NSG 123 Medical Surgical Nursing Exam
2 Questions & Answers
Main Cause of Cholelithiasis - correct Answer-Cholesterol stones account for most of
the remaining 75% of cases of gallbladder disease in the United States.
Symptoms of Cholelithias - correct Answer-Nausea
Vomiting
Right upper quadrant abdominal pain or epigastric pain that radiates to the right
shoulder especially after meals when the gallbladder is stimulated to release bile.
Patient Teaching for Cholelithiasis - correct 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.
Purpose of Medication in Cholelithiasis - correct Answer-Purpose of Medications:
reduces hepatic production of cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual dissolution of
cholesterol gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
Purpose of Adding Fat to Emulsion to TPN - correct Answer-Fat emulsions (lipids) are
usually given to clients receiving TPN to provide supplemental kilocalories and prevent
fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
Carbon Dioxide in Laparoscopic Cholecystectomy - correct Answer-Carbon dioxide is
used during the procedure
Explain to the patient that they might feel pain in the right shoulder or scapular area
(from migration of the carbon dioxide used to insufflate the abdominal cavity during the
procedure).
Laparoscopic Colecystectomy 3 Things to do After - correct Answer-Recommend a
heating pad for 15 to 20 minutes hourly or
Encourage the client to ambulate frequently to reduce the bloating.
Manage nausea assess bowel sounds for further complications.
Preoperative Assessment for Open Cholecystectomy - correct Answer-Priority
assessment should focus on the client's respiratory status.
If a traditional surgical approach is planned, the high abdominal incision required during
surgery may interfere with full respiratory excursion.
, The nurse notes a history of smoking, previous respiratory problems, shallow
respirations, a persistent or ineffective cough, and the presence of adventitious breath
sounds.
CBC and BMP should also be assessed
4 Postoperative Complications of Cholecystostomy - correct Answer-After these surgical
procedures, the client is observed for indications of infection, leakage of bile into the
peritoneal cavity, and obstruction of bile drainage.
If bile is not draining properly, an obstruction is probably causing bile to be forced back
into the liver and bloodstream.
Because jaundice may result, the nurse should assess the color of the sclerae. Yellow-
colored sclerae or skin can indicate jaundice.
Clay-colored stool should be reported as this indicates a complication.
Discharge Teaching for Open Cholecystectomy - correct Answer-Usually, only a small
amount of serosanguineous fluid drains in the initial 24 hours after surgery; afterward,
the drain is removed.
The drain is typically maintained if there is excess oozing or bile leakage.
Empty the drainage bag attached at least every 8 hours and as needed, to prevent
reflux back into the bile duct.
Take showers not baths to prevent infection of the incision site.
What disease is characterized by possible malnourishment (anemic) and frequenct
diarrhea? - correct Answer-Crohn's disease
The disease characterized by blood sools and left lower quadrent pain - correct Answer-
Ulcerative Colitis
What GI disease would be best diagnosed with colonoscopy? - correct Answer-
Ulcerative Colitis
What testing would you expect to see from a patient recieving parenteral nutrition? -
correct Answer-Blood Glucose
What time of day should Famotidine (pepcid) be administered? - correct Answer-Bed
time
What is an intragastric balloon used for? - correct Answer-Non-invasive weight loss
The nurse needs to check Mg++ before administration of what drug? - correct Answer-
Magnesium hydroxide/aluminum hydrate MAALOX
Which weight loss drug requirres a fat soluble vitamin supplement? - correct Answer-
Orlistat (XENICAL)
2 Questions & Answers
Main Cause of Cholelithiasis - correct Answer-Cholesterol stones account for most of
the remaining 75% of cases of gallbladder disease in the United States.
Symptoms of Cholelithias - correct Answer-Nausea
Vomiting
Right upper quadrant abdominal pain or epigastric pain that radiates to the right
shoulder especially after meals when the gallbladder is stimulated to release bile.
Patient Teaching for Cholelithiasis - correct 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.
Purpose of Medication in Cholelithiasis - correct Answer-Purpose of Medications:
reduces hepatic production of cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual dissolution of
cholesterol gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
Purpose of Adding Fat to Emulsion to TPN - correct Answer-Fat emulsions (lipids) are
usually given to clients receiving TPN to provide supplemental kilocalories and prevent
fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
Carbon Dioxide in Laparoscopic Cholecystectomy - correct Answer-Carbon dioxide is
used during the procedure
Explain to the patient that they might feel pain in the right shoulder or scapular area
(from migration of the carbon dioxide used to insufflate the abdominal cavity during the
procedure).
Laparoscopic Colecystectomy 3 Things to do After - correct Answer-Recommend a
heating pad for 15 to 20 minutes hourly or
Encourage the client to ambulate frequently to reduce the bloating.
Manage nausea assess bowel sounds for further complications.
Preoperative Assessment for Open Cholecystectomy - correct Answer-Priority
assessment should focus on the client's respiratory status.
If a traditional surgical approach is planned, the high abdominal incision required during
surgery may interfere with full respiratory excursion.
, The nurse notes a history of smoking, previous respiratory problems, shallow
respirations, a persistent or ineffective cough, and the presence of adventitious breath
sounds.
CBC and BMP should also be assessed
4 Postoperative Complications of Cholecystostomy - correct Answer-After these surgical
procedures, the client is observed for indications of infection, leakage of bile into the
peritoneal cavity, and obstruction of bile drainage.
If bile is not draining properly, an obstruction is probably causing bile to be forced back
into the liver and bloodstream.
Because jaundice may result, the nurse should assess the color of the sclerae. Yellow-
colored sclerae or skin can indicate jaundice.
Clay-colored stool should be reported as this indicates a complication.
Discharge Teaching for Open Cholecystectomy - correct Answer-Usually, only a small
amount of serosanguineous fluid drains in the initial 24 hours after surgery; afterward,
the drain is removed.
The drain is typically maintained if there is excess oozing or bile leakage.
Empty the drainage bag attached at least every 8 hours and as needed, to prevent
reflux back into the bile duct.
Take showers not baths to prevent infection of the incision site.
What disease is characterized by possible malnourishment (anemic) and frequenct
diarrhea? - correct Answer-Crohn's disease
The disease characterized by blood sools and left lower quadrent pain - correct Answer-
Ulcerative Colitis
What GI disease would be best diagnosed with colonoscopy? - correct Answer-
Ulcerative Colitis
What testing would you expect to see from a patient recieving parenteral nutrition? -
correct Answer-Blood Glucose
What time of day should Famotidine (pepcid) be administered? - correct Answer-Bed
time
What is an intragastric balloon used for? - correct Answer-Non-invasive weight loss
The nurse needs to check Mg++ before administration of what drug? - correct Answer-
Magnesium hydroxide/aluminum hydrate MAALOX
Which weight loss drug requirres a fat soluble vitamin supplement? - correct Answer-
Orlistat (XENICAL)
