Right upper quadrant abdominal pain that radiates to the back after consuming high-fat meals, with normal ECG findings, may indicate:
gastroesophageal reflux.
appendicitis.
cholecystitis.
a myocardial infarction.
The Correct Answer is C
A. gastroesophageal reflux.: This typically presents as retrosternal burning or pyrosis that may worsen when lying supine. While high-fat meals can trigger it, the pain is usually midline and substernal. It does not typically localize to the right upper quadrant.
B. appendicitis.: This inflammatory process begins with periumbilical pain that subsequently migrates to the right lower quadrant at McBurney's point. It is not triggered by the ingestion of fatty foods or biliary stimulation. The anatomical location is inferior to the RUQ.
C. cholecystitis.: Ingestion of lipids triggers cholecystokinin release, causing gallbladder contraction against an obstructing stone. This results in visceral pain in the right upper quadrant that often radiates to the right scapula. Normal cardiac findings support a biliary etiology.
D. a myocardial infarction.: While inferior wall MI can present with epigastric pain, a normal electrocardiogram makes this diagnosis less likely in an acute setting. The specific trigger of high-fat meals and RUQ localization points toward a gallbladder pathology. It is a cardiac emergency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Alzheimer's disease. : This neurodegenerative condition is defined by progressive cortical atrophy leading to significant cognitive and memory impairment. While late-stage patients may develop gait changes, they do not exhibit the classic rhythmic resting tremor. It is primarily a dementing illness.
B. Parkinson's disease. : The loss of dopaminergic inhibition in the basal ganglia leads to the characteristic 4 to 6 Hz resting tremor. Postural instability occurs due to the loss of righting reflexes and truncal rigidity. These are core clinical motor features.
C. Huntington's disease. : This genetic disorder is characterized by chorea, which consists of involuntary, jerky, and rapid movements. It differs significantly from the slow, rhythmic pill-rolling resting tremor seen in parkinsonism. It involves the degeneration of the caudate nucleus.
D. Multiple sclerosis. : This condition often presents with intention tremors, which occur during purposeful movement rather than at rest. While it can cause ataxia and gait imbalances, it lacks the specific resting tremor of basal ganglia origin. It is a white matter disease.
Correct Answer is C
Explanation
A. chordae tendineae pull the heart valve tightly closed. : These collagenous tendons function to prevent eversion of the atrioventricular valves during ventricular systole. Excessive tension prevents regurgitation rather than causing the displacement seen in prolapse. This mechanism maintains normal valvular competence under high pressure.
B. a blood clot blocks the heart valve leaflets. : Thrombus formation on the endocardial surface of a valve is defined as a vegetation or embolism. This mechanical obstruction interferes with laminar blood flow or causes valvular stenosis. It does not describe the structural bulging of the leaflets.
C. heart valve leaflets become floppy and bulge backward. : Myxomatous degeneration weakens the connective tissue of the valve leaflets, causing them to move into the atrium during contraction. This redundant tissue leads to superior displacement beyond the annular plane. This is the hallmark anatomical feature of prolapse.
D. the heart valve becomes stiff and cannot open. : This condition is medically defined as valvular stenosis, where calcification or fibrosis limits leaflet mobility. It results in narrowed orifices and increased pressure gradients across the valve. This represents a failure of opening, the opposite of prolapse.
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