A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink without becoming nauseated and vomiting. Which finding should the nurse report to the healthcare provider?
Amber urine.
Yellow sclera.
Flatulence.
Belching.
The Correct Answer is B
B. Obstruction of bile flow leads to accumulation of bilirubin, a pigment produced by the breakdown of red blood cells, in the bloodstream and causes jaundice (yellowing of the sclera). Yellow sclera is a concerning sign that should be reported promptly to the healthcare provider as it indicates potential bile duct obstruction and impaired liver function
A. Amber urine refers to urine that is dark yellow, often indicating concentrated urine due to dehydration or certain medications. While amber urine may be noted in various conditions, it is not specifically indicative of a complication related to cholelithiasis.
C. While flatulence may be uncomfortable for the client, it is not typically indicative of a complication such as a gallstone lodged in the common bile duct.
D. belching may be uncomfortable for the client but is not typically indicative of a complication such as a gallstone lodged in the common bile duct.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Consuming dairy products, especially those rich in milk and cream, can stimulate gastric acid secretion and exacerbate symptoms of a duodenal ulcer. Therefore, it is essential for the nurse to review with the client the importance of avoiding foods that can aggravate the ulcer and worsen symptoms.
B. While reinforcing teaching about dietary modifications is important, encouraging the client to make a list of snack foods high in dairy content would not address the issue of avoiding dairy products to protect the duodenal ulcer.
C. While switching to decaffeinated coffee and tea can be beneficial for individuals with duodenal ulcers, it does not directly address the client's misconception about using dairy products to coat and protect the ulcer.
D. Eating frequent small meals can help reduce discomfort associated with duodenal ulcers by minimizing gastric acid secretion and preventing large fluctuations in stomach volume.
However, this option does not address the client's misconception.
Correct Answer is D
Explanation
D. For individuals with Huntington's disease, who may experience motor impairments and difficulties with coordination and balance, having someone escort them to the cafeteria could be the most practical and supportive approach.
A. Verbal directions may be a component of assistance but they may not be the most effective approach on their own.
B. Individuals with Huntington's disease may still have difficulties with executive function and orientation, which could limit their ability to effectively use a color coding system independently.
C. Providing a visual representation of the hospital layout using a map could be a helpful approach for a client with Huntington's disease. However, the cognitive and motor impairment present may hinder access even in the presence of a map.
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