AA 1 CHAPTER 59 ADAPTIVE QUIZZING.
The nurse is teaching a patient with gallbladder disease about diet modification. Which meal
does the nurse suggest to the patient?
Steak and French fries
Fried chicken and mashed potatoes
Turkey sandwich on wheat bread
Sausage and scrambled eggs
The nurse expects that which patient will be discharged to the home environment first?
Older obese adult who has had a laparoscopic cholecystectomy
Middle-aged thin adult who has had a laparoscopic cholecystectomy
Middle-aged thin adult with a heart murmur who has had a traditional cholecystectomy
Older obese adult with chronic obstructive pulmonary disease (COPD) who has had a traditional
cholecystectomy
.
A patient with acute cholecystitis is admitted to the medical-surgical unit. Which nursing activity
associated with the patient's care will be best for the nurse to delegate to the unlicensed assistive
personnel (UAP)?
Assessing dietary risk factors for cholecystitis.
Checking for bowel sounds and distention.
Determining precipitating factors for abdominal pain.
Obtaining the admission weight, height, and vital signs.
What finding is priority for a patient who has just undergone an open cholecystectomy?
Output of 25 mL/hr
Reddened incision site
Pain of 7/10 at the incision site
Respiratory rate of 8 breaths/minute
A patient reports fever, yellowing of the skin and eyes, clay-colored stools, and dark urine to the
nurse. What do these symptoms indicate?
Peritonitis
Malnutrition
Vitamin
deficiency
Chronic cholecystitis
The nurse is teaching a female patient about cholecystectomy via a natural orifice transluminal
endoscopic surgery (NOTES). What statement by the patient indicates that the teaching has been
effective?
"I will only have two small scars."
"I can still have gallstones after this procedure."
"This procedure will repair, not remove, my gallbladder."
"A small incision will be made in my vagina to access my gallbladder."
A patient is undergoing extracorporeal shockwave lithotripsy. The patient complains of pain in
the abdomen. What action by the nurse is appropriate?
Reposition the patient
Prepare for conscious sedation
,AA 1 CHAPTER 59 ADAPTIVE QUIZZING.
Ask the interventionist to stop the procedure
Let the patient know this is normal when the stones are breaking up and moving
Which drug is often used as a contrast medium in a magnetic resonance imaging (MRI) scan?
Ketorolac
Morphine
Gadolinium
Meperidine
A patient who has undergone a laparoscopic cholecystectomy reports mild postoperative
abdominal bloating and discomfort. Which nursing action is correct?
Administer an opioid analgesic medication.
Encourage the patient to ambulate in
the hall. Notify the provider of possible
peritonitis.
Withhold oral fluids until these symptoms have passed.
A patient who underwent a traditional cholecystectomy is concerned that the drainage in the
Jackson-Pratt drain is now green. What statement by the nurse is most appropriate?
"It is normal for the first 24 hours."
"The drain may need to be repositioned."
"Why don't we have you roll on your other side?"
"I'm going to take a small sample and send it to the lab."
The nurse suspects that which patient is at highest risk for developing gallstones?
Obese male with a history of chronic obstructive pulmonary disease
Obese female on hormone replacement therapy
Thin male with a history of coronary artery bypass grafting
Thin female who has recently given birth
A patient who has undergone an open cholecystectomy 12 hours prior has a Jackson-Pratt (JP)
drain. The nurse empties the drainage and notes bile-stained serosanguineous fluid. Which
nursing action is correct?
Contact the provider to report a possible surgical infection.
Notify the provider that the patient may have a perforation of the bile duct.
Raise the drainage system above the site of insertion to minimize blood loss.
Record the amount and color of the fluid and continue to monitor the patient.
What elevated blood level indicates inflammation in a patient diagnosed with cholecystitis?
White blood cell count
Lactate dehydrogenase
Serum alkaline phosphate
Aspartate aminotransferase
The nurse is teaching a patient about extracorporeal shockwave lithotripsy. What statement by
the patient indicates a need for further teaching?
