The nurse knows a Whipple procedure may be performed for:

Choice A reason: Excessive alcohol consumption is a leading cause of pancreatic disease, particularly chronic pancreatitis. Alcohol induces oxidative stress and toxic metabolites, damaging pancreatic acinar cells, leading to inflammation, fibrosis, and impaired enzyme secretion, making it a well-established risk factor for pancreatic pathology.

Choice B reason: Excessive vitamin C intake is not associated with pancreatic disease. High doses may cause gastrointestinal upset or kidney stones but do not directly damage the pancreas or contribute to conditions like pancreatitis, making this an unlikely and irrelevant risk factor for pancreatic issues.

Choice C reason: A very low-fat diet is not a common cause of pancreatic disease. While low-fat diets may be recommended for pancreatitis management, they do not contribute to its development. Pancreatic damage is more linked to alcohol or gallstones, not dietary fat restriction.

Choice D reason: A high protein diet is not a primary risk factor for pancreatic disease. Excessive protein may stress the kidneys or liver in certain conditions, but it does not directly cause pancreatitis or other pancreatic disorders, unlike alcohol, which has a direct toxic effect on the pancreas.

Choice A reason: Right shoulder pain post-laparoscopic cholecystectomy is not due to prolonged positioning. It results from carbon dioxide used to insufflate the abdomen, irritating the diaphragm and causing referred pain via the phrenic nerve, making this statement incorrect for explaining the pain’s origin.

Choice B reason: Nitrous dioxide is not used in laparoscopic cholecystectomy; carbon dioxide is the standard insufflation gas. This gas causes diaphragmatic irritation, leading to referred shoulder pain, not nitrous dioxide, making this statement factually incorrect regarding the cause of postoperative pain.

Choice C reason: Ambulation helps dissipate carbon dioxide gas trapped in the abdomen post-laparoscopic cholecystectomy, reducing diaphragmatic irritation and referred shoulder pain. Movement facilitates gas absorption and excretion via the lungs, alleviating discomfort, making this the correct nursing statement to relieve the patient’s pain.

Choice D reason: Residual pain from cholecystitis is unlikely post-cholecystectomy, as the gallbladder, the source of inflammation, is removed. Shoulder pain is due to surgical gas, not ongoing cholecystitis, making this statement incorrect for explaining the postoperative pain experienced by the client.