Which of the following pretest evaluation measures should the nurse ensure before a client undergoes the gallbladder series test?

Correct Answer: C

Rationale: Step-by-step rationale for the correct answer (C): Determining whether the client is pregnant is crucial before a gallbladder series test because the test involves radiation exposure, which can be harmful to a developing fetus. It is essential to ensure the safety of both the client and the unborn child. Summary: - A: Determining the work environment of the client is not directly related to the safety or appropriateness of a gallbladder series test. - B: Determining whether the client has a family history of GI disorders is important for overall health assessment but not specifically necessary for the pretest evaluation of a gallbladder series test. - D: Determining whether the client is allergic to seafood or iodine is relevant for contrast materials used in some imaging tests but not specifically for a gallbladder series test.

Correct Answer: C

Rationale: The correct answer is C: Decreasing secretions and peristaltic action. Atropine, as an anticholinergic drug, inhibits the action of acetylcholine, leading to decreased secretions and peristaltic movement in the GI tract. This results in reduced motility and secretion production. A: Increasing gastric emptying - This is incorrect because atropine actually slows down gastric emptying by reducing peristaltic action. B: Relaxing pyloric and ileocecal sphincters - This is incorrect because atropine does not directly relax these sphincters. D: Stimulating the nervous system of the GI tract - This is incorrect because atropine inhibits the parasympathetic nervous system, leading to decreased GI tract activity.

Correct Answer: B

Rationale: The correct answer is B because an increase in serum transferrin levels indicates improvement in protein-calorie malnutrition as transferrin is a protein that binds and transports iron, which is essential for various body functions. When protein intake increases, transferrin levels also increase to support iron transport. A: Decreased lymphocytes do not directly reflect improvement in protein-calorie malnutrition. C: Increased serum potassium is not specific to improvement in protein-calorie malnutrition. D: Decreased serum prealbumin levels indicate ongoing malnutrition, not improvement.

Correct Answer: A

Rationale: The correct answer is A: Avoid sugary foods and limit fluids to prevent dumping syndrome. After a Roux-en-Y gastric bypass, the patient's stomach size is reduced, making it important to avoid sugary foods that can cause rapid spikes in blood sugar and lead to dumping syndrome. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms like nausea, vomiting, diarrhea, and weakness. Limiting fluids can also help prevent this by slowing down digestion. Choices B and C are incorrect as increasing food intake rapidly or maintaining a liquid diet long-term can be harmful post-surgery. Choice D is incorrect because consuming foods high in complex carbohydrates, protein, and fiber can be difficult for the patient to digest due to the altered anatomy.

Correct Answer: D

Rationale: Step 1: Peptic ulcers are mainly caused by H. pylori infection or NSAIDs use, not directly related to acid injury. Step 2: Ammonia formation in the mucosal wall neutralizes acid, protecting mucosal cells. Step 3: Ammonia is produced by H. pylori urease enzyme, contributing to ulcer formation. Step 4: Acid back diffusion (B) and histamine release (C) are consequences, not direct causes of ulcers. Summary: Ammonia formation (D) is the correct answer as it directly contributes to mucosal injury in peptic ulcers. Acid back diffusion (B) and histamine release (C) are secondary effects of ulcer formation, not the primary cause.