American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is the primary treatment for choledocholithiasis?

1. Elective cholecystectomy

2. Emergent ERCP

3. IV antibiotics

4. Urinary catheterization

The correct answer is: Emergent ERCP

The primary treatment for choledocholithiasis, which is the presence of stones in the common bile duct, involves the use of emergent endoscopic retrograde cholangiopancreatography (ERCP). This procedure not only allows for the visualization of the bile duct and any obstructing stones but also provides the capability to remove those stones, relieving the obstruction and associated symptoms. When a patient presents with choledocholithiasis, they may experience complications such as cholangitis or pancreatitis due to bile duct obstruction. An emergent ERCP is often performed when there are signs of these complications, making it critical for both diagnosis and therapeutic intervention. While elective cholecystectomy may eventually be performed to prevent future incidents (as the gallbladder is often the source of the stones), it is not the primary or immediate treatment for the current episode of choledocholithiasis. Similarly, while IV antibiotics can be important in managing any infection that may arise from the condition, they do not address the underlying cause, which is the obstruction of the bile duct. Urinary catheterization is unrelated to the management of choledocholithiasis, as it primarily pertains to urinary issues rather than biliary tract problems.