Nokea
Which is a classic location and radiation of the pain associated with cholecystitis?
- A. Substernal, radiating to the left shoulder and arm
- B. Epigastric, radiating to the back
- C. Right upper abdomen, radiating to the back or right scapula
- D. Left upper abdomen, radiating to the jaw and neck
Correct Answer: C
Rationale: It localizes in the right upper quadrant epigastric region. The pain radiates around the mid torso to the right scapular area.
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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.
Which should the nurse expect of a patient with a malabsorption of vitamin K?
- A. Anemia
- B. Excess platelet production
- C. Increased coagulation time
- D. Elevated for infection due to diminished white blood cell count
Correct Answer: C
Rationale: Prothrombin times are increased because malabsorption of vitamin K or inability to produce the clotting factors VII, IX, and X cause the patient to have bleeding tendencies.
Which is the most common procedure for the removal of the gallbladder?
- A. Laparoscopic cholecystectomy
- B. Cholangiography
- C. Open cholecystectomy
- D. Choledochostomy
Correct Answer: A
Rationale: The most recently developed operative procedure, which is now the most common treatment for cholecystitis and cholelithiasis, is done by way of endoscopy. It is called laparoscopic cholecystectomy and uses laser cautery to remove the gallbladder.
Why is morphine contraindicated in the patient with pancreatitis?
- A. Meperidine is less expensive.
- B. Tylenol is more effective at managing this type of pain.
- C. Morphine may cause spasms of the sphincter of Oddi.
- D. These patients do not experience pain.
Correct Answer: C
Rationale: A common complaint is constant, severe pain; in such cases, meperidine is often administered. Morphine may cause spasms of the sphincter of Oddi.
Which should the nurse avoid contamination from to prevent the transmission of hepatitis A?
- A. Food or water
- B. Blood transfusion
- C. Needles
- D. Sexual contact
Correct Answer: A
Rationale: Hepatitis A virus is transmitted when a person puts something in his or her mouth that is contaminated with fecal material (called fecal-oral transmission). Teach patients the importance of good hand washing after the bathroom or changing a diaper, as well as proper food preparation, to prevent the spread of hepatitis A.