The nurse is caring for a client who had a cholecystectomy two days ago. The client is febrile, reporting upper abdominal pain radiating to the back and has had three episodes of vomiting in the last 8 hours. The nurse reviews the client's serum amylase and lipase level results which are twice the normal value. Based on these findings, the nurse should recognize the client is exhibiting symptoms of which condition?

Hepatorenal failure.

Acute pancreatitis.

Surgical site infection.

Biliary duct obstruction.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is incorrect because hepatorenal failure is a condition that involves both liver and kidney dysfunction, usually as a complication of cirrhosis or portal hypertension. The symptoms of hepatorenal failure may include jaundice, ascites, edema, oliguria, or encephalopathy. However, these are not consistent with the client's presentation of fever, abdominal pain, vomiting, and elevated amylase and lipase levels.

Choice B reason: This is correct because acute pancreatitis is an inflammation of the pancreas that can be caused by gallstones, alcohol abuse, trauma, infection, or drugs. The symptoms of acute pancreatitis may include fever, upper abdominal pain that radiates to the back, nausea, vomiting, and elevated amylase and lipase levels. These are consistent with the client's presentation and suggest that the cholecystectomy may have triggered an attack of acute pancreatitis.

Choice C reason: This is incorrect because surgical site infection is an infection that occurs at or near the incision site after surgery. The symptoms of surgical site infection may include redness, swelling, warmth, pus drainage, or pain at the wound site. However, these are not consistent with the client's presentation of fever, abdominal pain radiating to the back, vomiting, and elevated amylase and lipase levels.

Choice D reason: This is incorrect because biliary duct obstruction is a blockage of the bile ducts that carry bile from the liver and gallbladder to the intestine. The causes of biliary duct obstruction may include gallstones, tumors, inflammation, or scarring. The symptoms of biliary duct obstruction may include jaundice, dark urine, pale stools, itching, or abdominal pain. However, these are not consistent with the client's presentation of fever, abdominal pain radiating to the back, vomiting, and elevated amylase and lipase levels.

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Correct Answer is B

Explanation

Choice A reason: Using incentive spirometer is not an information that the nurse should include in the discharge instructions for a client with BPH following a TUNA, because it is not related to the procedure or the condition. The incentive spirometer is a device that helps improve lung function and prevent respiratory complications by encouraging deep breathing and coughing. Therefore, this choice is incorrect.

Choice B reason: Monitoring urinary stream for decrease in output is an information that the nurse should include in the discharge instructions for a client with BPH following a TUNA, because it can indicate urinary retention or obstruction, which are potential complications of the procedure. The client should report any difficulty or inability to urinate, severe pain, or fever to the health care provider. Therefore, this choice is correct.

Choice C reason: Reporting when hematuria becomes pink tinged is not an information that the nurse should include in the discharge instructions for a client with BPH following a TUNA, because it is not a sign of a problem. Hematuria, or blood in the urine, is a common and expected finding after the procedure, and it usually resolves within a few days. The client should drink plenty of fluids to flush out the blood clots and debris. Therefore, this choice is incorrect.

Choice D reason: Restricting physical activities is an information that the nurse should include in the discharge instructions for a client with BPH following a TUNA, but it is not the best answer. The client should avoid strenuous activities, such as lifting heavy objects, driving, or sexual intercourse, for at least two weeks after the procedure to prevent bleeding and infection. However, this information is less important than monitoring urinary stream for decrease in output. Therefore, this choice is not the best answer.

A. The humoral immune response lacks B cells that form antibodies and opportunistic infections result. B. Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages. C. Bone marrow suppression of white blood cells causes insufficient cells to phagocytize organisms. D. Exposure to multiple environmental infectious agents overburdens the immune system until it fails.

Correct Answer is B

Explanation

Choice A reason: The humoral immune response is mediated by B cells that produce antibodies against specific antigens. However, this response is not the main problem in AIDS, because B cells are not directly affected by the human immunodeficiency virus (HIV) that causes AIDS. Therefore, this choice is incorrect.

Choice B reason: The cellular immune response is mediated by T lymphocytes that activate other immune cells, such as macrophages, to destroy infected or abnormal cells. This response is the main problem in AIDS, because HIV infects and destroys CD4+ T cells, which are essential for coordinating the cellular immunity. As a result, the client becomes susceptible to opportunistic infections, such as Pneumocystis jiroveci pneumonia. Therefore, this choice is correct.

Choice C reason: Bone marrow suppression of white blood cells can cause immunodeficiency, but it is not the primary cause of AIDS. Bone marrow suppression can occur as a side effect of some drugs or treatments, such as chemotherapy or radiation therapy, but it is not directly caused by HIV. Therefore, this choice is incorrect.

Choice D reason: Exposure to multiple environmental infectious agents can challenge the immune system, but it does not necessarily cause it to fail. The immune system can adapt and respond to different pathogens, unless it is compromised by an underlying condition, such as AIDS. Therefore, this choice is incorrect.

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Naxlex Comprehensive Predictor Exams

A client with benign prostatic hyperplasia (BPH) is preparing for discharge following a transurethral needle ablation (TUNA), which information should the nurse include in the discharge instructions?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

A client with acute renal injury (AKI) weighs 110.3 pounds (50 kg) and has a potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first? Reference Range: Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

A client with obstructive sleep apnea (OSA) calls the clinic to report difficulty wearing the continuous positive air pressure (CPAP) mask because it is uncomfortable. The client asks the nurse for an alternative way to manage sleep apnea. Which recommendation should the nurse provide?

A client is hospitalized with an inflammatory bowel disease (IBD) exacerbation and is being treated with a corticosteroid. The client develops a rigid abdomen with rebound tenderness. Which action should the nurse take?

A client asks the nurse for information about how to reduce risk factors for benign prostatic hyperplasia (BPH). Which information should the nurse provide?

The nurse is caring for a client with chemotherapy-induced mucositis who is describing soreness of the tongue and oral issues. Which is the best initial nursing action?

After teaching a client newly diagnosed with cholecystitis about recommended diet changes, the nurse evaluates the client's learning. Which food choices eliminated by the client indicate to the nurse that teaching has been successful?

A client presents with the onset of a severe headache, fever, nuchal rigidity, and a petechial rash on arms and legs. The nurse recognizes the client is exhibiting symptoms of which condition?

Two weeks after returning home from traveling, a client presents to the clinic with conjunctivitis and describes a recent loss in the ability to taste and smell. The nurse obtains a nasal swab to test for COVID-19. Which action is most important for the nurse to take?