NSG 123 Medical Surgical Nursing Exam 2
1. Main Cause of Cholelithiasis: Cholesterol stones account for most of the
remaining 75% of cases of gallbladder disease in the United States.
2. Symptoms of Cholelithias: Nausea
Vomiting
Right upper quadrant abdominal pain or epigastric pain that radiates to the right
shoulder especially after meals when the gallbladder is stimulated to release bile.
3. Patient Teaching for Cholelithiasis: The diet immediately after an
episode is usually low-fat liquids. These can include powdered supplements
high in protein and carbohydrate stirred into skim milk.
4. Purpose of Medication in Cholelithiasis: Purpose of Medications: reduces
hepatic production of cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual
dissolution of cholesterol gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
5. Purpose of Adding Fat to Emulsion to TPN: Fat emulsions (lipids) are usually
given to clients receiving TPN to provide supplemental kilocalories and prevent
fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
6. Carbon Dioxide in Laparoscopic Cholecystectomy: Carbon dioxide is used
during the procedure
Explain to the patient that they might feel pain in the right shoulder or scapular area
(from migration of the carbon dioxide used to insufflate the abdominal cavity during
the procedure).
7. Laparoscopic Colecystectomy 3 Things to do After: Recommend a heating
pad for 15 to 20 minutes hourly or
Encourage the client to ambulate frequently to reduce the bloating.
Manage nausea assess bowel sounds for further complications.
8. Preoperative Assessment for Open Cholecystectomy: Priority assessment
should focus on the client's respiratory status.
, NSG 123 Medical Surgical Nursing Exam 2
If a traditional surgical approach is planned, the high abdominal incision required
during surgery may interfere with full respiratory excursion.
The nurse notes a history of smoking, previous respiratory problems, shallow
respirations, a persistent or ineffective cough, and the presence of adventitious
breath sounds.
CBC and BMP should also be assessed
9. 4 Postoperative Complications of Cholecystostomy: After these surgica
procedures, the client is observed for indications of infection, leakage of bile into
the peritoneal cavity, and obstruction of bile drainage.
If bile is not draining properly, an obstruction is probably causing bile to be forced
back into the liver and bloodstream.
Because jaundice may result, the nurse should assess the color of the sclerae.
Yellow-colored sclerae or skin can indicate jaundice.
Clay-colored stool should be reported as this indicates a complication.
10. Discharge Teaching for Open Cholecystectomy: Usually, only a smal
amount of serosanguineous fluid drains in the initial 24 hours after surgery;
afterward, the drain is removed.
The drain is typically maintained if there is excess oozing or bile leakage.
Empty the drainage bag attached at least every 8 hours and as needed, to prevent
reflux back into the bile duct.
Take showers not baths to prevent infection of the incision site.
11. What disease is characterized by possible malnourishment (anemic) and
frequenct diarrhea?: Crohn's disease
12. The disease characterized by blood sools and left lower quadrent pain:
Ulcerative Colitis
13. What GI disease would be best diagnosed with colonoscopy?: Ulcerative
Colitis
14. What testing would you expect to see from a patient recieving parenteral
nutrition?: Blood Glucose
, NSG 123 Medical Surgical Nursing Exam 2
15. What time of day should Famotidine (pepcid) be administered?: Bed time
16. What is an intragastric balloon used for?: Non-invasive weight loss
17. The nurse needs to check Mg++ before administration of what drug?:
Magnesium hydroxide/aluminum hydrate MAALOX
18. Which weight loss drug requirres a fat soluble vitamin supplement?:
Orlistat (XENICAL)
19. What do you give to treat travelers diarrhea?: Bismuth Salts-pepto bismol
20. This conditon is charcterized by perianal vascular congestion from
straining to have a bowel movement?: Hemorrhoids
21. How often should 30mL of water be flushed through an NG tuve for
assessment of function: Every 4 hours
22. A patient is experiencing diarrhea secondary to ulcerative colitis, do you
treat it?: No, their body is flushing out the infection
23. Bulk forming laxative: Citrucel or Metamucil
24. A patient has a NG tube placed and running suction. What lab should the
nurse monitor?: BMP, fluid and electrolytes
25. What do you give a patient recieving a TPN to prevent hypoglycemia?:
D5W or D10W
26. What are most gallstones comprised of?: Cholesterol
1. Main Cause of Cholelithiasis: Cholesterol stones account for most of the
remaining 75% of cases of gallbladder disease in the United States.
