Review Cholecystitis

Digestive System Disorders > Medical Surgical

Exam Review

Cholecystitis

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Question 1:

A nurse is providing education to a client diagnosed with cholecystitis. Which statement by the client indicates a need for further teaching?

A. "I should avoid fatty foods in my diet to prevent aggravating my condition." B. "I will take my prescribed antibiotics regularly to treat the infection." C. "I will increase my alcohol intake to help reduce inflammation in my gallbladder." D. "I will apply a warm compress to my abdomen to relieve the pain."

Answer and Explanation

Choice A:

This statement is correct and does not indicate a need for further teaching. Avoiding fatty foods is essential in managing cholecystitis as it reduces the stimulation of the gallbladder and may prevent symptom exacerbation.

Choice B:

This statement is correct and does not indicate a need for further teaching. Taking prescribed antibiotics is important if the cholecystitis is caused by an infection, as it helps in treating the underlying cause.

Choice C:

This statement is incorrect and indicates a need for further teaching. Increasing alcohol intake can worsen inflammation and exacerbate cholecystitis symptoms. Clients with cholecystitis should avoid alcohol to support their recovery.

Choice D:

This statement is correct and does not indicate a need for further teaching. Applying a warm compress to the abdomen can help relieve pain associated with cholecystitis and promote comfort.

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Question 2:

A client diagnosed with acute cholecystitis is scheduled for a cholecystectomy. Which intervention should the nurse implement preoperatively?

A. Encourage deep breathing and coughing exercises. B. Place the client in a supine position with legs elevated. C. Allow the client to have a regular diet until the surgery. D. Administer anticoagulants to prevent postoperative complications.

Answer and Explanation

Choice A:

This statement is correct and is an appropriate preoperative intervention. Encouraging deep breathing and coughing exercises helps prevent postoperative respiratory complications such as atelectasis and pneumonia.

Choice B:

This statement is incorrect and is not an appropriate preoperative intervention. Placing the client in a supine position with legs elevated can increase intraabdominal pressure and worsen cholecystitis symptoms.

Choice C:

This statement is incorrect and is not an appropriate preoperative intervention. The client should be on a restricted diet, avoiding fatty and heavy foods, to prevent exacerbation of cholecystitis symptoms and reduce the risk of complications during surgery.

Choice D:

This statement is incorrect and is not an appropriate preoperative intervention. Anticoagulants are not typically administered preoperatively for cholecystectomy. Their use may increase bleeding risk during surgery and is generally avoided unless medically indicated.

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Question 3:

A nurse is assessing a client with suspected cholecystitis. Which symptom would the nurse expect to find during the physical examination?

A. Hyperactive bowel sounds. B. Severe left upper quadrant pain. C. Right upper quadrant tenderness. D. Pain radiating to the left shoulder.

Answer and Explanation

Choice A:

This statement is incorrect. Hyperactive bowel sounds are not typically associated with cholecystitis and may be seen in conditions such as gastroenteritis or irritable bowel syndrome.

Choice B:

This statement is incorrect. Severe left upper quadrant pain is not characteristic of cholecystitis. Cholecystitis typically presents with right upper quadrant pain.

Choice C:

This statement is correct. Right upper quadrant tenderness is a hallmark symptom of cholecystitis. The inflamed gallbladder causes pain and tenderness in this area.

Choice D:

This statement is incorrect. Pain radiating to the left shoulder is more indicative of conditions such as splenic disorders, not cholecystitis.

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Question 4:

A nurse is providing discharge instructions to a client who underwent a cholecystectomy. Which statement by the client indicates a need for further teaching?

A. "I will eat a low-fat diet to prevent gallstone formation in the future." B. "I should avoid heavy lifting for at least four weeks after the surgery." C. "I will continue to take my prescribed antibiotics until they are finished." D. "I can resume my regular exercise routine immediately after the surgery."

Answer and Explanation

Choice A:

This statement is correct and does not indicate a need for further teaching. Eating a low-fat diet after cholecystectomy is recommended to prevent symptoms and complications related to the digestion of fatty foods.

Choice B:

This statement is correct and does not indicate a need for further teaching. Avoiding heavy lifting for at least four weeks after cholecystectomy is important to allow the surgical site to heal properly and prevent strain on the incision site.

Choice C:

This statement is correct and does not indicate a need for further teaching. It is essential to continue taking prescribed antibiotics until they are finished to prevent infection and promote proper healing after surgery.

Choice D:

This statement is incorrect and indicates a need for further teaching. The client should not resume their regular exercise routine immediately after the surgery. After cholecystectomy, clients should avoid strenuous physical activities for a period specified by the healthcare provider to promote proper healing and prevent complications. The nurse should educate the client on gradually increasing their activity level and resuming exercise after receiving clearance from their healthcare provider.

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Question 5:

A nurse is caring for a client diagnosed with cholecystitis. The nurse should assess the client for which of the following classic clinical manifestations of this condition?