"I will sit in 12 inches of water."
, AA 1 CHAPTER 59 ADAPTIVE QUIZZING.
"The stones will pass through my digestive system."
"The shockwaves will turn the big stones into small stones."
"I may need to take ursodeoxycholic acid after this procedure."
A patient with cholecystitis has jaundice and icterus. These signs are typical of which type of
cholecystitis?
Acalculous
Acute
Calculous
Chronic
What patient has the highest risk for development of cholecystitis?
28-year-old Caucasian male who just had gastric bypass
55-year-old American Indian female with Crohn's disease
38-year-old African American male patient with elevated cholesterol
32-year-old African American female oncology patient receiving total parenteral nutrition (TPN)
A patient who has cholesterol-based gallstones and good gallbladder function is interested in
nonsurgical management options for this condition. Which other factor must be present for this
patient to be a candidate for a nonsurgical approach?
Ability to tolerate iodine
Absence of infection
Low serum cholesterol
Normal weight
A female patient is scheduled for a cholecystectomy by natural orifice transluminal endoscopic
surgery (NOTES). Which area is most commonly used for inserting the endoscope during this
procedure?
Mouth
Vagina
Rectum
Umbilicus
Which diagnostic results lead the nurse to suspect that a patient may have gallbladder disease?
Increased white blood cell (WBC) count, visualization of calcified gallstones, edema of the
gallbladder wall
Decreased WBC count, visualization of calcified gallstones, increased alkaline phosphatase
Increased WBC count, visualization of noncalcified gallstones, edema of the gallbladder wall
Decreased WBC count, visualization of noncalcified gallstones, increased alkaline phosphatase
Which finding is expected in a patient who has a liver function abnormality?
Increased white blood cell (WBC) count
Decreased level of lactate dehydrogenase
Decreased level of aspartate aminotransferase
Increase in serum levels of alkaline phosphatase
The nurse is teaching a patient with gallbladder disease about diet modification. Which meal
does the nurse suggest to the patient?
Steak and French fries
Fried chicken and mashed potatoes
Turkey sandwich on wheat bread
Sausage and scrambled eggs
The nurse expects that which patient will be discharged to the home environment first?
Older obese adult who has had a laparoscopic cholecystectomy
Middle-aged thin adult who has had a laparoscopic cholecystectomy
Middle-aged thin adult with a heart murmur who has had a traditional cholecystectomy
Older obese adult with chronic obstructive pulmonary disease (COPD) who has had a traditional
cholecystectomy
.
A patient with acute cholecystitis is admitted to the medical-surgical unit. Which nursing activity
associated with the patient's care will be best for the nurse to delegate to the unlicensed assistive
personnel (UAP)?
Assessing dietary risk factors for cholecystitis.
Checking for bowel sounds and distention.
Determining precipitating factors for abdominal pain.
Obtaining the admission weight, height, and vital signs.
What finding is priority for a patient who has just undergone an open cholecystectomy?
Output of 25 mL/hr
Reddened incision site
Pain of 7/10 at the incision site
Respiratory rate of 8 breaths/minute
A patient reports fever, yellowing of the skin and eyes, clay-colored stools, and dark urine to the
nurse. What do these symptoms indicate?
Peritonitis
Malnutrition
Vitamin
deficiency
Chronic cholecystitis
The nurse is teaching a female patient about cholecystectomy via a natural orifice transluminal
endoscopic surgery (NOTES). What statement by the patient indicates that the teaching has been
effective?
"I will only have two small scars."
"I can still have gallstones after this procedure."
"This procedure will repair, not remove, my gallbladder."
"A small incision will be made in my vagina to access my gallbladder."
A patient is undergoing extracorporeal shockwave lithotripsy. The patient complains of pain in
the abdomen. What action by the nurse is appropriate?
