NCLEX Biliary Practice questions
A 40 year old client is admitted to the hospital with cholecystitis. The nurse should contact the physician to question which of the following prescriptions? a. IV fluid therapy of normal saline solution to be infused at 100 mL/h until further prescriptions b. Administer morphine sulfate 10 mg IM every 4 hours as needed for sever abdominal pain c. Nothing by mouth (NPO) until further prescriptions d. Insert a nasogastric tube and connect to low intermittent suction
B: A nurse should question the prescription for morphine sulfate because it is believed to cause biliary spasm. The preferred opioid analgesic to treat cholecystitis is meperidine (Demerol).
A client has undergone a laparoscopic cholecystectomy. Which of the following instructions should the nurse include in the discharge teaching? a. Empty the bile bag daily b. Breathe deeply into a paper bag when nauseated c. Keep adhesive dressings in place for 6 weeks d. Report bile-colored drainage from any incision
D: There should be no bile colored drainage coming from any of the incisions postoperatively. A laparoscopic cholecystectomy does not involve a bile bag. Breathing into a paper bag will prevent a person from passing out due to hyperventilation; it does not alleviate nausea. If the adhesives have not already fallen off, they are removed by the surgeon in 7-10 days, not 6 weeks.
A client is admitted to the hospital with a diagnosis of cholecystitis from cholelithiasis. The client has severe abdominal pain and nausea, and has vomited several times. Based on these data, which nursing action would have been the highest priority for intervention at this time? a. Manage anxiety b. Restore fluid loss c. Manage the pain d. Replace nutritional loss
C: The priority for nursing care at this time is to decrease the client's severe abdominal pain. The pain, which is frequently accompanied by nausea and vomiting, is caused by biliary spasm.
After a cholecystectomy, the client is to follow a low-fat diet. Which of the following foods would be most appropriate to include a low-fat diet? a. Cheese omlet b. Peanut butter c. Ham salad sandwich d.Roast Beef
D: Lean meats, such as beef, lamb, veal, and well trimmed lean ham and pork, are low in fat. Cheese omlet, peanut butter, and ham salad are high in fat.
A client's stool are light gray in color. The nurse should asses the client for which of the following? Select all that apply. a. Intolerance to fatty foods b. Fever c. Jaundice d. Respiratory distress e. Pain at McBurney's point f. Peptic ulcer disease
A, B, C: Bile is created in the liver, stored in the gallbladder, and released into the duodenum, giving stool its brown color. A bile duct obstruction can cause pale-colored stool. Respiratory distress is not a symptom. Pain at McBurney's point is associated with appendicitis. Bleeding ulcers produce black tarry stool.