A. Severe lower back pain B. Epigastric pain radiating to the left shoulder C. Right upper quadrant abdominal pain radiating to the right shoulder D. Left lower quadrant abdominal pain with rebound tenderness.

Answer and Explanation

Choice A:

Severe lower back pain is not a classic manifestation of cholecystitis. Cholecystitis typically presents with pain in the right upper quadrant of the abdomen that may radiate to the right shoulder.

Choice B:

Epigastric pain radiating to the left shoulder is not a classic manifestation of cholecystitis. Cholecystitis typically presents with pain in the right upper quadrant of the abdomen that may radiate to the right shoulder.

Choice C:

This statement is correct. Right upper quadrant abdominal pain that radiates to the right shoulder is a classic manifestation of cholecystitis. The pain is often described as sharp or colicky and may worsen after eating fatty or greasy foods.

Choice D:

Left lower quadrant abdominal pain with rebound tenderness is not a classic manifestation of cholecystitis. Cholecystitis typically presents with pain in the right upper quadrant of the abdomen.

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Question 6:

A client is diagnosed with acute cholecystitis and asks the nurse about the difference between acute and chronic cholecystitis. Which of the following responses should the nurse provide?

A. "Acute cholecystitis is a sudden onset of gallbladder inflammation, while chronic cholecystitis is a long-standing inflammation due to repeated episodes." B. "Acute cholecystitis is caused by gallbladder cancer, while chronic cholecystitis is caused by gallstones." C. "Acute cholecystitis is more common in older adults, while chronic cholecystitis is more common in young adults." D. "Acute cholecystitis is treated with lifestyle modifications, while chronic cholecystitis requires surgical removal of the gallbladder."

Answer and Explanation

Choice A:

This statement is correct and explains the difference between acute and chronic cholecystitis. Acute cholecystitis is characterized by a sudden onset of inflammation, often caused by gallstones blocking the cystic duct. On the other hand, chronic cholecystitis is a long-standing inflammation resulting from repeated episodes of acute cholecystitis or chronic irritation from gallstones.

Choice B:

This statement is incorrect. While gallstones can be a cause of both acute and chronic cholecystitis, gallbladder cancer is not a typical cause of either condition.

Choice C:

This statement is incorrect. Acute cholecystitis can affect individuals of all age groups, and age is not a differentiating factor between acute and chronic cholecystitis.

Choice D:

This statement is incorrect. Both acute and chronic cholecystitis may require surgical intervention, depending on the severity and complications of the condition. Lifestyle modifications are often recommended to prevent gallstone formation and manage symptoms, but they are not the sole treatment for acute cholecystitis.

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Question 7:

A nurse is caring for a client with acute cholecystitis. Which of the following clinical manifestations is most commonly associated with this condition?

A. Mild, intermittent right upper quadrant abdominal pain. B. Left lower quadrant abdominal pain with rebound tenderness. C. Severe, colicky abdominal pain radiating to the right shoulder. D. Epigastric pain worsened by fatty meals.

Answer and Explanation

Choice A:

Mild, intermittent right upper quadrant abdominal pain is not typically associated with acute cholecystitis. Acute cholecystitis is characterized by severe and constant pain in the right upper quadrant of the abdomen.

Choice B:

Left lower quadrant abdominal pain with rebound tenderness is not associated with acute cholecystitis. These symptoms may be indicative of other gastrointestinal conditions.

Choice C:

This statement is correct. Severe, colicky abdominal pain that radiates to the right shoulder is a classic clinical manifestation of acute cholecystitis. The pain is often triggered by fatty or greasy meals and can be accompanied by nausea and vomiting.

Choice D:

Epigastric pain worsened by fatty meals is not typically associated with acute cholecystitis. This symptom is more commonly seen in gastroesophageal reflux disease (GERD) or peptic ulcer disease.

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Question 8:

A client is diagnosed with chronic cholecystitis and asks the nurse about the potential complications of this condition. Which of the following responses should the nurse provide?

A. "Chronic cholecystitis can lead to gallbladder cancer if left untreated." B. "Complications of chronic cholecystitis may include pancreatitis or cholangitis." C. "Chronic cholecystitis can cause acute inflammation of the pancreas." D. "Complications of chronic cholecystitis may include lung infections."

Answer and Explanation

Choice A:

While chronic cholecystitis can lead to complications, such as gallbladder inflammation and gallstones, it is not a typical cause of gallbladder cancer.

Choice B:

This statement is correct. Complications of chronic cholecystitis may include pancreatitis, which is inflammation of the pancreas, and cholangitis, which is inflammation of the bile ducts. These complications can occur if gallstones migrate from the gallbladder and obstruct the pancreatic or bile ducts.

Choice C:

This statement is incorrect. Chronic cholecystitis is inflammation of the gallbladder, not the pancreas. However, complications of chronic cholecystitis, such as gallstone migration, can cause acute inflammation of the pancreas (pancreatitis).

