Postoperative And Post-Trauma Care Practice Test

A 50-year-old man has been in the ICU for two weeks recovering from severe thermal burns covering 40% of his body surface area. He has been receiving total parenteral nutrition (TPN) for the past 12 days. He develops a new fever to 39.0°C (102.2°F), right upper quadrant tenderness, and a white blood cell count of 16,000/mm³. An abdominal ultrasound shows a distended gallbladder with a thickened wall (>4 mm) and pericholecystic fluid, but no gallstones are visualized.

A 35-year-old woman who underwent a Roux-en-Y gastric bypass 3 years ago presents to the emergency department with a 12-hour history of severe, cramping, periumbilical abdominal pain and non-bilious vomiting. On examination, she is tachycardic to 120/min and has diffuse abdominal tenderness without peritoneal signs. A plain abdominal x-ray is unremarkable.