2. Symptoms of Cholelithias: Nausea
Vomiting
Right upper quadrant abdominal pain or epigastric pain that radiates to the right
shoulder especially after meals when the gallbladder is stimulated to release bile.
3. Patient Teaching for Cholelithiasis: The diet immediately after an
episode is usually low-fat liquids. These can include powdered supplements
high in protein and carbohydrate stirred into skim milk.
4. Purpose of Medication in Cholelithiasis: Purpose of Medications: reduces
hepatic production of cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual
dissolution of cholesterol gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
5. Purpose of Adding Fat to Emulsion to TPN: Fat emulsions (lipids) are usually
given to clients receiving TPN to provide supplemental kilocalories and prevent
fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
6. Carbon Dioxide in Laparoscopic Cholecystectomy: Carbon dioxide is used
during the procedure
Explain to the patient that they might feel pain in the right shoulder or scapular area
(from migration of the carbon dioxide used to insufflate the abdominal cavity during
the procedure).
7. Laparoscopic Colecystectomy 3 Things to do After: Recommend a heating
pad for 15 to 20 minutes hourly or
Encourage the client to ambulate frequently to reduce the bloating.
Manage nausea assess bowel sounds for further complications.
8. Preoperative Assessment for Open Cholecystectomy: Priority assessment
should focus on the client's respiratory status.
, NSG 123 Medical Surgical Nursing Exam 2
If a traditional surgical approach is planned, the high abdominal incision required
during surgery may interfere with full respiratory excursion.
The nurse notes a history of smoking, previous respiratory problems, shallow
respirations, a persistent or ineffective cough, and the presence of adventitious
breath sounds.
CBC and BMP should also be assessed
9. 4 Postoperative Complications of Cholecystostomy: After these surgica
procedures, the client is observed for indications of infection, leakage of bile into
the peritoneal cavity, and obstruction of bile drainage.
If bile is not draining properly, an obstruction is probably causing bile to be forced
back into the liver and bloodstream.
Because jaundice may result, the nurse should assess the color of the sclerae.
Yellow-colored sclerae or skin can indicate jaundice.
Clay-colored stool should be reported as this indicates a complication.
10. Discharge Teaching for Open Cholecystectomy: Usually, only a smal
amount of serosanguineous fluid drains in the initial 24 hours after surgery;
afterward, the drain is removed.
The drain is typically maintained if there is excess oozing or bile leakage.
Empty the drainage bag attached at least every 8 hours and as needed, to prevent
reflux back into the bile duct.
Take showers not baths to prevent infection of the incision site.
11. What disease is characterized by possible malnourishment (anemic) and
frequenct diarrhea?: Crohn's disease
12. The disease characterized by blood sools and left lower quadrent pain:
Ulcerative Colitis
13. What GI disease would be best diagnosed with colonoscopy?: Ulcerative
Colitis
14. What testing would you expect to see from a patient recieving parenteral
nutrition?: Blood Glucose
, NSG 123 Medical Surgical Nursing Exam 2
15. What time of day should Famotidine (pepcid) be administered?: Bed time
16. What is an intragastric balloon used for?: Non-invasive weight loss
17. The nurse needs to check Mg++ before administration of what drug?:
Magnesium hydroxide/aluminum hydrate MAALOX
18. Which weight loss drug requirres a fat soluble vitamin supplement?:
Orlistat (XENICAL)
19. What do you give to treat travelers diarrhea?: Bismuth Salts-pepto bismol
20. This conditon is charcterized by perianal vascular congestion from
straining to have a bowel movement?: Hemorrhoids
21. How often should 30mL of water be flushed through an NG tuve for
assessment of function: Every 4 hours
22. A patient is experiencing diarrhea secondary to ulcerative colitis, do you
treat it?: No, their body is flushing out the infection
23. Bulk forming laxative: Citrucel or Metamucil
24. A patient has a NG tube placed and running suction. What lab should the
nurse monitor?: BMP, fluid and electrolytes
25. What do you give a patient recieving a TPN to prevent hypoglycemia?:
D5W or D10W
26. What are most gallstones comprised of?: Cholesterol
