The Gallbladder (questions from Easy Notecards) B) Bleeding and perforation

A) Laparoscopic cholecystectomy C) Acidosis and hypoglycemia

1) A patient presents to the emergency B) Methyl tertiary butyl ether (MTBE) infusion D) Gangrene of the gallbladder and
department (ED) complaining of severe right C) Intracorporeal lithotripsy hyperglycemia
upper quadrant pain. The patient states that his D) Extracorporeal shock wave therapy (ESWL)
family doctor told him he had gallstones. The ED 8) A nurse is assessing an elderly patient with
nurse should recognize what possible 5) A patient with cholelithiasis has been gallstones. The nurse is aware that the patient
complication of gallstones? scheduled for a laparoscopic cholecystectomy. may not exhibit typical symptoms, and that
Why is laparoscopic cholecystectomy preferred particular symptoms that may be exhibited in the
A) Acute pancreatitis by surgeons over an open procedure? elderly patient may include what?
B) Atrophy of the gallbladder
C) Gallbladder cancer A) Laparoscopic cholecystectomy poses A) Fever and pain
D) Gangrene of the gallbladder fewer surgical risks than an open procedure. B) Chills and jaundice
B) Laparoscopic cholecystectomy can be C) Nausea and vomiting
2) A nurse is providing discharge education to a performed in a clinic setting, while an open D) Signs and symptoms of septic shock
patient who has undergone a laparoscopic
procedure requires an OR.
cholecystectomy. During the immediate recovery
C) A laparoscopic approach allows for the 9) A nurse is assisting with serving dinner trays
period, the nurse should recommend what
removal of the entire gallbladder. on the unit. Upon receiving the dinner tray for a
foods?
patient admitted with acute gallbladder
D) A laparoscopic approach can be performed
inflammation, the nurse will question which of
A) High-fiber foods under conscious sedation. the following foods on the tray?
B) Low-purine, nutrient-dense foods
C) Low-fat foods high in proteins and 6) A patient is admitted to the unit with acute A) Fried chicken
carbohydrates cholecystitis. The physician has noted that B) Mashed potatoes
surgery will be scheduled in 4 days. The patient
D) Foods that are low-residue and low in fat C) Dinner roll
asks why the surgery is being put off for a week
when he has a “sick gallbladder.” What rationale D) Tapioca pudding
3) A nurse is caring for a patient with gallstones would underlie the nurse’s response?
who has been prescribed ursodeoxycholic acid 10) A patient with gallstones has been
(UDCA). The patient asks how this medicine is A) Surgery is delayed until the patient can eat a prescribed ursodeoxycholic acid (UDCA). The
going to help his symptoms. The nurse should regular diet without vomiting. nurse understands that additional teaching is
be aware of what aspect of this drug’s B) Surgery is delayed until the acute needed regarding this medication when the
pharmacodynamics? patient states:
symptoms subside.
A) It inhibits the synthesis of bile. C) The patient requires aggressive nutritional A) “It is important that I see my physician for
B) It inhibits the synthesis and secretion of support prior to surgery. scheduled follow-up appointments while taking
cholesterol. D) Time is needed to determine whether a this medication.”
C) It inhibits the secretion of bile. laparoscopic procedure can be used. B) “I will take this medication for 2 weeks
D) It inhibits the synthesis and secretion of and then gradually stop taking it.”
7) The nurse is caring for a patient who has just
amylase. C) “If I lose weight, the dose of the medication
returned from the ERCP removal of gallstones.
4) A patient with ongoing back pain, nausea, The nurse should monitor the patient for signs of may need to be changed.”
and abdominal bloating has been diagnosed what complications? D) “This medication will help dissolve small
with cholecystitis secondary to gallstones. The gallstones made of cholesterol.”
nurse should anticipate that the patient will A) Pain and peritonitis
undergo what intervention?
11) A patient returns to the floor after a
laparoscopic cholecystectomy. The nurse should A) The need to protect the incision post 18) A nurse is assessing a patient who has been
assess the patient for signs and symptoms of procedure diagnosed with cholecystitis, and is experiencing
what serious potential complication of this B) The use of moderate sedation localized abdominal pain. When assessing the
surgery? characteristics of the patient’s pain, the nurse
C) The need to infuse 50% dextrose during the
should anticipate that it may radiate to what
procedure
A) Diabetic coma region?
D) The use of general anesthesia
B) Decubitus ulcer
C) Wound evisceration A) Left upper chest
15) A patient who had surgery for gallbladder B) Inguinal region
D) Bile duct injury
disease has just returned to the postsurgical unit
C) Neck or jaw
from postanesthetic recovery. The nurse caring
12) A patient has had a laparoscopic for this patient knows to immediately report what D) Right shoulder
cholecystectomy. The patient is now complaining assessment finding to the physician?
of right shoulder pain. What should the nurse
suggest to relieve the pain? A) Decreased breath sounds
B) Drainage of bile-colored fluid onto the
A) Aspirin every 4 to 6 hours as ordered
abdominal dressing
B) Application of heat 15 to 20 minutes each
C) Rigidity of the abdomen
hour
D) Acute pain with movement
C) Application of an ice pack for no more than
15 minutes 16) A patient has been scheduled for an
D) Application of liniment rub to affected area ultrasound of the gallbladder the following
morning. What should the nurse do in
13) A patient has undergone a laparoscopic preparation for this diagnostic study?
cholecystectomy and is being prepared for
discharge home. When providing health A) Have the patient refrain from food and
education, the nurse should prioritize which of fluids after midnight.
the following topics?
B) Administer the contrast agent orally 10 to 12
A) Management of fluid balance in the home hours before the study.
setting C) Administer the radioactive agent
B) The need for blood glucose monitoring for the intravenously the evening before the study.
next week D) Encourage the intake of 64 ounces of water 8
C) Signs and symptoms of intra-abdominal hours before the study.
complications
17) A patient’s abdominal ultrasound indicates
D) Appropriate use of prescribed pancreatic
cholelithiasis. When the nurse is reviewing the
enzymes patient’s laboratory studies, what finding is most
closely associated with this diagnosis?
14) A nurse is caring for a patient who has been
scheduled for endoscopic retrograde A) Increased bilirubin
cholangiopancreatography (ERCP) the following B) Decreased serum cholesterol
day. When providing anticipatory guidance for
C) Increased blood urea nitrogen (BUN)
this patient, the nurse should describe what
aspect of this diagnostic procedure? D) Decreased serum alkaline phosphatase level