MED SURG 2026 FINAL ASSESSMENT
TESTED CONTENT WITH ACCURATE
SOLUTIONS
◉ S/S of Cholelithiasis. Answer: Signs and Symptoms of Gallstones:
Gallstones may be silent, producing no pain and only mild GI
symptoms. Such stones may be detected incidentally during surgery
or evaluation for unrelated problems. The symptoms may be acute
or chronic. Epigastric distress, such as fullness, abdominal
distention, and vague pain in the right upper quadrant of the
abdomen, may occur
◉ Causes of Gallstones. Answer: In gallstone-prone patients, there is
decreased bile acid synthesis and increased cholesterol synthesis in
the liver, resulting in bile supersaturated with cholesterol, which
precipitates out of the bile to form stones. 2-4 times more women
than men. Stone formation is more frequent in people who use oral
contraceptives, estrogens, or clofibrate (Atromid-S); these
medications are known to increase biliary cholesterol saturation
◉ Gallstone Composition. Answer: There are two major types of
gallstones: those composed predominantly of pigment (10-25%)
and those composed primarily of cholesterol (75%).
, ◉ Cholelithiasis Dietary Teaching. Answer: The diet immediately
after an episode is usually low-fat liquids. These can include
powdered supplements high in protein and carbohydrate stirred
into skim milk. Cooked fruits, rice or tapioca, lean meats, mashed
potatoes, non-gas-forming vegetables, bread, coffee, or tea may be
added as tolerated. The patient should avoid eggs, cream, pork, fried
foods, cheese, rich dressings, gas-forming vegetables, and alcohol. It
is important to remind the patient that fatty foods may induce an
episode of cholecystitis. Dietary management may be the major
mode of therapy in patients who have had only dietary intolerance
to fatty foods and vague GI symptoms
◉ 2 Medications for Dissolving Gallstones. Answer: Medications for
Dissolving Gallstones:
Ursodeoxycholic acid (UDCA [Urso, Actigall])
Chenodeoxycholic acid (chenodiol or CDCA [Chenix])
have been used to dissolve small, radiolucent gallstones composed
primarily of cholesterol
Six to 12 months of therapy is required in many patients to dissolve
stones, and monitoring of the patient for recurrence of symptoms or
the occurrence of side effects (e.g., GI symptoms, pruritus, headache)
is required during this time. The effective dose of medication
depends on body weight
◉ Duodenal vs. Gastric Ulcers. Answer: Approximately 50% to 80%
of clients with duodenal ulcers awake with pain during the night.
TESTED CONTENT WITH ACCURATE
SOLUTIONS
◉ S/S of Cholelithiasis. Answer: Signs and Symptoms of Gallstones:
Gallstones may be silent, producing no pain and only mild GI
symptoms. Such stones may be detected incidentally during surgery
or evaluation for unrelated problems. The symptoms may be acute
or chronic. Epigastric distress, such as fullness, abdominal
distention, and vague pain in the right upper quadrant of the
abdomen, may occur
◉ Causes of Gallstones. Answer: In gallstone-prone patients, there is
decreased bile acid synthesis and increased cholesterol synthesis in
the liver, resulting in bile supersaturated with cholesterol, which
precipitates out of the bile to form stones. 2-4 times more women
than men. Stone formation is more frequent in people who use oral
contraceptives, estrogens, or clofibrate (Atromid-S); these
medications are known to increase biliary cholesterol saturation
◉ Gallstone Composition. Answer: There are two major types of
gallstones: those composed predominantly of pigment (10-25%)
and those composed primarily of cholesterol (75%).
, ◉ Cholelithiasis Dietary Teaching. Answer: The diet immediately
after an episode is usually low-fat liquids. These can include
powdered supplements high in protein and carbohydrate stirred
into skim milk. Cooked fruits, rice or tapioca, lean meats, mashed
potatoes, non-gas-forming vegetables, bread, coffee, or tea may be
added as tolerated. The patient should avoid eggs, cream, pork, fried
foods, cheese, rich dressings, gas-forming vegetables, and alcohol. It
is important to remind the patient that fatty foods may induce an
episode of cholecystitis. Dietary management may be the major
mode of therapy in patients who have had only dietary intolerance
to fatty foods and vague GI symptoms
◉ 2 Medications for Dissolving Gallstones. Answer: Medications for
Dissolving Gallstones:
Ursodeoxycholic acid (UDCA [Urso, Actigall])
Chenodeoxycholic acid (chenodiol or CDCA [Chenix])
have been used to dissolve small, radiolucent gallstones composed
primarily of cholesterol
Six to 12 months of therapy is required in many patients to dissolve
stones, and monitoring of the patient for recurrence of symptoms or
the occurrence of side effects (e.g., GI symptoms, pruritus, headache)
is required during this time. The effective dose of medication
depends on body weight
◉ Duodenal vs. Gastric Ulcers. Answer: Approximately 50% to 80%
of clients with duodenal ulcers awake with pain during the night.
