What type of pain does the nurse expect a patient with an ulcer of the posterior portion of the duodenum to experience?

Correct Answer: B

Rationale: The correct answer is B: Back pain that occurs 2 to 4 hours following meals. This type of pain is characteristic of duodenal ulcers due to increased acid secretion post-meals. Pain occurs when acidic stomach contents enter the duodenum, stimulating pain receptors. Back pain is common as the ulcer is located in the posterior portion of the duodenum. Choices A, C, and D are incorrect as they do not correspond to the typical pain pattern of a duodenal ulcer. Choice A is more indicative of gastritis, Choice C is suggestive of peptic ulcer disease, and Choice D is more characteristic of gastric ulcers.

Correct Answer: A

Rationale: The correct answer is A: Semiliquid stools with increased fluid requirements. A transverse colostomy is located in the upper part of the colon, where stool consistency is more liquid. This type of colostomy typically produces semiliquid stools due to the shorter transit time in the colon, leading to increased fluid requirements to prevent dehydration. Summary of other choices: B: Liquid stools in a pouch and increased fluid requirements - Incorrect because transverse colostomies produce semiliquid stools, not entirely liquid. C: Formed stools with a pouch, needing irrigation, but no fluid needs - Incorrect as transverse colostomies do not produce formed stools, and fluid intake is necessary. D: Semiformed stools in a pouch with the need to monitor fluid balance - Incorrect because transverse colostomies produce semiliquid stools, not semiformed, and increased fluid intake is needed.

Correct Answer: D

Rationale: Step-by-step rationale for why choice D is correct: Activation of the complement system by antigen-antibody complexes leads to systemic effects in viral hepatitis. This process triggers inflammation, tissue damage, and immune responses that contribute to the systemic effects seen in viral hepatitis. The other choices (A, B, and C) do not directly cause systemic effects in viral hepatitis. Cholestasis and impaired portal circulation are more localized effects, while toxins produced by the infected liver may contribute to liver damage but not necessarily systemic effects.

Correct Answer: C

Rationale: The correct answer is C: Abstinence from alcohol is the most important factor in improvement of the patient's condition. This is because alcohol is the primary cause of alcoholic cirrhosis, and continued consumption can worsen liver damage. Abstinence allows the liver to heal and potentially improve function. Explanation of why the other choices are incorrect: A: A daily exercise regimen is important for overall health but may not specifically increase blood flow through the liver in alcoholic cirrhosis. B: Cirrhosis is irreversible, although proper rest and nutrition can help manage symptoms and prevent further damage. D: Acetaminophen can be harmful to the liver in high doses and should be used cautiously in patients with cirrhosis.

Correct Answer: A

Rationale: The correct answer is A: Prepare for surgery immediately. This is the priority action because acute cholecystitis with suspected perforation is a surgical emergency that requires prompt intervention to prevent serious complications such as sepsis. Surgery is needed to remove the inflamed gallbladder and repair any perforation. Administering IV fluids, pain medication, and antibiotics are important supportive measures but do not address the underlying issue. Monitoring vital signs is also crucial, but immediate surgical intervention takes precedence in this critical situation.