Gallbladder Disorders NCLEX Questions

Question 1

The client is four hours postoperative open cholecystectomy Which data warrant immediate intervention by the nurse?

1. Absent bowel sounds in all four quadrants
2. The T-tube has 60 mL of green drainage
3. Urine output of 100 mL in the past 3 hours
4. Refusal to turn, deep breathe, and cough

Answer 1

4. Refusing to turn, deep breathe, and cough places the client at risk for pneumonia. This client needs immediate intervention to prevent complications.

Question 2

The client two hours postoperative laparoscopic cholecystectomy is complaining of severe pain in the right shoulder. Which nursing intervention should the nurse implement?

1. Apply a heating pad to the abdomen for 15 - 20 minutes
2. Administer morphine sulfate intravenously after diluting with saline
3. Contact the surgeon for an order to x-ray the right shoulder
4. Apply a sling to the right arm, which was injured during surgery

Answer 2

1. A heating pad should be applied for 15 to 20 minutes to assist the migration of the CO2 used to insufflate the abdomen. Shoulder pain is an expected occurrence.

Question 3

The nurse is teaching a client recovering from a laparoscopic cholecystectomy. Which statement indicates the discharge teaching is effective?

1. I will take my lipid-lowering medicine at the same time each night
2. I may experience some discomfort when I eat a high-fat meal
3. I need someone to stay with me for about a week after surgery
4. I should not splint my incision when I deep breathe and cough

Answer 3

2. After removal of the gallbladder, some clients experience abdominal discomfort when eating fatty foods.

Question 4

Which signs and symptoms should the nurse report to the health care provider for the client recovering from an open cholecystectomy? Select all that apply

Answer 4

1. Clay- collored stools are caused by recurring stricture of the common bile duct, which is a sign of post cholecystectomy syndrome.
2. Yellow tinted sclera and skin indicate residual effects of stricture of the common bile duct, which is a sign of post cholecystectomy syndrome.
3. Abdominal pain indicates a residual effect of a stricture of the common bile duct, inflammation, or calculi, which is a sign of post cholecystectomy syndrome.

Question 5

The nurse is caring for the immediate postoperative client who had a laparoscopic cholecystectomy. Which task could the nurse delegate to the unlicensed assistive personnel (UAP)?

1. Check the abdominal dressings for bleeding
2. Increase the IV fluid if the blood pressure is low
3. Ambulate the client to the bathroom
4. Auscultate the breath sounds in all lobes

Answer 5

3. A day surgery client can be ambulated to the bathroom, so this task can me delegated to the UAP.

Question 6

Which data should the nurse expect to assess in the client who had an upper gastrointestinal (UGI) series?

1. Chalky white stools
2. Increased heart rate
3. A firm hard abdomen
4. Hyperactive bowel sounds

Answer 6

1. A UGI series requires the client to swallow barium, which passes through the intestines, making the stools a chalky white color

Question 7

The client is one hour post endoscopic retrograde cholangiopancreatogram (ERCP). Which intervention should the nurse include in the plan of care?

1. Instruct the client to cough forcefully
2. Encourage early ambulation
3. Assess for return of a gag reflex
4. Administer held medications

Answer 7

3. The ERCP requires an anesthetic spray be used prior to insertion of the endoscope. If medications, food, or fluid are given orally prior to the return of the gag reflex, the client may aspirate.

Question 8

Which outcome should the nurse identify for the client scheduled to have a cholecystectomy?

1. Decreased pain management
2. Ambulate first day postoperative
3. No break in skin integrity
4. Knowledge of postoperative care

Answer 8

4. This would be an expected outcome for the client scheduled for surgery. This indicates preoperative teaching has been effective.

Question 9

Which assessment data indicate to the nurse the client recovering from an open cholecystectomy may require pain medication?

1. The clients pulse is 65 beats per minute
2. The client has shallow respirations
3. The clients bowel sounds are 20 per minute
4. The client uses a pillow to splint when coughing

Answer 9

2. An open cholecystectomy requires a large incision under the diaphragm. Deep breathing places pressure on the diaphragm and the incision, causing pain. Shallow respirations indicate inadequate pain control, and the nurse should intervene.

Question 10

The charge nurse is monitoring client laboratory values. Which value is expected in the client with cholecystitis who has chronic inflammation?

1. an elevated white blood cell count
2. an decreased lactate dehydrogenase
3. an elevated alkaline phosphatase
4. a decreased direct bilirubin level

Answer 10

1.The white blood cell count should be elevated in clients with chronic inflammation.

Question 11

Which problem is highest priority for the nurse to identify in the client who had an open cholecystectomy surgery?

1. Alteration in nutrition
2. Alteration in skin integrity
3. Alteration in urinary pattern
4. Alteration in comfort

Answer 11

4. Acute pain management is the highest priority client problem after surgery because pain may indicate a life-threatening problem

Question 12

The nurse assesses a large amount of red drainage on the dressing of a client who is six hours postoperative open cholecystectomy. Which intervention should the nurse implement?

1. measure the abdominal girth
2. Palpate the lower abdomen for a mass
3. Turn client onto side to assess for further drainage
4. Remove the dressing to determine the source

Answer 12

3. Turning the client to the side to assess the amount of drainage and possible bleeding is important prior to contacting the surgeon.