Which of the following tests is most commonly used to diagnose cholecystitis?

Correct Answer: B

Rationale: The most commonly used test to diagnose cholecystitis is an abdominal ultrasound. This imaging study is preferred due to its high sensitivity and specificity in identifying gallstones, inflammation, and other abnormalities in the gallbladder. Abdominal CT scan (Option A) is not the first-line diagnostic test for cholecystitis because it is less sensitive in detecting gallstones compared to ultrasound. Barium swallow (Option C) is used to visualize the esophagus and upper gastrointestinal tract, not the gallbladder, making it an inappropriate choice for diagnosing cholecystitis. Endoscopy (Option D) is used to visualize the upper gastrointestinal tract and is not the indicated test for assessing the gallbladder and diagnosing cholecystitis. In an educational context, understanding the appropriate diagnostic tests for specific conditions is crucial for nursing practice. By knowing the rationale behind choosing the right test, nurses can provide optimal care to patients with suspected cholecystitis, ensuring timely and accurate diagnosis and treatment.

Correct Answer: D

Rationale: In the context of a client being treated for chronic cholecystitis, the correct instruction is to use anticholinergics as prescribed (Option D). Anticholinergics help to decrease the spasms in the smooth muscle of the gastrointestinal tract, including the gallbladder, which can be beneficial in managing the symptoms associated with cholecystitis. Option A, increasing rest, while important for overall health, does not directly address the treatment of cholecystitis. Option B, avoiding antacids, is not specifically indicated for cholecystitis treatment and may not have a direct impact on the condition. Option C, increasing protein in the diet, is not the priority in the management of cholecystitis as dietary modifications typically focus on reducing fat intake to decrease gallbladder stimulation. From an educational standpoint, understanding the rationale behind the correct answer helps students grasp the pharmacological management of gastrointestinal conditions. It reinforces the importance of tailored interventions for specific conditions and highlights the role of medications in symptom management. This question also emphasizes the need for critical thinking in selecting the most appropriate intervention based on the client's condition.

Correct Answer: C

Rationale: In a client with a duodenal ulcer, the presence of melena (option C) is a common finding on assessment. Melena refers to black, tarry stools caused by upper gastrointestinal bleeding. This occurs because the blood is partially digested as it passes through the gastrointestinal tract. Detecting melena indicates active bleeding and is a crucial sign in assessing the severity of the ulcer and the need for intervention. Option A, hematemesis, is vomiting of blood and is more commonly associated with gastric ulcers. Option B, malnourishment, can be a consequence of chronic gastrointestinal issues like ulcers, but it is not a direct finding on assessment for a duodenal ulcer. Option D, pain with eating, is a common symptom of duodenal ulcers but is not specific to their assessment findings. Educationally, understanding these assessment findings is crucial for nurses caring for patients with gastrointestinal issues. Recognizing the specific signs and symptoms associated with duodenal ulcers helps in prompt diagnosis, appropriate interventions, and effective patient care. It also highlights the importance of differentiating between various gastrointestinal conditions based on assessment findings for accurate treatment and management.

Correct Answer: D

Rationale: In distinguishing between the pain associated with duodenal and gastric ulcers, it is crucial to understand the pathophysiology of each condition. The correct answer, "D) Pain on an empty stomach," is indicative of a duodenal ulcer. This pain worsens when the stomach is empty due to the exposure of the ulcer to gastric acid during fasting periods. The presence of pain at night or in between meals is a classic symptom of a duodenal ulcer. Option A, "Early satiety," is more commonly associated with gastric ulcers. Gastric ulcers tend to cause pain or discomfort shortly after eating, leading to early satiety as a result of the irritation in the stomach lining postprandially. Option B, "Pain on eating," is not a typical characteristic of either duodenal or gastric ulcers. Pain that worsens with eating is more indicative of esophageal or gastric conditions such as gastritis. Option C, "Dull upper epigastric pain," is a general symptom that can be present in both duodenal and gastric ulcers. However, the specific characteristic that distinguishes duodenal ulcers is the relief of pain with food intake due to neutralization of stomach acid. Understanding these distinctions is vital in clinical practice as it guides healthcare providers in making accurate diagnoses and implementing appropriate treatment plans for patients with gastrointestinal ulcers.

Correct Answer: A

Rationale: In the context of medical-surgical nursing, the correct answer (A) instructing the client to tilt his head back for insertion in the nostril and then flex his neck for the final insertion is the most appropriate technique for nasogastric (NG) tube insertion. Tilting the head back helps align the nasal passages and facilitates the smooth passage of the tube. Flexing the neck during the final insertion aids in guiding the tube through the nasopharynx into the esophagus. Option B (instructing the client to extend his neck after insertion) is incorrect as extending the neck can obstruct the pathway of the NG tube. Option C (introducing the tube with the client's head tilted back, then keeping the head upright for final insertion) is incorrect as keeping the head upright can hinder the tube's progression. Option D (instructing the client to hold his chin down, then back for insertion) is also incorrect as this position can cause difficulty in advancing the tube through the nasopharynx. Educationally, understanding the correct technique for NG tube insertion is crucial for nurses to ensure patient safety and comfort. Proper positioning of the client facilitates the procedure and reduces the risk of complications such as trauma to the nasal passages or misplacement of the tube. Nurses must be knowledgeable about the anatomical considerations and patient positioning to perform procedures effectively in a clinical setting.