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A nurse is reinforcing teaching with a client who needs to have a cholecystectomy due to gallstones. Which of the following is the best response from the nurse to explain what caused this problem?

A.

The gallbladder became infected by a virus and needs to be removed.

B.

The gallbladder has become inflamed due to the cholesterol in the gallstones,

C.

The gallbladder has become blocked by a tumor and is no longer working.

D.

The gallbladder has become inflamed due to a build-up of gallstones that are blocking the common bile duct.

Answer and Explanation

The Correct Answer is B

A. The gallbladder became infected by a virus and needs to be removed. Gallstones are not caused by viral infections; they typically develop from an imbalance in the substances that make up bile, such as cholesterol and bilirubin.

B. The gallbladder has become inflamed due to the cholesterol in the gallstones.  Cholesterol is a common component of gallstones, and these stones can cause inflammation of the gallbladder (cholecystitis), leading to the need for removal.

C. The gallbladder has become blocked by a tumor and is no longer working. Tumors can obstruct the gallbladder, but this is not the cause of gallstones or the primary reason for a cholecystectomy.

D. The gallbladder has become inflamed due to a build-up of gallstones that are blocking the common bile duct. This describes choledocholithiasis, a condition where gallstones block the common bile duct, but it is not the primary cause of gallbladder inflammation requiring a cholecystectomy.


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Related Questions

Correct Answer is C

Explanation

A. Loss of pain, temperature, and light touch sensation on the same side as the injury. In Brown-Sequard syndrome, pain, temperature, and light touch are typically lost on the opposite (contralateral) side of the injury.

B. Loss of motor function and deep pressure sensation on the opposite side of the injury. Motor function and deep pressure sensation loss occur on the same side (ipsilateral) as the injury.

C. Loss of motor function and position sense on the same side as the injury. Brown-Sequard syndrome is a spinal cord hemisection injury leading to loss of motor function and proprioception on the same side as the injury.

D. Loss of motor function with preserved pain and temperature sensation in the lower extremities. Pain and temperature sensations are lost on the opposite side of the injury in Brown-Sequard syndrome, not preserved.

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A,B"}}

Explanation

Polyuria/Polydipsia:

  • Supports both DKA and HHS as both conditions typically exhibit severe dehydration and excessive thirst and urination.

Heart Rate (tachycardia):

  • Consistent with both DKA and HHS due to dehydration and fluid shifts, though heart rate alone does not differentiate the two.

Respirations (Kussmaul's):

  • Suggests DKA; deep, labored Kussmaul respirations typically help compensate for metabolic acidosis, which is characteristic of DKA.

Mental Status (confusion, lethargy):

  • More common in HHS, where very high glucose and osmolality levels often lead to more profound neurologic changes. Can also occur in DKA.

Serum Glucose >600 mg/dL and Serum Osmolality >320 mOsm/kg:

  • Consistent with both DKA and HHS, though more frequently seen in HHS given the higher osmolality. In DKA, serum glucose usually elevated but often lower than in HHS. Osmolality may be increased but not as high as in HHS.

Insidious onset (days to weeks):

  • Suggests HHS, as it often has a slower onset than DKA, which typically presents more acutely.

Infection as precipitating factor:

  • Could support either condition as infections can precipitate both DKA and HHS.

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