Choice D:

Complications of chronic cholecystitis do not typically include lung infections. The primary complications are related to the gallbladder, pancreas, and bile ducts.

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Question 9:

A nurse is teaching a client with chronic cholecystitis about dietary modifications to manage the condition. Which of the following instructions should the nurse include?

A. "You should avoid foods high in fiber to reduce gallstone formation." B. "Limit your fluid intake to prevent exacerbation of chronic cholecystitis." C. "You should avoid fatty and greasy foods to minimize symptoms." D. "Increase your intake of carbonated beverages to improve digestion."

Answer and Explanation

Choice A:

Avoiding foods high in fiber is not recommended to reduce gallstone formation. In fact, a diet high in fiber can promote regular bowel movements and may be beneficial in preventing gallstone formation.

Choice B:

Limiting fluid intake is not recommended to manage chronic cholecystitis. Staying adequately hydrated is essential for overall health and can help prevent gallstone formation.

Choice C:

This statement is correct. Avoiding fatty and greasy foods is recommended to manage chronic cholecystitis. These foods can trigger gallbladder contractions and exacerbate symptoms in individuals with gallstones or chronic inflammation.

Choice D:

Increasing the intake of carbonated beverages is not recommended to improve digestion or manage chronic cholecystitis. Carbonated beverages can potentially worsen symptoms in some individuals with gallbladder conditions.

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Question 10:

A client with acute cholecystitis is scheduled for surgery. Which of the following interventions should the nurse implement preoperatively?

A. Encourage the client to eat a high-fat meal the night before the surgery. B. Administer antibiotics prophylactically before the surgery. C. Advise the client to avoid deep breathing exercises. D. Instruct the client to remain NPO (nothing by mouth) after midnight before the surgery.

Answer and Explanation

Choice A:

Encouraging the client to eat a high-fat meal the night before the surgery is not recommended. Instead, clients scheduled for surgery, especially abdominal surgery, are typically instructed to have a clear liquid diet or nothing by mouth (NPO) after midnight to prevent aspiration during anesthesia.

Choice B:

Administering antibiotics prophylactically before surgery is often done to prevent infection during the procedure. However, it is at the discretion of the healthcare provider based on the client's specific condition and surgical plan.

Choice C:

Avoiding deep breathing exercises is not recommended preoperatively. Deep breathing exercises help prevent respiratory complications after surgery and promote lung function.

Choice D:

This statement is correct. Instructing the client to remain NPO after midnight before the surgery is essential to prevent aspiration during anesthesia. Clients should not eat or drink anything after the specified time to ensure their stomach is empty during the surgery.

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Question 11:

A client asks a nurse about the risk factors for developing cholecystitis. Which of the following factors should the nurse include in the response?

A. Age below 30 years B. Regular physical exercise C. Family history of gallstones D. Low-fat diet consumption

Answer and Explanation

Choice A:

Age below 30 years is not a risk factor for developing cholecystitis. Cholecystitis is more commonly seen in individuals over the age of 40, especially in those with additional risk factors such as obesity or a high-fat diet.

Choice B:

Regular physical exercise is not considered a risk factor for cholecystitis. In fact, staying physically active is generally beneficial for overall health and may help reduce the risk of gallstone formation.

Choice C:

This statement is correct. Family history of gallstones is a significant risk factor for developing cholecystitis. Genetics can play a role in the composition of bile and the propensity to form gallstones.

Choice D:

Consuming a low-fat diet is not a risk factor for cholecystitis. On the contrary, a high-fat diet is associated with an increased risk of gallstone formation and subsequent cholecystitis.

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Question 12:

A nurse is teaching a client about the etiology of cholecystitis. Which of the following factors should the nurse include as a common cause of gallbladder inflammation?

A. Chronic alcohol consumption B. Excessive consumption of dairy products C. Blockage of the cystic duct by a gallstone D. Allergic reactions to certain foods

Answer and Explanation

Choice A:

Chronic alcohol consumption is not a common cause of gallbladder inflammation or cholecystitis. However, excessive alcohol consumption can contribute to liver disease, which may increase the risk of gallstone formation.

Choice B:

Excessive consumption of dairy products is not a common cause of gallbladder inflammation. The primary factors leading to cholecystitis are gallstones, inflammation of the gallbladder wall, or infection.

Choice C:

This statement is correct. Blockage of the cystic duct by a gallstone is a common cause of gallbladder inflammation. When a gallstone obstructs the cystic duct, bile cannot flow freely, leading to increased pressure and inflammation of the gallbladder wall, resulting in cholecystitis.

Choice D:

Allergic reactions to certain foods are not a common cause of gallbladder inflammation or cholecystitis. Cholecystitis is primarily related to gallstones, bile flow abnormalities, or infections.

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Question 13:

A client with obesity is concerned about the risk of developing cholecystitis. Which of the following explanations should the nurse provide regarding the relationship between obesity and gallstone formation?

