choice C reason: Mr. Jennings’ condition is stable with an almost equal in-and-out bladder irrigation, though bladder spasms should be addressed, it is not as immediately critical as Mr. Bradford's symptoms.
Choice D reason: Ms. Griffiths is stable with managed pain levels and normal lab results except for elevated liver enzymes, which do not present an immediate threat compared to Mr. Bradford's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is D
Explanation
Choice A reason: Monitoring bowel sounds is important for assessing gastrointestinal function, but it does not directly measure the effectiveness of lactulose in treating hepatic encephalopathy.
Choice B reason: Temperature monitoring is essential for detecting infection, but it does not indicate the effectiveness of lactulose in reducing ammonia levels.
Choice C reason: Abdominal pain should be monitored as a potential side effect of lactulose, but it is not an indicator of its effectiveness in treating hepatic encephalopathy.
Choice D reason: Stool frequency is the correct measure for monitoring the effectiveness of lactulose. Lactulose works by promoting the excretion of ammonia in the stool, thereby reducing serum ammonia levels and improving the symptoms of hepatic encephalopathy. Increased stool frequency indicates the medication is working.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.