The nurse is caring for several clients on the med-surg unit. Who would be most at risk for development of gallstones?

The 19-year-old Native American male hospitalized with a shoulder injury.

The 40-year-old Caucasian pregnant woman who has been on bedrest for the past three months.

The 64-year-old African-American woman who is being treated for GERD.

The 25-year-old Asian woman who has been losing weight steadily for the past year.

Answer and Explanation

The Correct Answer is B

Choice A rationale

The 19-year-old Native American male hospitalized with a shoulder injury is less likely to develop gallstones. While there is a higher prevalence of gallstones among Native American populations, the risk is not significantly elevated in a young male with no other contributing factors such as obesity, rapid weight loss, or prolonged immobility.

Choice B rationale

The 40-year-old Caucasian pregnant woman who has been on bedrest for the past three months is at a high risk for developing gallstones. Pregnancy increases the risk due to hormonal changes that slow down the emptying of the gallbladder. Prolonged bed rest can lead to bile stasis, and the increased levels of estrogen can raise cholesterol levels in bile, both contributing to gallstone formation.

Choice C rationale

The 64-year-old African-American woman being treated for GERD is at a moderate risk for gallstones. Age and gender are risk factors for gallstones, but without other significant contributing factors such as obesity, rapid weight loss, or specific family history, her risk is not as high as the pregnant woman on bed rest.

Choice D rationale

The 25-year-old Asian woman who has been losing weight steadily for the past year is also at risk for gallstones, but the risk is less compared to the pregnant woman on bed rest. Rapid weight loss can cause gallstones due to the liver secreting extra cholesterol into bile, but steady weight loss over a longer period is less likely to cause such rapid changes in bile composition. .

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Correct Answer is B

Explanation

Choice B rationale

After an open cholecystectomy, bowel sounds are typically absent or hypoactive due to the effects of anesthesia and the manipulation of the intestines during surgery. It takes time for normal bowel function to resume.

Choice A rationale

Normoactive bowel sounds are not expected immediately after abdominal surgery due to the temporary paralysis of intestinal motility caused by anesthesia and surgical manipulation.

Choice C rationale

Hyperactive bowel sounds are uncommon after surgery. They are more often associated with conditions like gastroenteritis or bowel obstruction rather than the immediate postoperative period of an open cholecystectomy.

Choice D rationale

Borborygmi, or loud, rumbling bowel sounds, are not expected after abdominal surgery. These sounds can indicate increased bowel activity, which is not typical in the immediate postoperative phase following an open cholecystectomy.

A. Reroutes bile into the intestine for excretion. B. Assists the surgeon to visualize the gallbladder and duct system. C. Helps to maintain patency of the common bile duct. D. Prevents leakage of bile onto the client's skin.

Correct Answer is C

Explanation

Choice A rationale

A T-tube does not reroute bile into the intestine. Its purpose is to drain bile externally from the common bile duct to prevent obstruction and ensure healing.

Choice B rationale

The T-tube is not used for visualization of the gallbladder or duct system during surgery. Instead, it provides an external bile drainage route postoperatively to avoid bile buildup.

Choice C rationale

The T-tube helps to maintain patency of the common bile duct by providing a direct drainage path for bile. This prevents bile from accumulating and causing complications like jaundice or infection.

Choice D rationale

Preventing leakage of bile onto the skin is not the primary purpose of a T-tube. Its main function is to ensure bile can bypass any postoperative swelling or blockage in the bile ducts.

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The nurse is caring for several clients on the med-surg unit. Who would be most at risk for development of gallstones?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is 4 hours post-op after an open cholecystectomy. The nurse would expect the client's bowel sounds to be:

Correct Answer is B

Explanation

The client asks about the use of a T-tube following an open cholecystectomy. The nurse's best response is that a T-tube:

Correct Answer is C

Explanation

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