A nurse assesses a client who has cholecystitis. Which clinical manifestation indicates that the condition is chronic rather than acute?
a. Temperature of 100.1 F (37.8 C)
b. Positive Murphy's sign
c. Light-colored stools
d. Upper abdominal pain after eating
Question 2A nurse cares for a client who is prescribed patient-controlled analgesia (PCA) after a cholecystectomy. The client states, When I wake up I am in pain. Which action should the nurse take?
a. Administer intravenous morphine while the client sleeps.
b. Encourage the client to use the PCA pump upon awakening.
c. Contact the provider and request a different analgesic.
d. Ask a family member to initiate the PCA pump for the client.
Question 3A nurse cares for a client with end-stage pancreatic cancer. The client asks, Why is this happening to me? How should the nurse respond?
a. I don't know. I wish I had an answer for you, but I don't.
b. It's important to keep a positive attitude for your family right now.
c. Scientists have not determined why cancer develops in certain people.
d. I think that this is a trial so you can become a better person because of it.
Question 4A nurse assesses a client who is recovering from an open Whipple procedure. Which action should the nurse perform first?
a. Assess the client's endotracheal tube with 40 FiO2.
b. Insert an indwelling Foley catheter to gravity drainage.
c. Place the client's nasogastric tube to low intermittent suction.
d. Start lactated Ringer's solution through an intravenous catheter.
Question 5After teaching a client who is prescribed pancreatic enzyme replacement therapy, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
a. The capsules can be opened and the powder sprinkled on applesauce if needed.
b. I will wipe my lips carefully after I drink the enzyme preparation.
c. The best time to take the enzymes is immediately after I have a meal or a snack.
d. I will not mix the enzyme powder with food or liquids that contain protein.
Question 6A nurse prepares to assess the emotional state of a client with end-stage pancreatic cancer. Which action should the nurse take first?
a. Bring the client to a quiet room for privacy.
b. Pull up a chair and sit next to the client's bed.
c. Determine whether the client feels like talking about his or her feelings.
d. Review the health care provider's notes about the prognosis for the client.
Question 7A nurse cares for a client who is recovering from laparoscopic cholecystectomy surgery. The client reports pain in the shoulder blades. How should the nurse respond?
a. Ambulating in the hallway twice a day will help.
b. I will apply a cold compress to the painful area on your back.
c. Drinking a warm beverage can relieve this referred pain.
d. You should cough and deep breathe every hour.
Question 8After teaching a client who is recovering from laparoscopic cholecystectomy surgery, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
a. Drinking at least 2 liters of water each day is suggested.
b. I will decrease the amount of fatty foods in my diet.
c. Drinking fluids with my meals will increase bloating.
d. I will avoid concentrated sweets and simple carbohydrates.
Question 9After teaching a client who has a history of cholelithiasis, the nurse assesses the client's understanding. Which menu selection made by the client indicates the client clearly understands the dietary teaching?
a. Lasagna, tossed salad with Italian dressing, and low-fat milk
b. Grilled cheese sandwich, tomato soup, and coffee with cream
c. Cream of potato soup, Caesar salad with chicken, and a diet cola
d. Roasted chicken breast, baked potato with chives, and orange juice
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