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 B
Explanation
Choice A reason: Macaroni and cheese is high in fat due to the cheese content, which can exacerbate symptoms of cholecystitis. Patients with cholecystitis should avoid high-fat foods to prevent gallbladder irritation.
Choice B reason: Roast turkey, if prepared without added fats, is a lean protein option that is suitable for a cholecystitis diet. It provides necessary nutrients without the high fat content that could trigger symptoms.
Choice C reason: Ice cream is high in fat and sugar, making it unsuitable for someone with cholecystitis. High-fat foods can lead to increased bile production and gallbladder contractions, causing pain and discomfort.
Choice D reason: Creamed chicken typically contains high amounts of fat from cream, which should be avoided by cholecystitis patients to prevent aggravating their condition.
Correct Answer is D
Explanation
Choice A reason: Hypercalcemia is not a typical electrolyte imbalance seen in prerenal acute kidney injury (AKI). Instead, the focus should be on electrolytes more directly related to kidney function.
Choice B reason: Hypernatremia, or high sodium levels, can occur but is not as typical or expected as other imbalances in prerenal AKI.
Choice C reason: Hypophosphatemia, or low phosphate levels, is not a typical finding in prerenal AKI. Phosphate levels are more likely to be affected by other conditions.
Choice D reason: Hyperkalemia, or elevated potassium levels, is a common and significant electrolyte imbalance seen in prerenal AKI. The kidneys' reduced ability to excrete potassium leads to its accumulation in the blood, which can cause serious complications such as cardiac arrhythmias.
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