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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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Correct Answer is B

Explanation

Choice A rationale

An increase in B-lymphocytes and IgM is not how HIV suppresses the immune system. B-lymphocytes are responsible for producing antibodies, and IgM is a type of antibody. HIV primarily affects T-lymphocytes, specifically helper T-cells (CD4 cells), rather than B-lymphocytes.

Choice B rationale

The destruction of helper T-cells and CD4 cells is the primary mechanism by which HIV suppresses the immune system. HIV targets and infects these cells, leading to their depletion. Helper T-cells play a crucial role in coordinating the immune response, and their loss results in a weakened immune system, making the body more susceptible to infections and diseases.

Choice C rationale

A deficiency of cytotoxic T cells is not the primary mechanism by which HIV suppresses the immune system. Cytotoxic T cells (CD8 cells) are involved in directly killing infected cells, but the main impact of HIV is on helper T-cells (CD4 cells), which are essential for orchestrating the immune response.

Choice D rationale

The proliferation of suppressor T-cells is not how HIV suppresses the immune system. Suppressor T-cells (regulatory T cells) help regulate and control the immune response, but HIV primarily affects helper T-cells (CD4 cells), leading to their destruction and a weakened immune system.

Correct Answer is C

Explanation

Choice A rationale

Restricting fluids is not a primary limitation for clients with Crohn’s disease. Adequate hydration is important for overall health and managing symptoms.

Choice B rationale

Limiting foods high in calcium and iron is not typically recommended for Crohn’s disease. These nutrients are important for maintaining bone health and preventing anemia, which can be concerns for individuals with Crohn’s disease.

Choice C rationale

An elimination diet can help identify trigger foods that may exacerbate symptoms of Crohn’s disease. This approach involves removing certain foods from the diet and gradually reintroducing them to determine which foods cause symptoms.

Choice D rationale

Avoiding gluten is not necessary for all individuals with Crohn’s disease. While some may benefit from a gluten-free diet, it is not a universal recommendation for managing the condition.

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