NR 304 Pre-Simulation Questions for Mary Cohen

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Mary Cohen, a 50-year-old white female, visited the emergency department in the afternoon, presenting with right upper quadrant abdominal pain. The pain occurred approximately one hour after consuming a fatty meal. Mary was diagnosed with cholecystitis due to her history of gallstones and intermittent abdominal pain. She was subsequently admitted to the hospital for a cholecystectomy.

Question 1

According to Mayo Clinic, cholecystitis refers to the inflammation of the gallbladder, which is situated below the liver on the right side of the abdomen. Symptoms include severe upper or center abdominal pain, tenderness when touched, nausea, vomiting, and fever, typically occurring after consuming a large or fatty meal. The condition is commonly caused by gallstones obstructing the tube leading out of the gallbladder, resulting in bile buildup and subsequent inflammation. Cholecystitis can lead to severe complications like gallbladder rupture, making prompt treatment essential. Considering the provided information and further research, the symptoms experienced by Mary are consistent with cholecystitis, especially considering her history of gallstones, which increases her risk for the condition.

NR 304 Pre-Simulation Questions for Mary Cohen

Question 2

Patients diagnosed with cholecystitis should receive detailed information about the causes, typical signs and symptoms, potential complications if left untreated, and available treatment options, such as surgery. This knowledge is essential to raise awareness and motivate patients to seek timely medical care (Jarvis & Eckhart, 2019). Cholecystitis is a severe and potentially life-threatening condition. Furthermore, patients should be educated on strategies to reduce the risk of developing cholecystitis, such as gradual weight loss, maintaining a healthy weight, and adopting a nutritious diet (Mayo Clinic, 2020). Discussing preventive measures can be beneficial in helping patients understand how to manage and prevent this condition.

Question 3

The treatment approach for cholecystitis typically involves a hospital stay to manage gallbladder inflammation, with surgery often necessary. During the hospital stay, the patient’s doctor will employ various measures to control the signs and symptoms. Standard treatment options include fasting, intravenous fluids, antibiotics to combat infections, pain medications, and a procedure to remove gallstones (Mayo Clinic, 2020). For prophylactic antibiotic coverage against common pathogens, patients with cholecystitis may benefit from antibiotic therapy using levofloxacin and metronidazole. Medications such as Promethazine or Prochlorperazine can help alleviate nausea and prevent fluid and electrolyte imbalances. Pain relief and control of inflammatory symptoms can be achieved through Oxycodone or acetaminophen (Nurse Slabs, 2017).

NR 304 Pre-Simulation Questions for Mary Cohen


Mary Cohen, a 50-year-old woman with a history of gallstones, presented to the emergency department with right upper quadrant abdominal pain after a fatty meal. She was diagnosed with cholecystitis and admitted to the hospital for a cholecystectomy. Cholecystitis is defined as inflammation of the gallbladder, characterized by severe abdominal pain, tenderness, nausea, vomiting, and fever. Gallstones blocking the gallbladder’s tube are a common cause of cholecystitis. Prompt treatment is crucial to prevent complications like gallbladder rupture. Patients with cholecystitis should be educated about the condition, its symptoms, potential complications, and treatment options. Preventive measures such as weight management and a healthy diet should also be discussed. Treatment for cholecystitis typically involves a hospital stay, with fasting, intravenous fluids, antibiotics, pain medications, and gallstone removal being common approaches. Medications for nausea and pain relief are also used.


Jarvis, J. C., & Eckhart, A. E. (2019). Physical Examination and Health Assessment (8th Ed.). Saunders. Mayo Clinic. (2020, August 28). Cholecystitis – Symptoms and causes.

Mayo Clinic. (2020, August 28). Cholecystitis – Diagnosis and treatment – Mayo Clinic. Mayo Clinic – Mayo Clinic.

Nurse slabs. (2017, September 24). Cholecystitis nursing care management and study guide. Nurse slabs.