A. "Obesity increases the production of bile, reducing the risk of gallstone formation." B. "Obesity leads to decreased cholesterol levels in the bile, reducing the risk of gallstone formation." C. "Obesity increases the concentration of cholesterol in the bile, promoting gallstone formation." D. "Obesity slows down the emptying of the gallbladder, reducing the risk of gallstone formation."

Answer and Explanation

Choice A:

Obesity does not increase the production of bile. However, it can lead to changes in bile composition, increasing the risk of gallstone formation.

Choice B:

This statement is incorrect. Obesity is associated with an increased concentration of cholesterol in the bile, which can contribute to gallstone formation.

Choice C:

This statement is correct. Obesity increases the concentration of cholesterol in the bile, which promotes gallstone formation. When there is an excess of cholesterol in the bile, it can crystallize and form gallstones.

Choice D:

Obesity does not slow down the emptying of the gallbladder. On the contrary, obesity may lead to reduced gallbladder motility, which can contribute to gallstone formation due to stasis of bile.

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Question 14:

A nurse is providing education to a client with a history of diabetes mellitus about the risk of developing cholecystitis. Which of the following explanations should the nurse include in the teaching?

A. "Diabetes increases the bile production, reducing the risk of gallstone formation." B. "Diabetes leads to decreased cholesterol levels in the bile, reducing the risk of gallstone formation." C. "Diabetes impairs the function of the sphincter of Oddi, increasing the risk of gallstone formation." D. "Diabetes increases the motility of the gallbladder, reducing the risk of gallstone formation."

Answer and Explanation

Choice A:

Diabetes does not increase bile production. However, it can lead to changes in bile composition, increasing the risk of gallstone formation.

Choice B:

This statement is incorrect. Diabetes is associated with increased cholesterol levels in the bile, which can contribute to gallstone formation.

Choice C:

This statement is correct. Diabetes can impair the function of the sphincter of Oddi, a muscular valve that controls the flow of bile into the duodenum. Dysfunction of the sphincter can lead to bile stasis and increase the risk of gallstone formation.

Choice D:

Diabetes does not increase the motility of the gallbladder. Instead, it may lead to reduced gallbladder motility, which can contribute to gallstone formation due to stasis of bile.

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Question 15:

A client is concerned about the risk of developing cholecystitis due to a family history of gallstones. Which of the following explanations should the nurse provide regarding the genetic predisposition to gallstone formation?

A. "Genetic factors have no influence on gallstone formation." B. "Family history increases the risk of developing gallstones by approximately 10%." C. "Genetic factors play a significant role in determining bile composition, increasing the risk of gallstone formation." D. "Family history only affects the risk of gallstones in men, not women."

Answer and Explanation

Choice A:

This statement is incorrect. Genetic factors can influence bile composition and the risk of gallstone formation.

Choice B:

This statement is incorrect. Family history of gallstones can significantly increase the risk of developing gallstones, more than 10%.

Choice C:

This statement is correct. Genetic factors play a significant role in determining bile composition and gallstone formation. Certain genetic variations can increase cholesterol levels or affect the balance of bile components, predisposing individuals to gallstone formation.

Choice D:

Family history of gallstones can affect the risk of gallstones in both men and women. It is not limited to a specific gender.

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Question 16:

A client presents to the emergency department with severe right upper quadrant abdominal pain, nausea, and vomiting. The client states the pain radiates to the right shoulder. Which of the following conditions should the nurse suspect based on these clinical manifestations?

A. Appendicitis B. Gastroenteritis C. Cholecystitis D. Pancreatitis

Answer and Explanation

Choice A:

Appendicitis typically presents with pain in the lower right abdomen and may be associated with fever and rebound tenderness.

Choice B:

Gastroenteritis can cause abdominal pain and vomiting, but it does not usually cause pain radiating to the right shoulder.

Choice C:

This statement is correct. Cholecystitis is characterized by severe right upper quadrant abdominal pain that may radiate to the right shoulder, along with nausea and vomiting.

Choice D:

Pancreatitis may cause upper abdominal pain, but it typically radiates to the back rather than the right shoulder.

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Question 17:

A nurse is assessing a client with suspected acute cholecystitis. Which of the following physical examination findings is a hallmark sign of this condition?

A. Rebound tenderness in the right upper quadrant B. Murphy's sign C. Hypoactive bowel sounds D. Left lower quadrant abdominal pain

Answer and Explanation

Choice A:

Rebound tenderness in the right upper quadrant is not a hallmark sign of acute cholecystitis. It may be present in conditions such as appendicitis or peritonitis.

Choice B:

This statement is correct. Murphy's sign is a hallmark sign of acute cholecystitis. It is elicited by asking the client to take a deep breath while the nurse palpates the right upper quadrant. If the client abruptly stops breathing due to pain upon palpation, it indicates inflammation of the gallbladder (positive Murphy's sign).

Choice C:

Hypoactive bowel sounds may be present in some gastrointestinal conditions but are not specific to acute cholecystitis.