Reposition the patient
Prepare for conscious sedation
,AA 1 CHAPTER 59 ADAPTIVE QUIZZING.
Ask the interventionist to stop the procedure
Let the patient know this is normal when the stones are breaking up and moving
Which drug is often used as a contrast medium in a magnetic resonance imaging (MRI) scan?
Ketorolac
Morphine
Gadolinium
Meperidine
A patient who has undergone a laparoscopic cholecystectomy reports mild postoperative
abdominal bloating and discomfort. Which nursing action is correct?
Administer an opioid analgesic medication.
Encourage the patient to ambulate in
the hall. Notify the provider of possible
peritonitis.
Withhold oral fluids until these symptoms have passed.
A patient who underwent a traditional cholecystectomy is concerned that the drainage in the
Jackson-Pratt drain is now green. What statement by the nurse is most appropriate?
"It is normal for the first 24 hours."
"The drain may need to be repositioned."
"Why don't we have you roll on your other side?"
"I'm going to take a small sample and send it to the lab."
The nurse suspects that which patient is at highest risk for developing gallstones?
Obese male with a history of chronic obstructive pulmonary disease
Obese female on hormone replacement therapy
Thin male with a history of coronary artery bypass grafting
Thin female who has recently given birth
A patient who has undergone an open cholecystectomy 12 hours prior has a Jackson-Pratt (JP)
drain. The nurse empties the drainage and notes bile-stained serosanguineous fluid. Which
nursing action is correct?
Contact the provider to report a possible surgical infection.
Notify the provider that the patient may have a perforation of the bile duct.
Raise the drainage system above the site of insertion to minimize blood loss.
Record the amount and color of the fluid and continue to monitor the patient.
What elevated blood level indicates inflammation in a patient diagnosed with cholecystitis?
White blood cell count
Lactate dehydrogenase
Serum alkaline phosphate
Aspartate aminotransferase
The nurse is teaching a patient about extracorporeal shockwave lithotripsy. What statement by
the patient indicates a need for further teaching?
"I will sit in 12 inches of water."
, AA 1 CHAPTER 59 ADAPTIVE QUIZZING.
"The stones will pass through my digestive system."
"The shockwaves will turn the big stones into small stones."
"I may need to take ursodeoxycholic acid after this procedure."
A patient with cholecystitis has jaundice and icterus. These signs are typical of which type of
cholecystitis?
Acalculous
Acute
Calculous
Chronic
What patient has the highest risk for development of cholecystitis?
28-year-old Caucasian male who just had gastric bypass
55-year-old American Indian female with Crohn's disease
38-year-old African American male patient with elevated cholesterol
32-year-old African American female oncology patient receiving total parenteral nutrition (TPN)
A patient who has cholesterol-based gallstones and good gallbladder function is interested in
nonsurgical management options for this condition. Which other factor must be present for this
patient to be a candidate for a nonsurgical approach?
Ability to tolerate iodine
Absence of infection
Low serum cholesterol
Normal weight
A female patient is scheduled for a cholecystectomy by natural orifice transluminal endoscopic
surgery (NOTES). Which area is most commonly used for inserting the endoscope during this
procedure?
Mouth
Vagina
Rectum
Umbilicus
Which diagnostic results lead the nurse to suspect that a patient may have gallbladder disease?
Increased white blood cell (WBC) count, visualization of calcified gallstones, edema of the
gallbladder wall
Decreased WBC count, visualization of calcified gallstones, increased alkaline phosphatase
Increased WBC count, visualization of noncalcified gallstones, edema of the gallbladder wall
Decreased WBC count, visualization of noncalcified gallstones, increased alkaline phosphatase
Which finding is expected in a patient who has a liver function abnormality?
Increased white blood cell (WBC) count
Decreased level of lactate dehydrogenase
Decreased level of aspartate aminotransferase
Increase in serum levels of alkaline phosphatase
