A client is admitted to the hospital with a diagnosis of obstruction of the common bile duct due to cholelithiasis. Which of the following assessment findings are consistent with this diagnosis?
Casts in the urine
Dark, tarry stool
Jaundice
Pain in the left upper quadrant
The Correct Answer is C
A. Casts in the urine are typically associated with kidney problems, such as glomerulonephritis or kidney infections, rather than biliary obstruction. Casts are formed from proteins or cells in the renal tubules and are not related to bile duct obstruction or cholelithiasis.
B. Dark, tarry stools are indicative of upper gastrointestinal bleeding and the presence of digested blood in the stool. This condition, known as melena, is not typically associated with obstruction of the common bile duct due to cholelithiasis.
C. Jaundice is a common and significant finding in cases of obstruction of the common bile duct due to cholelithiasis. When the bile duct is obstructed, bilirubin, which is a component of bile, accumulates in the bloodstream because it cannot be properly excreted into the intestine.
D. Pain from cholelithiasis (gallstones) typically occurs in the right upper quadrant, not the left. The right upper quadrant pain is often associated with gallbladder inflammation or bile duct obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","E","F"]
Explanation
A. Cardiac catheterization is often used in the management of an acute myocardial infarction to assess the extent of coronary artery disease and to determine the need for interventions such as angioplasty and stenting. This procedure is crucial for reperfusion therapy, especially in the context of ST-elevation MI (STEMI). Given the client’s symptoms and diagnostic findings, preparing for cardiac catheterization is an appropriate order.
B. While an echocardiogram can be useful for evaluating cardiac function and determining the extent of myocardial damage, it is not typically the immediate priority in the acute management of an MI. The focus is usually on rapid reperfusion therapy and stabilizing the patient. Therefore, this option is less urgent compared to others like administering oxygen and preparing for cardiac catheterization.
C. Warfarin is an oral anticoagulant used for long-term anticoagulation management and is not typically used in the acute setting of an MI. In acute MI management, other anticoagulants such as heparin or low molecular weight heparin are preferred for immediate anticoagulation. Administering warfarin in the acute setting is not appropriate.
D. Furosemide is a diuretic used to manage fluid overload and reduce symptoms of heart failure. It is not indicated as an immediate intervention in acute MI unless there is evidence of significant fluid overload or heart failure symptoms. The client’s current presentation does not suggest an immediate need for furosemide.
E. Supplemental oxygen is important in the management of acute myocardial infarction to ensure
adequate oxygen delivery to the myocardium and to alleviate hypoxia, especially since the client’s oxygen saturation is low at 92%. Providing supplemental oxygen is a standard intervention in the acute management of MI.
F. Sublingual nitroglycerin is commonly used to relieve chest pain in myocardial infarction by causing vasodilation. However, it should be used with caution in the presence of hypotension or other contraindications. Given the client’s symptoms and high heart rate, nitroglycerin could be appropriate,
but should be carefully monitored for effects on blood pressure.
G. A clear liquid diet is not an immediate priority in the management of acute myocardial infarction. Diet modification may be considered later in the course of treatment, but it is not a critical intervention in the acute phase.
Correct Answer is A
Explanation
A. Age-related hearing loss, also known as presbycusis, is a common condition among older adults. It typically involves a gradual decline in hearing ability due to changes in the inner ear or auditory nerve as people age. This statement acknowledges a common experience and helps normalize the patient's condition without suggesting immediate medical intervention or attributing it to something specific.
B. While hearing aids can significantly improve the quality of life for individuals with hearing loss, not all cases immediately require them. It’s important to assess the severity of hearing loss and discuss various options with the patient, including potential benefits and drawbacks of hearing aids.
C. Hearing loss that develops gradually over time is usually related to aging, not an infection. While infections can cause temporary hearing loss, age-related hearing loss is a different issue and is typically not due to an infection.
D. While some medications can cause temporary or permanent hearing loss as a side effect (a condition known as ototoxicity), it’s important to consult a healthcare provider before making any changes to medication regimens.
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