A client diagnosed with cholecystitis reports right upper quadrant pain that radiates to the right shoulder. Which of the following interventions is the priority for the nurse to implement?

Administer IV ketorolac.

Report findings to healthcare provider.

Offer a high-calorie, high-fat meal.

Assess the pain level.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is incorrect because administering IV ketorolac is not a priority intervention for a client with cholecystitis. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal bleeding and kidney damage, which are contraindicated in cholecystitis. The nurse should administer analgesics as prescribed, but only after assessing the pain level and severity.

Choice B reason: This is incorrect because reporting findings to healthcare provider is not a priority intervention for a client with cholecystitis. The nurse should communicate with the healthcare provider about the client's condition and treatment plan, but only after assessing the pain level and other vital signs.

Choice C reason: This is incorrect because offering a high-calorie, high-fat meal is not an intervention for a client with cholecystitis, but a potential trigger. High-fat foods can stimulate the gallbladder to contract and cause more pain and inflammation. The nurse should advise the client to avoid fatty foods and follow a low-fat diet.

Choice D reason: This is the correct answer because assessing the pain level is a priority intervention for a client with cholecystitis. Pain is the most common symptom of cholecystitis and can indicate the severity and complications of the condition. The nurse should assess the pain level using a numeric or descriptive scale, and monitor for changes in location, intensity, and duration.

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Correct Answer is A

Explanation

Choice A reason: This is correct because hearing loss is the most common complaint associated with a problem involving the inner ear. The inner ear consists of the cochlea, which is the organ of hearing, and the vestibular system, which is the organ of balance. The inner ear converts sound waves into nerve impulses that are sent to the brain. Any damage or dysfunction of the inner ear can impair hearing and cause hearing loss.
Choice B reason: This is incorrect because tinnitus is not the most common complaint associated with a problem involving the inner ear, but rather a symptom that can occur with various ear problems. Tinnitus is a ringing, buzzing, or hissing sound in the ears that is not caused by an external source. Tinnitus can be caused by exposure to loud noise, ear infections, earwax buildup, aging, or certain medications, but it is not specific to the inner ear.
Choice C reason: This is incorrect because pruritus is not a complaint associated with a problem involving the inner ear, but rather a complaint associated with a problem involving the outer ear. Pruritus is itching of the skin that can be caused by dryness, irritation, infection, or allergy. Pruritus can affect the outer ear, which is the visible part of the ear that collects and directs sound waves into the ear canal, but it has no relation to the inner ear.
Choice D reason: This is incorrect because muffled sounds are not a complaint associated with a problem involving the inner ear, but rather a complaint associated with a problem involving the middle ear. Muffled sounds are sounds that are unclear or distorted due to reduced sound transmission or perception. Muffled sounds can be caused by fluid buildup, inflammation, infection, or perforation of the eardrum in the middle ear, which is the air-filled space between the eardrum and the inner ear that contains three tiny bones that amplify sound vibrations.

A. "I will eat frequent small meals." B. "I will increase the intake of leafy greens and other sources of dietary fiber." C. "I will increase fluids." D. "I will take prescribed medications on schedule to regulate bowel patterns."

Correct Answer is B

Explanation

Choice A Reason: This is correct because eating frequent small meals can help the client with IBS to avoid overloading the digestive system and triggering diarrhea. The nurse should advise the client to eat slowly and chew well, and avoid foods that are spicy, fatty, or gas-producing.

Choice B Reason: This is incorrect because increasing the intake of leafy greens and other sources of dietary fiber can worsen diarrhea by increasing stool bulk and motility. The nurse should advise the client to limit or avoid high-fiber foods, such as whole grains, fruits, vegetables, nuts, and seeds, during acute flare-ups of IBS. The client can gradually reintroduce fiber when the symptoms subside.

Choice C Reason: This is correct because increasing fluids can help the client with IBS to prevent dehydration and electrolyte imbalance caused by diarrhea. The nurse should advise the client to drink at least 8 glasses of water per day and avoid caffeinated, alcoholic, or carbonated beverages that can irritate the bowel or cause gas.

Choice D Reason: This is correct because taking prescribed medications on schedule can help the client with IBS to regulate bowel patterns and reduce diarrhea. The nurse should instruct the client on how to use medications, such as antidiarrheals, antispasmodics, or probiotics, as ordered by the provider. The nurse should also monitor the client for any adverse effects or interactions of the medications.

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A client diagnosed with cholecystitis reports right upper quadrant pain that radiates to the right shoulder. Which of the following interventions is the priority for the nurse to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is diagnosed with a problem involving the inner ear. Which is the most common client complaint associated with a problem involving this part of the ear?

Correct Answer is A

Explanation

The nurse provides instructions to a client diagnosed with inflammatory bowel syndrome (IBS) about measures to treat diarrhea caused by acute flare-ups. Which statement by the client indicates a need for further teaching?

Correct Answer is B

Explanation

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