Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
             Disease
Assessment :
• Preadmission testing is often completed a week or more
before admission.
•
Assessment should focus on the patient respiratory
status; the nurse notes a history of smoking, previous
respiratory problem, shallow respiration, persistence of
ineffective cough and the presence breathing sound. the
nurse instructs the patient about the need to avoid
smoking
to
enhance
pulmonary
recovery
postoperatively and avoid respiratory complication.
• Instruct the patient to avoid the use of aspirin
and other agents that can alter coagulations.
• Nutritional status is evaluated through dietary
history and general examination
Nursing Diagnosis
• Impaired gas exchange related to high abdominal
surgical incision
• Acute pain and discomfort related to surgical
incision
• Impaired skin integrity related to altered biliary
drainage after surgical intervention
• Imbalanced
nutrition,
less
than
body
requirement, related to inadequate bile secretion
• Deficient knowledge about self care activities
related to incision care, dietary modification,
medication
Planning and Goals
The goals for the patient include
• Adequate ventilation, 
• Relief of pain, 
• Intact skin and improved biliary drainage,
• Optimal nutritional intake, 
• Absence of complication and understanding of 
self- care routines
Improving Respiratory Status
• Patients are prone to pulmonary complication. 
• The nurse teach patient to take deep breath and
cough every hour to expand the lung fully and
prevent atelectasis.
• Use incentive spirometer also helps improve
respiratory function.
• Early
ambulation
prevents
pulmonary
complications and other complications such as
thrombophlebitis.
Relieving Pain
• Location of sub-costal incisions likely cause the
patient to avoid turning and ambulate as
indicated. Use of a pillow or binder, to splint the
affected site and encourage patient
to take
breath to avoid pain.
• To prevent postoperative complications, the
nurse should administer analgesic as prescribed
to relieve pain in addition to helping the patient
turn, cough, breathe deeply and er over the
incision may reduce pain.
Promoting skin care and biliary 
drainage
• The nurse should fasten tubing to the dressing or
the patient gown and teach patient to move
without dislodging or kinking it.
• The patient is observed for indication of infection,
leakage
of
bile
into
peritoneal
cavity
and
obstruction of bile drainage.
• If the bile is not draining properly an obstruction
may probably cause the bile to return back into the
liver and blood stream, the nurse observe for
yellow discoloration of the sclera. Also note and
report
right
upper
quadrant
abdominal
pain,
nausea and vomiting, bile drainage around any
drainage tube, clay- colored stool and change in
vital signs.
• Frequently change of the outer dressing and
protection of the skin from irritation because bile
is corrosive to the skin.
• Every 24 h the nurse measures the bile collected
and record the amount, color and character of
the draina

            Quiz: