The nurse knows a Whipple procedure may be performed for:

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.

Choice A reason: Increased thirst (polydipsia) is a symptom of hyperglycemia, not hypoglycemia, in type 1 diabetes. It results from osmotic diuresis due to elevated glucose, not low glucose levels, making it irrelevant for immediate intervention in a hypoglycemic crisis requiring rapid glucose administration.

Choice B reason: Tremors and sweating are classic signs of hypoglycemia in type 1 diabetes, caused by sympathetic nervous system activation and catecholamine release in response to low blood glucose. These indicate an urgent need for glucose to prevent seizures or unconsciousness, making this the priority symptom.

Choice C reason: Increased appetite (polyphagia) is associated with hyperglycemia, not hypoglycemia, as cells are starved of glucose due to insulin deficiency. It does not require immediate intervention in a hypoglycemic context, as it reflects a different metabolic state, making this symptom less urgent.

Choice D reason: Frequent urination (polyuria) is a hyperglycemia symptom, driven by osmotic diuresis from high glucose levels, not hypoglycemia. It does not indicate an acute crisis requiring immediate action, unlike tremors and sweating, which signal a potentially life-threatening low glucose state.