Choice D:

Left lower quadrant abdominal pain is not associated with acute cholecystitis. This type of pain is more commonly seen in conditions such as diverticulitis or colitis.

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Question 18:

A client diagnosed with cholecystitis reports experiencing severe itching (pruritus) on the skin. Which of the following explanations should the nurse provide for this symptom?

A. "The itching is unrelated to your cholecystitis and may be due to an allergic reaction." B. "Cholecystitis can cause bile salts to accumulate in your skin, leading to itching." C. "The itching is a result of dehydration, which is common in cholecystitis." D. "Cholecystitis can cause elevated blood sugar levels, which may lead to itching."

Answer and Explanation

Choice A:

Itching is not typically associated with an allergic reaction and is more likely related to cholecystitis itself or complications such as cholangitis or bile duct obstruction.

Choice B:

This statement is correct. Cholecystitis can cause bile salts to accumulate in the skin, leading to pruritus (itching). When the bile flow is obstructed or altered, bile salts may not be properly eliminated from the body, leading to their accumulation in the skin and causing itching.

Choice C:

Dehydration may occur in some cases of cholecystitis due to nausea, vomiting, or reduced fluid intake, but it is not the primary cause of pruritus.

Choice D:

Cholecystitis does not typically cause elevated blood sugar levels. However, certain conditions like diabetes mellitus may increase the risk of cholecystitis.

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Question 19:

A nurse is caring for a client with suspected cholecystitis. The client complains of dark urine and pale-colored stools. Which of the following explanations should the nurse provide for these changes in bowel habits?

A. "These changes are unrelated to your condition and may be due to a gastrointestinal infection." B. "Cholecystitis can lead to malabsorption of nutrients, resulting in changes in stool color." C. "Cholecystitis can obstruct the bile duct, leading to decreased bilirubin excretion and changes in urine and stool color." D. "These changes are related to dehydration, which is common in cholecystitis."

Answer and Explanation

Choice A:

Dark urine and pale-colored stools are not typically associated with a gastrointestinal infection. These symptoms are more indicative of changes in bile flow or bilirubin excretion.

Choice B:

While cholecystitis can lead to malabsorption of nutrients, it is not the primary cause of changes in stool color to pale.

Choice C:

This statement is correct. Cholecystitis can obstruct the bile duct, leading to a decrease in bilirubin excretion. Bilirubin gives urine its characteristic color, and when excretion is reduced, the urine becomes darker (brownish). Likewise, the absence of bilirubin in the stool leads to pale-colored or clay-colored stools.

Choice D:

Dehydration may occur in some cases of cholecystitis, but it is not the primary cause of changes in urine and stool color.

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Question 20:

A client presents with severe right upper quadrant abdominal pain, fever, and jaundice (yellowing of the skin and eyes). Which of the following conditions should the nurse suspect based on these clinical manifestations?

A. Gastroenteritis B. Cholecystitis with cholangitis C. Urinary tract infection D. Gastroesophageal reflux disease (GERD)

Answer and Explanation

Choice A:

Gastroenteritis typically presents with symptoms such as diarrhea, vomiting, and abdominal cramps. It does not cause jaundice or severe right upper quadrant pain.

Choice B:

This statement is correct. Cholecystitis with cholangitis is characterized by severe right upper quadrant abdominal pain, fever, and jaundice. Cholangitis is an inflammation of the bile ducts, often caused by gallstone migration and obstruction.

Choice C:

A urinary tract infection may cause symptoms such as burning urination and frequent urination but does not present with right upper quadrant abdominal pain or jaundice.

Choice D:

GERD is a condition characterized by acid reflux and heartburn. It does not cause severe right upper quadrant abdominal pain or jaundice.

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Question 21:

A nurse is preparing a client for an abdominal ultrasound to evaluate suspected cholecystitis. Which of the following instructions should the nurse provide to the client before the procedure?

A. "You should fast for at least 12 hours before the ultrasound." B. "You need to drink a gallon of water before the ultrasound to fill your bladder." C. "You should avoid drinking any liquids for 2 hours before the ultrasound." D. "You need to have a full bladder for the ultrasound, so please drink 16 ounces of water."

Answer and Explanation

Choice A:

Fasting for 12 hours is not required before an abdominal ultrasound. However, the client may be asked to avoid eating fatty or heavy meals before the procedure.

Choice B:

Filling the bladder with a gallon of water is unnecessary and not related to an abdominal ultrasound. A full bladder is required for pelvic ultrasounds, not abdominal ultrasounds.

Choice C:

Avoiding drinking liquids for 2 hours before the ultrasound is not necessary. In fact, a full bladder is preferred for better visualization during an abdominal ultrasound.

Choice D:

This statement is correct. To have a full bladder for the ultrasound, the client should drink 16 ounces of water about one hour before the procedure. A full bladder helps lift the intestines and improves the visualization of the gallbladder and surrounding structures.

