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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. While vitamin A can interact with some medications, it does not have a significant effect on verteporfin.
B. Verteporfin does not typically affect blood sugar levels.
C. Verteporfin is usually administered intravenously, so it is not taken orally.
D. Verteporfin is a photosensitizing agent used in photodynamic therapy for age-related macular degeneration. After treatment with verteporfin, the client should avoid sunlight and other intense light for several days to prevent a severe sunburn-like reaction. This is because verteporfin makes the skin and eyes more sensitive to light.

A. Laparoscopic splenectomy B. Transfusion of platelets C. Replacement of ADAMTS-13 D. Administration of protamine sulfate

Correct Answer is A

Explanation

A. Laparoscopic splenectomy involves the surgical removal of the spleen. The spleen is an organ where platelets are often destroyed in ITP. Removing the spleen can reduce the destruction of platelets and potentially improve platelet counts. This procedure is considered when medical therapy fails to adequately control the condition and is often effective in increasing platelet counts for many patients with chronic ITP.
B. Transfusion of platelets is generally not effective in ITP because the underlying problem is that the platelets are being destroyed by the immune system. Platelet transfusions may provide a temporary increase in platelet count but do not address the underlying cause of platelet destruction.
C. ADAMTS-13 is a von Willebrand factor-cleaving protease associated with thrombotic thrombocytopenic purpura (TTP), not ITP. Replacement of ADAMTS-13 is relevant for treating TTP, a different condition that also involves thrombocytopenia but has a different pathophysiology.
D. Protamine sulfate is used to reverse the effects of heparin, an anticoagulant. It is not used to treat ITP and does not affect platelet destruction or platelet count. This procedure is not relevant to the management of ITP.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with age-related macular degeneration (AMD) is undergoing photodynamic therapy with the medication Verteporfin. What should the nurse include in the discharge teaching for this client?

Correct Answer is D

Explanation

A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelet count remains low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?

Correct Answer is A

Explanation

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