The patient has persistent and continuous pain at McBurney's point. The nursing assessment reveals rebound tenderness and muscle guarding with the patient preferring to lie still with the right leg flexe What should the nursing interventions for this patient include?

Correct Answer: B

Rationale: The correct answer is B: NPO status in preparation for possible appendectomy. This patient presents with classic signs of appendicitis, such as persistent pain at McBurney's point, rebound tenderness, muscle guarding, and preference for lying still with the right leg flexed. NPO status is crucial to prevent complications if surgery is needed. Laxatives (choice A) are not indicated as the focus should be on diagnosing and treating appendicitis. Parenteral fluids and antibiotics (choice C) may be necessary but not specifically for 6 hours before surgery. Inserting an NG tube (choice D) is not necessary for appendicitis.

Correct Answer: D

Rationale: Step 1: HBV vaccine is given to provide active immunity to the individual against Hepatitis B virus. Step 2: HBIG is given for immediate, short-term passive immunity by providing pre-formed antibodies. Step 3: Using both HBV vaccine and HBIG together provides both immediate and long-term protection. Step 4: Interferon is not used for prophylaxis against HBV as it is used for treatment rather than prevention. Summary: Choice D is correct because it combines active and passive immunity for comprehensive protection. Choices A, B, and C are incorrect as they do not provide the necessary dual protection against HBV post-needle stick exposure.

Correct Answer: D

Rationale: The correct answer is D: Pancreatic abscess. A pancreatic abscess is a serious complication of acute pancreatitis that can lead to sepsis if not promptly drained surgically. Abscess formation occurs when infected necrotic tissue accumulates in the pancreas. Prompt surgical drainage is necessary to prevent the spread of infection and systemic complications. A: Tetany is not a complication of acute pancreatitis that requires surgical drainage to prevent sepsis. Tetany is associated with hypocalcemia, which can occur in pancreatitis but is managed medically. B: Pseudocyst is a common complication of pancreatitis but usually resolves spontaneously or can be managed conservatively unless it becomes infected or causes symptoms. C: Pleural effusion can occur in severe cases of pancreatitis but is managed medically through supportive care and may not always require surgical drainage unless it leads to complications like infection.

Correct Answer: B

Rationale: The correct answer is B because bile acid therapy is indeed used to dissolve small, cholesterol-based gallstones by helping to break down the cholesterol within the stones. This therapy is not the first-line treatment for all patients (A), as larger stones may require other interventions like surgery. It is also not effective only in patients with obstructed bile ducts (C) but can be used in various cases. Lastly, it is not contraindicated in patients with diabetes (D), as long as there are no specific contraindications related to the individual's health status.