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Question 22:

A client is scheduled for a hepatobiliary iminodiacetic acid (HIDA) scan to evaluate suspected cholecystitis. Which of the following explanations should the nurse provide to the client about the purpose of this test?

A. "The HIDA scan will provide detailed images of your gallbladder using magnetic resonance imaging." B. "During the HIDA scan, a radioactive tracer will be injected to evaluate the function of your liver." C. "The HIDA scan will assess the patency of your biliary system and the emptying of your gallbladder." D. "This scan uses an endoscope to visualize your pancreas and detect any abnormalities."

Answer and Explanation

Choice A:

This statement is incorrect. The HIDA scan does not use magnetic resonance imaging (MRI) to visualize the gallbladder. It is a nuclear medicine test that uses a radioactive tracer.

Choice B:

This statement is incorrect. While the HIDA scan involves the use of a radioactive tracer, its purpose is not to evaluate liver function. Instead, it assesses the biliary system and gallbladder.

Choice C:

This statement is correct. The HIDA scan is a nuclear medicine test used to assess the patency of the biliary system and the emptying of the gallbladder. A radioactive tracer is injected into the client's bloodstream, and its uptake and excretion into the biliary system are monitored.

Choice D:

This statement is incorrect. The HIDA scan does not involve the use of an endoscope. It is a non-invasive imaging test that is performed externally, not internally.

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Question 23:

A nurse is reviewing the diagnostic results for a client with suspected cholecystitis. Which of the following laboratory findings is commonly elevated in this condition?

A. Serum amylase B. Blood urea nitrogen (BUN) C. Serum bilirubin D. C-reactive protein (CRP)

Answer and Explanation

Choice A:

Serum amylase is typically elevated in pancreatitis, not cholecystitis.

Choice B:

Blood urea nitrogen (BUN) is a kidney function marker and is not directly related to cholecystitis.

Choice C:

This statement is correct. Serum bilirubin is commonly elevated in cholecystitis due to bile duct obstruction or impaired bile flow. Elevated bilirubin levels can cause jaundice (yellowing of the skin and eyes) in some cases.

Choice D:

C-reactive protein (CRP) is a marker of inflammation and can be elevated in various conditions, including cholecystitis. However, it is not specific to cholecystitis and may also be elevated in other inflammatory processes.

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Question 24:

A client is undergoing an endoscopic retrograde cholangiopancreatography (ERCP) to evaluate the biliary system for suspected cholecystitis. Which of the following explanations should the nurse provide to the client about this procedure?

A. "ERCP involves the use of magnetic resonance imaging to visualize your biliary system." B. "During ERCP, a radioactive tracer will be injected to assess your gallbladder function." C. "ERCP is an invasive procedure that uses an endoscope to visualize and treat your biliary system." D. "This procedure is a non-invasive test that uses sound waves to create images of your abdomen."

Answer and Explanation

Choice A:

This statement is incorrect. ERCP does not involve the use of magnetic resonance imaging (MRI). It is an endoscopic procedure that combines endoscopy with fluoroscopy to visualize the biliary system.

Choice B:

This statement is incorrect. ERCP uses a contrast dye, not a radioactive tracer, to visualize the biliary system and identify abnormalities or obstructions.

Choice C:

This statement is correct. ERCP is an invasive procedure that involves the use of an endoscope. The endoscope is inserted through the mouth and guided through the digestive tract to the duodenum, where contrast dye is injected into the biliary and pancreatic ducts to visualize their structures and identify any abnormalities.

Choice D:

This statement is incorrect. ERCP is not a non-invasive test that uses sound waves. It is an invasive procedure that requires the insertion of an endoscope into the body to view the biliary system.

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Question 25:

A client is diagnosed with acute cholecystitis and is scheduled for a cholecystectomy. The client asks the nurse about the benefits of laparoscopic surgery compared to open surgery. Which of the following responses should the nurse provide?

A. "Laparoscopic surgery involves a smaller incision, resulting in less postoperative pain and a shorter hospital stay." B. "Open surgery is preferred for cholecystitis as it allows for better visualization and reduces the risk of surgical complications." C. "Both laparoscopic and open surgeries have similar outcomes, but laparoscopic surgery has a longer recovery time." D. "You can choose either type of surgery, but laparoscopic surgery is associated with a higher risk of postoperative infection."

Answer and Explanation

Choice A:

This statement is correct. Laparoscopic cholecystectomy involves making several small incisions, resulting in less postoperative pain, reduced scarring, and a shorter hospital stay compared to open surgery.

Choice B:

Open surgery may have advantages in certain situations, but for uncomplicated cases of acute cholecystitis, laparoscopic surgery is generally preferred due to its minimally invasive nature.

Choice C:

Laparoscopic surgery is associated with a shorter recovery time and faster return to normal activities compared to open surgery.

Choice D:

Laparoscopic surgery is not associated with a higher risk of postoperative infection. In fact, it is known for having lower rates of surgical site infections compared to open surgery.

