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Three days after a cholecystectomy for cholelithiasis, a female client reports having persistent upper abdominal pain that radiates to her back. Based on these findings, the nurse should observe the client for which pathophysiological condition?

A.

Acute pancreatitis.

B.

Biliary duct obstruction.

C.

Surgical site infection.

D.

Hepatorenal failure.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

Acute pancreatitis is a potential complication after cholecystectomy. The persistent upper abdominal pain radiating to the back is a classic symptom of acute pancreatitis. This condition can occur due to the migration of gallstones or other factors affecting the pancreas.

 

Choice B rationale

 

Biliary duct obstruction can cause upper abdominal pain, but it is less likely to present with pain radiating to the back. This condition typically presents with jaundice and other symptoms.

 

Choice C rationale

 

Surgical site infection can cause abdominal pain, but it is usually localized to the surgical site and does not typically radiate to the back. Other signs of infection, such as fever and redness, would also be present.

 

Choice D rationale

 

Hepatorenal failure is a severe condition that can occur in patients with liver disease, but it is not commonly associated with pain radiating to the back. It typically presents with symptoms of liver and kidney dysfunction.

 


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Reported history of alcoholism is the most important assessment finding to address before administering terbinafine HCL. Terbinafine is metabolized by the liver, and clients with a history of alcoholism may have impaired liver function, increasing the risk of hepatotoxicity. Monitoring liver function and assessing for signs of liver damage are crucial before starting treatment.

Choice B rationale

Toenails appear thick and yellow is a common symptom of fungal toenail infection, but it is not the most critical assessment finding to address before administering terbinafine HCL. The focus should be on assessing liver function.

Choice C rationale

Employed as a construction worker is not the most critical assessment finding to address before administering terbinafine HCL. While occupational exposure to fungi may be relevant, the primary concern is liver function.

Choice D rationale

White blood cell count of 8,500/mm³ (8.5 x 10⁹/L) is within the normal range and is not the most critical assessment finding to address before administering terbinafine HCL. The primary concern is liver function.

Correct Answer is D

Explanation

Choice A rationale

Counting the apical and radial pulses simultaneously is important for assessing pulse deficits, but it is not the most critical assessment for a client receiving hydromorphone.

Choice B rationale

Measuring the client’s capillary glucose level is important for clients with diabetes, but it is not directly related to the administration of hydromorphone.

Choice C rationale

Observing for edema around the ankles is important for assessing fluid retention, but it is not the most critical assessment for a client receiving hydromorphone.

Choice D rationale

Auscultating the client’s bowel sounds is crucial because hydromorphone is a potent opioid analgesic that can slow peristalsis and frequently causes constipation. Monitoring bowel sounds helps prevent complications such as bowel obstruction. .

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