A nurse is caring for a client who is postoperative following an open cholecystectomy. Which of the following assessment findings should the nurse report to the provider?

Report of shoulder pain

Thick, green-brown drainage on dressing

Incisional pain 5 out of 10 on a pain scale

Abdominal dressing dry and intact

Answer and Explanation

The Correct Answer is B

This finding could indicate the presence of bile leakage, which can occur following a cholecystectomy. The provider should be notified immediately as the client may require further interventions. Incisional pain, shoulder pain, and a dry and intact abdominal dressing are expected findings in the postoperative period.

Choice A, reporting of shoulder pain, is not the correct answer because this is a common finding post-cholecystectomy, which is often due to the presence of carbon dioxide used during the surgical procedure.

Choice C, incisional pain 5 out of 10 on a pain scale, is not the correct answer because this level of pain is within the expected range for the postoperative period.

Choice D, abdominal dressing dry and intact, is not the correct answer because this is an expected finding in the postoperative period.

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Correct Answer is D

Explanation

The correct answer is choice D. Requires nasogastric suction.

Nasogastric suction removes gastric secretions that contain potassium, leading to a loss of potassium from the body.

This can cause hypokalemia, which is a low level of potassium in the blood.

Choice A is wrong because Addison’s disease causes hyperkalemia, which is a high level of potassium in the blood.

Choice B is wrong because tissue damage can release potassium from the cells into the blood, causing hyperkalemia.

Choice C is wrong because uric acid level is not related to potassium level.

Uric acid is a waste product of purine metabolism that can cause gout or kidney stones if elevated.

A. Place the client in the Trendelenburg position B. Encourage active range of motion exercises of the right arm C. Keep the client's right arm immobilized D. Instruct the client to cough frequently

Correct Answer is C

Explanation

The client's right arm should be immobilized to prevent dislodgment of the central venous catheter. The Trendelenburg position is not indicated in this situation and may increase the risk of complications. Active range of motion exercises of the right arm and frequent coughing can also increase the risk of catheter dislodgment.

Choice A, placing the client in the Trendelenburg position, is not the correct answer because it is not indicated in this situation and may increase the risk of complications.

Choice B, encouraging active range of motion exercises of the right arm, is not the correct answer because it can increase the risk of catheter dislodgment.

Choice D, instructing the client to cough frequently, is not the correct answer because it can increase the risk of catheter dislodgment.

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A nurse is caring for a client who is postoperative following an open cholecystectomy. Which of the following assessment findings should the nurse report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse caring for a client reviews the medical record and determines the client is at risk for developing a potassium deficit because of which situation?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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