You arrive for your morning 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 with complaints of severe hip pain and anorexia. His lab tests were normal with the exception of elevated liver enzymes. After an initial dose of Dilaudid 1 mg, he reports his pain as 2 on a 0 to 10 scale and has slept fitfully overnight.
Mr. Bradford, 5 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 three years ago, was admitted via the ER overnight with complaints 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 C
Choice A reason: Mr. Dominic's pain has been controlled to a manageable level, and although he experienced elevated liver enzymes, there are no acute symptoms requiring immediate intervention. He has been able to sleep, indicating that his current condition is stable.
Choice B reason: Mr. Bradford, although experiencing discomfort and blood-tinged urine, is post-surgical, and his condition is stable with managed output. Ambulating is a positive sign post-surgery, indicating recovery. His condition needs monitoring but is not the most urgent.
Choice C reason: Mr. Jennings, who had a TURBT yesterday, is experiencing bladder spasms and high volume irrigation. The output is almost equivalent to the input, which is a positive sign, but bladder spasms can indicate irritation, infection, or a blockage that needs prompt assessment and intervention to prevent further complications.
Choice D reason: Ms. Griffiths presents a similar case to Mr. Dominic, with controlled pain and elevated liver enzymes. She is stable overnight, and her pain level is low after medication, indicating her condition is currently managed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is C
Explanation
Choice A reason: A bladder infection can cause various symptoms, but blood-tinged urine is less specific to it.
Choice B reason: Dehydration typically leads to concentrated urine, not blood-tinged urine.
Choice C reason: Prostate enlargement (benign prostatic hyperplasia) can cause blood-tinged urine due to irritation and pressure on the urethra.
Choice D reason: Pernicious anemia affects red blood cell production but is not directly related to the presence of blood in the urine.
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