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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

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.

A. Neutrophils 3,000/mm B. Lymphocytes 3,000/mm C. WBC 17,000/mm D. RBC 4.2 million/mm

Correct Answer is C

Explanation

Choice A reason: Neutrophils at 3,000/mm might indicate an infection, but for acute appendicitis, one would expect to see a significant increase in the overall white blood cell count rather than just the neutrophils.
Choice B reason: Lymphocytes at 3,000/mm do not specifically indicate acute appendicitis. Lymphocyte counts are more commonly elevated in viral infections rather than bacterial ones like appendicitis.
Choice C reason: A WBC count of 17,000/mm is indicative of an acute bacterial infection like appendicitis. The elevated WBC count shows the body’s response to the infection, making this the most accurate indicator among the options provided.
Choice D reason: RBC at 4.2 million/mm is within the normal range and does not provide specific information related to acute appendicitis. This value is unrelated to the acute inflammatory process expected in appendicitis.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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