Nokea
A patient with a T tube for an open cholecystectomy has resumed oral intake. The T tube is clamped 2 hours before meals and unclamped 2 hours after meals to aid in the digestion of fat. During the time the tube is clamped the patient complains of abdominal pain and nausea. Which intervention is most appropriate?
- A. Notify the health care provider.
- B. Unclamp the tube immediately.
- C. Increase the IV fluids.
- D. Change the T-tube dressing.
Correct Answer: B
Rationale: While the tube is clamped, the patient may show signs of abdominal pain, nausea, vomiting, etc. Unclamp the tube immediately to allow for drainage and relief of both nausea and pain.
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Which patient statement indicates that the patient requires additional teaching about an endoscopic retrograde cholangiopancreatography?
- A. Right after the test, I want breakfast with black coffee.'
- B. The instrument will be put down my throat.'
- C. I haven't had anything to eat or drink since 9 p.m. last night.'
- D. My doctor said I could have medicine to relax me before the test.'
Correct Answer: A
Rationale: After the procedure, keep the patient at nothing by mouth status (NPO) until the gag reflex returns.
The nurse clarifies that which event happens to unconjugated bilirubin, which is made up of broken-down red cells?
- A. It is stored in the gallbladder to make bile.
- B. Water-insoluble bilirubin must be converted by the liver.
- C. A by-product is excreted directly into the bowel for excretion.
- D. Red blood cells are necessary for digestion of fats.
Correct Answer: B
Rationale: Unconjugated bilirubin is a water-insoluble product that must be converted in the liver to conjugated bilirubin (water soluble) so that it may be excreted through the bowel.
is a condition characterized by yellowing of the sclera and the skin.
Correct Answer: Jaundice
Rationale: Jaundice is the discoloration of body tissues caused by abnormally high blood levels of bilirubin.
A patient returning from a 2-week camping trip a few days ago, reports having nausea, anorexia, and dark urine. Which additional information would assist in diagnosing hepatitis A?
- A. Exposure to blood
- B. Recent ingestion of raw fish
- C. History of intravenous drug use
- D. Multiple sex partners
Correct Answer: B
Rationale: Hepatitis A spreads by direct contact through the oral-fecal route, usually by food and water contaminated with feces.
A patient was scheduled for a laparoscopic cholecystectomy, but complications developed and the patient underwent an open cholecystectomy with a T tube inserted into the common bile duct. Which is the purpose of the T tube?
- A. To decompress the duct and relieve pain caused by stimulation of the sphincter of Oddi.
- B. To improve diaphragmatic expansion and prevention of atelectasis.
- C. To shorten postoperative recovery and hasten the healing process.
- D. To keep the duct open and allow drainage of the bile until edema resolves.
Correct Answer: D
Rationale: If the stones are in the common bile duct and edema is present, a biliary drainage tube, or T tube, will be inserted to keep the duct open and allow drainage of the bile until the edema resolves.