Nokea
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.
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Which should the nurse explain is the major purpose of the Sengstaken-Blakemore tube (S/B tube)?
- A. Decompress the stomach.
- B. Control esophageal varices bleeding.
- C. A route for tube feedings.
- D. Obtain specimen for gastric analyzing.
Correct Answer: B
Rationale: The major purpose of the S/B tube is to control bleeding by pressure against the vessels in the esophagus. The two balloons of the tube are inflated to put direct pressure on the esophagus and are anchored by the inflated balloon in the stomach. The tube can suction blood from the stomach as well.
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 tumor marker that is elevated in patients with pancreatic cancer is
Correct Answer: CA19-9
Rationale: The tumor marker CA19-9 is elevated in the presence of pancreatic cancer.
The patient with cirrhosis has a rising ammonia level and is becoming disoriented. The patient's hands flap when the patient stretches out the arm. How will the nurse interpret this?
- A. As an attempt to get the nurse's attention
- B. As asterixis
- C. As an indication of respiratory obstruction from varices
- D. As spasticity
Correct Answer: B
Rationale: Asterixis is the 'flapping tremor' seen as the patient deteriorates into ammonia intoxication or hepatic encephalopathy.
A patient with pancreatitis is on nothing by mouth status (NPO). The patient asks the nurse 'Why am I unable to have anything by mouth?'. Which is the best response?
- A. Diagnostic tests depend on you not eating anything.'
- B. The pancreas is stimulated whenever you eat or drink and causes pain.'
- C. Eating causes the need for a bowel movement, which excretes your medication too rapidly.'
- D. Resting your gastrointestinal tract will cure your pancreatitis.'
Correct Answer: B
Rationale: Food and fluids are withheld to avoid stimulating pancreatic activity, and IV fluids are administered.