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Question 26:

A client is recovering from a cholecystectomy and reports feeling nauseous and experiencing episodes of vomiting. The nurse reviews the client's medication history and notes that opioid analgesics were administered for postoperative pain. Which of the following interventions should the nurse implement to address this issue?

A. Administer an antiemetic medication as prescribed to alleviate nausea and vomiting. B. Encourage the client to eat a high-fat diet to stimulate gallbladder function and reduce symptoms. C. Explain to the client that nausea and vomiting are common after surgery and will resolve on their own. D. Request an order for additional opioids to manage pain, as they may have contributed to the nausea.

Answer and Explanation

Choice A:

This statement is correct. Administering an antiemetic medication can help alleviate nausea and vomiting, which are common side effects of opioid analgesics used for postoperative pain management.

Choice B:

Eating a high-fat diet is not recommended after cholecystectomy, as the gallbladder has been removed. Consuming high-fat foods may exacerbate symptoms and lead to digestive discomfort.

Choice C:

While nausea and vomiting can be common after surgery, it is important to address these symptoms to ensure the client's comfort and prevent dehydration or other complications.

Choice D:

Requesting additional opioids to manage pain may worsen the nausea and vomiting. It is essential to balance pain management with measures to minimize side effects like nausea.

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Question 27:

A nurse is caring for a client with chronic cholecystitis who is experiencing intermittent pain and discomfort. Which of the following measures should the nurse recommend to manage pain and improve symptoms in this client?

A. Encourage the client to engage in strenuous physical activities to distract from the pain. B. Suggest using a heating pad on the abdomen to alleviate pain and discomfort. C. Advise the client to consume a high-fat diet to maintain gallbladder function. D. Recommend the use of over-the-counter NSAIDs for pain relief.

Answer and Explanation

Choice A:

Engaging in strenuous physical activities may exacerbate the pain and discomfort in a client with chronic cholecystitis. Moderate physical activity is encouraged, but strenuous activities should be avoided.

Choice B:

This statement is correct. Applying a heating pad on the abdomen can help alleviate pain and discomfort associated with chronic cholecystitis. Heat therapy helps relax muscles and may ease the tension in the affected area.

Choice C:

Consuming a high-fat diet is not recommended for a client with chronic cholecystitis. A low-fat diet is recommended to reduce gallbladder stimulation and prevent symptoms.

Choice D:

While over-the-counter NSAIDs can be effective for mild pain relief, they should be used with caution in clients with cholecystitis, especially if there is any concern about gallstone-related inflammation. It is best to consult with a healthcare provider before using NSAIDs in this case.

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Question 28:

A nurse is caring for a client who had a cholecystostomy for cholecystitis. The client reports pain at the site of the drainage tube. Upon assessment, the nurse notes redness and swelling around the insertion site. Which of the following actions should the nurse take first?

A. Administer a pain medication to relieve the client's discomfort. B. Notify the healthcare provider about the client's symptoms and findings. C. Apply an ice pack to the insertion site to reduce inflammation. D. Change the dressing and clean the insertion site with an antiseptic solution.

Answer and Explanation

Choice A:

While pain relief is important, it is essential to address the redness and swelling first, as they may indicate an infection or other complication related to the cholecystostomy.

Choice B:

This statement is correct. The nurse should notify the healthcare provider immediately about the client's symptoms and findings to ensure prompt evaluation and appropriate interventions.

Choice C:

Applying an ice pack may provide some relief for pain and inflammation, but it does not address the potential underlying cause of redness and swelling.

Choice D:

Changing the dressing and cleaning the insertion site is important for maintaining cleanliness, but the nurse should first notify the healthcare provider about the client's symptoms for further evaluation.

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Question 29:

A nurse is providing discharge instructions to a client who underwent a cholecystectomy. The client asks when they can resume their regular physical activities. Which of the following responses should the nurse provide?

A. "You can resume your regular physical activities immediately after the surgery." B. "You should wait at least 24 hours before resuming any physical activities." C. "You can start light physical activities within a few days and gradually increase as tolerated." D. "It is best to avoid physical activities for at least four weeks after the surgery."

Answer and Explanation

Choice A:

Resuming physical activities immediately after surgery may put the client at risk of complications and delayed healing. It is essential to allow sufficient time for recovery before engaging in physical activities.

Choice B:

Waiting only 24 hours may not provide enough time for the client to recover from the surgery and avoid potential complications.

Choice C:

This statement is correct. The client can start light physical activities within a few days after the surgery, as long as they are tolerated well. Gradually increasing physical activities over time is important to prevent strain and ensure a safe recovery.

Choice D:

Avoiding physical activities for four weeks is unnecessary and may lead to physical deconditioning. Gradual reengagement in physical activities is encouraged to support the healing process.

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Question 30:

A client is recovering from a cholecystectomy and asks the nurse about dietary recommendations post-surgery. Which of the following responses should the nurse provide?

