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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 B

Explanation

Choice A reason: Tenderness in the left upper abdomen is not typically associated with an obstruction of the common bile duct. Pain and tenderness would more commonly be located in the right upper quadrant of the abdomen, where the liver and gallbladder are situated.
Choice B reason: Fatty stools (steatorrhea) are a common finding in bile duct obstruction. The lack of bile entering the intestine prevents the digestion and absorption of fats, leading to pale, greasy stools that float.
Choice C reason: Straw-colored urine is normal and does not indicate a bile duct obstruction. In cases of bile duct obstruction, the urine is often dark-colored due to the excretion of bilirubin.
Choice D reason: Ecchymosis of the extremities is not related to bile duct obstruction and is more indicative of bleeding disorders or trauma.

A. Urinary incontinence B. Urinary retention C. Urinary frequency D. Urinary tract infection

Correct Answer is D

Explanation

Choice A reason: Urinary incontinence is the involuntary leakage of urine and is not specifically associated with the described urine characteristics of dark amber, cloudiness, and unpleasant odor. These symptoms indicate an infection rather than a condition involving control over urination.
Choice B reason: Urinary retention involves the inability to completely empty the bladder, leading to retained urine. It does not typically manifest with dark amber, cloudy urine, and unpleasant odor, which are more indicative of an infection.
Choice C reason: Urinary frequency refers to the need to urinate more often than usual and does not specifically align with the described urine characteristics. The focus in this case is on the urine's appearance and smell, pointing more towards an infection.
Choice D reason: Urinary tract infection (UTI) is the most likely condition associated with dark amber, cloudy urine, and unpleasant odor. UTIs result from bacterial infection, leading to inflammation and the presence of pus or blood, which causes the described symptoms. Prompt diagnosis and treatment are necessary to prevent complications.

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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 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?

Correct Answer is B

Explanation

A nurse is caring for a client and observes that the client's urine is dark amber, cloudy, and has an unpleasant odor. The nurse should recognize that these findings are associated with which of the following?

Correct Answer is D

Explanation

A nurse is teaching a client who has hepatitis A. Which of the following information should the nurse include?

A nurse in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

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

A nurse is preparing to obtain a 24-hour urine collection from a client. Which of the following actions should the nurse plan to take?

The patient is having a gastroduodenostomy (Billroth I operation) for stomach cancer. Which complication is occurring when the patient reports generalized weakness, sweating, palpitations, and dizziness 15 minutes after eating?

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?

A nurse is caring for a client who is postoperative following an open cholecystectomy. Which of the following actions should the nurse take when caring for the client's Jackson-Pratt (JP) drain?

A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan?