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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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Cleaning the inside of the container with a wipe is not part of the standard procedure for collecting a midstream urine sample. The focus should be on maintaining external cleanliness to avoid contamination of the sample.
Choice B reason: Urinating a little then stopping is part of the process, but this statement alone does not indicate a complete understanding of the procedure. The critical aspect is how the client cleans and collects the sample to ensure it is not contaminated.
Choice C reason: Using the cleansing wipe from front to back is the correct procedure for collecting a midstream urine sample. This method helps prevent contamination from bacteria that could be present around the genital area, ensuring a more accurate sample for analysis.
Choice D reason: Using each cleansing wipe twice is not advised as it can lead to contamination. Each wipe should be used only once to maintain hygiene and ensure the accuracy of the urine sample.

A. Nausea and vomiting B. Bradycardia C. Hyperactive bowel sounds D. Increased urinary output

Correct Answer is A

Explanation

Choice A reason: Nausea and vomiting are common manifestations of peritonitis, an infection of the peritoneal cavity, often a complication of peritoneal dialysis. These symptoms, along with abdominal pain and fever, indicate peritoneal irritation and inflammation.
Choice B reason: Bradycardia, or slow heart rate, is not a typical symptom of peritonitis. It is more commonly associated with other conditions such as heart-related issues or severe hypothermia.
Choice C reason: Hyperactive bowel sounds can occur with various gastrointestinal disturbances, but they are not specifically indicative of peritonitis. Peritonitis typically presents with decreased bowel sounds due to inflammation and irritation of the peritoneum.
Choice D reason: Increased urinary output is not a symptom of peritonitis. In fact, peritonitis can sometimes cause decreased urine output if the infection affects kidney function.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is C

Explanation

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis?

Correct Answer is A

Explanation

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

The healthcare provider prescribes lactulose for a patient with hepatic encephalopathy. Which data would the nurse monitor for effectiveness of this medication?

A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan?

A nurse is planning care for a client who is scheduled to have a kidney biopsy. Which of the following information should the nurse include in the plan? (Select all that apply)

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect?

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

After a patient has undergone cholecystectomy, for which immediate complication would the nurse monitor?

A nurse is caring for a child who has acute appendicitis. Which of the following results should the nurse anticipate when reviewing this client's laboratory values?