A nurse is providing education to a client who needs a cholecystectomy due to a build-up of calculi or gallstones. Which of the following is the best response from the nurse to explain what caused this problem?
The gallbladder has become blocked by a tumor and is no longer working.
The gallbladder has become inflamed due to a build-up of gallstones that are blocking the common bile duct.
The gallbladder has become inflamed due to the cholesterol in the gallstones.
The gallbladder became infected by a virus and needs to be removed.
The Correct Answer is B
Choice A Reason:
This option suggests that the gallbladder is blocked by a tumor. While tumors can cause blockages, they are not the most common cause of gallbladder inflammation requiring a cholecystectomy. Gallstones are a more frequent cause of such issues.
Choice B Reason:
This is the correct answer. Gallstones can block the common bile duct, leading to inflammation of the gallbladder, a condition known as cholecystitis. This blockage prevents bile from flowing out of the gallbladder, causing pain and potentially leading to infection.
Choice C Reason:
While cholesterol is a component of many gallstones, the inflammation of the gallbladder is typically due to the physical blockage caused by the stones rather than the cholesterol itself. The blockage leads to bile buildup and subsequent inflammation.
Choice D Reason:
Gallbladder infections caused by viruses are extremely rare. Most gallbladder infections are bacterial and occur secondary to blockages caused by gallstones.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Choice A Reason: Production of potassium
The musculoskeletal system does not produce potassium. Potassium is an essential mineral that is obtained through the diet and is crucial for various bodily functions, including muscle contraction and nerve function. The musculoskeletal system, however, is not involved in its production.
Choice B Reason: Maintains the body’s form and shape
One of the primary functions of the musculoskeletal system is to maintain the body’s form and shape. The skeletal system provides the framework that supports the body and gives it structure. Muscles attached to the bones help maintain posture and allow for movement, contributing to the overall form and shape of the body.
Choice C Reason: Provides reflexive responses to injuries
While the musculoskeletal system is involved in movement and support, reflexive responses to injuries are primarily mediated by the nervous system3. Reflex actions are automatic responses to stimuli that involve the spinal cord and peripheral nerves, not the musculoskeletal system directly.
Choice D Reason: Formation of blood cells through red or yellow marrow
The formation of blood cells, known as hematopoiesis, occurs in the bone marrow, which is part of the skeletal system. Red bone marrow is responsible for producing red blood cells, white blood cells, and platelets. Yellow bone marrow, primarily composed of fat cells, can also convert to red marrow if necessary to increase blood cell production.
Choice E Reason: Protection of soft organs
The musculoskeletal system plays a crucial role in protecting soft organs. For example, the rib cage protects the heart and lungs, the skull encases the brain, and the vertebrae shield the spinal cord. This protective function is vital for preventing injury to these essential organs.
Correct Answer is A
Explanation
Choice A Reason:
Contact precautions are recommended for patients with MRSA to prevent the spread of the bacteria. This includes measures such as placing the patient in a single room, using personal protective equipment (PPE) like gowns and gloves, and ensuring proper hand hygiene. These precautions help to minimize the risk of transmission through direct or indirect contact with the patient or their environment.
Choice B Reason:
Protective precautions, also known as reverse isolation, are used to protect immunocompromised patients from infections. This is not applicable for MRSA patients, as the goal is to prevent the spread of MRSA to others, not to protect the patient from external infections.
Choice C Reason:
Airborne precautions are used for diseases that are transmitted through the air, such as tuberculosis or measles. MRSA is not transmitted through airborne particles, so this type of precaution is not appropriate.
Choice D Reason:
Droplet precautions are used for diseases that are spread through large respiratory droplets, such as influenza or pertussis. MRSA is primarily spread through direct contact, not through respiratory droplets, making droplet precautions unnecessary.
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