A. "You can resume your regular diet immediately after the surgery." B. "You should follow a low-fat diet for several weeks to aid in healing." C. "A high-protein diet is recommended to promote wound healing." D. "You should avoid all solid foods for the first 24 hours after the surgery."

Answer and Explanation

Choice A:

Resuming a regular diet immediately after a cholecystectomy may be too heavy for the digestive system, which is still recovering from the surgery.

Choice B:

This statement is correct. Following a low-fat diet for several weeks after a cholecystectomy can reduce the strain on the digestive system and allow the body to adjust to the absence of the gallbladder.

Choice C:

While protein is essential for wound healing, a high-protein diet is not specifically recommended for a client recovering from a cholecystectomy.

Choice D:

Avoiding all solid foods for 24 hours after the surgery is unnecessary and may lead to nutritional deficits. The client can gradually resume a low-fat, solid diet after the surgery.

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Question 31:

A nurse is caring for a client with cholecystitis who is experiencing severe abdominal pain. Which of the following actions should the nurse take first?

A. Administer pain medication as prescribed. B. Assess the client's vital signs and pain level. C. Place the client in a semi-Fowler's position. D. Offer the client a cup of herbal tea for relaxation.

Answer and Explanation

Choice A:

Administering pain medication is important, but assessing the client's vital signs and pain level takes priority to determine the severity of the pain and the appropriate intervention.

Choice B:

This statement is correct. Assessing the client's vital signs and pain level is the first action the nurse should take to evaluate the client's condition and determine the appropriate intervention.

Choice C:

Placing the client in a semi-Fowler's position may provide some comfort, but it does not address the underlying pain or assist in determining the severity of the situation.

Choice D:

Offering herbal tea for relaxation is a non-pharmacological intervention that can be helpful, but it is not the first action the nurse should take when the client is experiencing severe abdominal pain.

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Question 32:

A client with cholecystitis is scheduled for a cholecystectomy and expresses fear and anxiety about the surgery. Which of the following statements by the nurse is most appropriate?

A. "Don't worry, cholecystectomy is a routine procedure with minimal risks." B. "You should avoid thinking about the surgery until the day of the procedure." C. "Tell me more about your fears and concerns regarding the surgery." D. "I had the same surgery before, and everything went perfectly fine."

Answer and Explanation

Choice A:

While cholecystectomy is a common procedure, minimizing the client's fear and anxiety by downplaying the risks is not appropriate. It is essential to acknowledge the client's concerns and address them appropriately.

Choice B:

Avoiding thinking about the surgery may not be helpful for the client. It is essential to encourage open communication and support the client in expressing their fears and concerns.

Choice C:

This statement is correct. Encouraging the client to express their fears and concerns allows the nurse to address them appropriately and provide the necessary support and information to reduce anxiety.

Choice D:

While sharing personal experiences can sometimes be helpful, it is essential to focus on the client's feelings and needs rather than diverting attention to the nurse's experience.

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Question 33:

A client with cholecystitis is scheduled for a laparoscopic cholecystectomy. The nurse is preparing the client for surgery and explains the importance of deep breathing exercises. Which of the following benefits of deep breathing should the nurse include in the explanation?

A. "Deep breathing exercises can help prevent postoperative infection." B. "Deep breathing exercises can strengthen your abdominal muscles." C. "Deep breathing exercises can promote lung expansion and prevent respiratory complications." D. "Deep breathing exercises can help reduce the risk of gallstone formation."

Answer and Explanation

Choice A:

Deep breathing exercises do not directly prevent postoperative infection. However, they can help with postoperative lung expansion and prevent respiratory complications, indirectly reducing the risk of infection.

Choice B:

While deep breathing exercises can help improve respiratory function, they are not specifically targeted at strengthening abdominal muscles.

Choice C:

This statement is correct. Deep breathing exercises promote lung expansion and prevent atelectasis (partial lung collapse) after surgery. They help maintain adequate oxygenation and prevent respiratory complications.

Choice D:

Deep breathing exercises are not directly related to reducing the risk of gallstone formation. Gallstone formation is primarily influenced by factors such as diet, bile composition, and gallbladder function.

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Question 34:

A nurse is providing discharge instructions to a client after a cholecystectomy. Which of the following statements by the client indicates a need for further teaching?

A. "I will avoid lifting heavy objects for the next few weeks." B. "I should report any signs of infection or wound complications." C. "I can resume my regular diet immediately after the surgery." D. "I will take my prescribed pain medication as needed for discomfort."

Answer and Explanation

Choice A:

Avoiding heavy lifting is important after a cholecystectomy to prevent strain on the surgical site and reduce the risk of complications.

Choice B:

Reporting signs of infection or wound complications is essential for early detection and appropriate management.

Choice C:

This statement indicates a need for further teaching. After a cholecystectomy, the client should follow a low-fat diet for several weeks before gradually reintroducing regular foods.

Choice D:

Taking prescribed pain medication as needed is essential for managing postoperative discomfort and promoting recovery.

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