Deck 32: Gallbladder, Pancreatic, and Bile Duct Dysfunction

Question 1

The nurse is reviewing anatomy and physiology with staff nurses. Which structure does the nurse identify as being at risk for choledocholithiasis?
1)Cystic duct
2)Hepatic duct
3)Pancreatic duct
4)Common bile duct

Answer 1

4

Question 2

The nurse is reviewing both the functions and dysfunctions of the pancreas. Which diagnosis related to pancreatic dysfunction is the greatest risk to the client with chronic pancreatitis?
1)Diabetes mellitus
2)Inflammation
3)Gland destruction
4)Insulin insufficiency

Answer 2

3

Question 3

Which hormone produced by the intestine triggers the release of pancreatic enzymes?
1)Secretin
2)Somatostatin
3)Insulin
4)Chymotrypsin

Answer 3

1

Question 4

The nurse instructor is teaching a group of nursing students about the pathophysiology of cholecystitis. The nursing instructor asks, "What happens during chronic cholecystitis?" Which statement by a student nurse indicates effective learning?
1)"The gallbladder is filled with purulent effusion."
2)"Perforation and gangrene develop on the wall of the gallbladder."
3)"The gallstone passes from the cystic duct into the common bile duct."
4)"The gallbladder becomes thickened and functions poorly."

Question 5

The nurse is caring for a client with abdominal distention and pain in the right upper quadrant. The nurse suspects a biliary disorder in the client. Which medication does the nurse expect the health-care provider to prescribe for the client to relieve pain?
1)Morphine
2)Codeine
3)Dilaudid
4)NSAIDs

Question 6

Which client benefits from early endoscopic retrograde cholangiopancreatography (ERCP)?
1)A client with cholelithiasis
2)A client with cholecystitis
3)A client with acute pancreatitis
4)A client with severe gallstone pancreatitis

Question 7

The nurse is using the Ranson's criteria to assess a client's pancreatitis. After 48 hours, which finding validates the client's need to remain hospitalized?
1)White blood cell (WBC) count greater than 16,000
2)Lactic dehydrogenase greater than 600 U/L
3)Glucose greater than 10 mmol/L
4)Partial pressure of oxygen less than 60 mm Hg

Question 8

A physical examination of a client elicits the Cullen sign and Grey-Turner sign. Which condition does the nurse suspect in the client?
1)Acute cholecystitis
2)Biliary disorders
3)Acute pancreatitis
4)Emphysematous cholecystitis

Question 9

The nurse is reviewing the medical record of a client admitted with severe malabsorption disorder because of pancreatic enzyme deficiency. The nurse is aware of a variety of disorders that can cause the diagnosis. Which pancreatic disorder does the nurse recognize as being genetically related?
1)Cystic fibrosis
2)Celiac disease
3)Crohn's disease
4)Systemic lupus erythematosus

Question 10

The client's laboratory reports indicate high levels of bilirubin. Which conclusion does the nurse infer from the report?
1)The client has stones in the common bile duct.
2)The client has decreased pancreatic enzymes.
3)The client has stones in the gallbladder.
4)The client has an infection of the pancreas.

Question 11

The nurse is preparing teaching material to present to a community group about the common risk factors for cholecystitis. Which factor does the nurse include for female attendees?
1)Age greater than 40 years
2)High-calorie, high-cholesterol diet
3)Incidence of multiple pregnancies
4)Genetic predisposition

Question 12

A nurse is caring for a client with cholecystitis and diagnosed with pruritus. Which medication does the nurse expect the health-care provider to prescribe for the client?
1)Ursodiol (Actigall)
2)Hydromorphone (Dilaudid)
3)Chenodiol (Chenix)
4)Cholestyramine (Questran)

Question 13

The nurse is assessing a client with pain in the right upper quadrant for 4 hours. The client reports the pain is radiating to the upper thoracic region. A laboratory report suggests elevated liver enzymes and serum bilirubin. Which condition does the nurse suspect from the findings?
1)Biliary tract disorder
2)Biliary colic
3)Cholecystitis
4)Acute pancreatitis

Question 14

The nurse is reviewing anatomical information about the pancreas. Which conclusion about the function of the pancreas is correct?
1)It is a hollow organ that sits just beneath the liver.
2)It is involved in the digestion of carbohydrates.
3)It produces a bicarbonate as a natural antacid.
4)It stimulates the secretion of cholecystokinin (CCK).

Question 15

The nurse is providing care for a client admitted with an obstruction of the common bile duct. Which additional condition does the nurse associate with the admitting diagnosis?
1)Cholecystitis
2)Pancreatic cancer
3)Jaundice
4)Biliary sludge

Question 16

The nurse is orienting a group of staff nurses to the laparoscopic cholecystectomy procedure. Which statement by an attending nurse indicates effective learning?
1)"The client should be on bed rest for 2 weeks."
2)"The client will have severe pain after the surgery."
3)"The procedure has a high risk of complications."
4)"The client is discharged less than 24 hours after the surgery."

Question 17

The nurse is assessing a client with episodic abdominal pain, constipation, and flatulence. Upon physical assessment and review of the laboratory findings, the nurse concludes the client has jaundice and elevated serum amylase. Which condition does the nurse suspect in the client?
1)Cholelithiasis
2)Cholecystitis
3)Acute pancreatitis
4)Chronic pancreatitis

Question 18

A client is brought to the hospital because of severe abdominal pain, nausea, and vomiting. The client reports increased pain in the abdomen and in the epigastric region radiating to the back when lying supine. During physical assessment, the nurse finds the client has fever and hypotension. Which condition does the nurse suspect from these findings?
1)The client has cholelithiasis.
2)The client has cholecystitis.
3)The client has acute pancreatitis.
4)The client has chronic pancreatitis.

Question 19

The nurse finds increased glucose levels in a client with chronic pancreatitis. Which does the nurse interpret from the finding?
1)The client's beta cells are damaged.
2)The client has decreased pancreatic enzymes.
3)The client has high bile salts in the blood.
4)The client's gallbladder was surgically removed.

Question 20

Which diagnostic procedure does the health-care provider use to confirm advanced chronic pancreatitis with exocrine insufficiency in a client?
1)Ultrasound
2)Cholecystogram
3)Fecal chymotrypsin
4)Endoscopic retrograde cholangiopancreatography (ERCP)

Question 21

Which factor is identified as a cause for acute inflammation of the pancreas?
1)Moderate alcohol intake
2)High triglyceride level
3)Influenza antibodies
4)Live virus vaccine

Question 22

The radiographic diagnostic reports for a client show the presence of stones in the common bile duct. Which complications does the nurse expect in the client? Select all that apply.
1)Increase in blood glucose levels
2)Increase in bilirubin levels
3)Increase in bile salts
4)Increase in lipase levels
5)Increase in amylase levels

Question 23

Which complications does the nurse suspect in a client when bile is obstructed from flowing into the intestine? Select all that apply.
1)Steatorrhea
2)Calculus
3)Jaundice
4)Pruritus
5)Autodigestion

Question 24

The nurse is reviewing Ranson's criteria to assess the severity of pancreatitis in a client. Which findings observed in the client by the nurse within a 48-hour period indicate that the client has chronic pancreatitis? Select all that apply.
1)Glucose of 10 mmol/L
2)White blood cell count of 15,000 mm³
3)Fluid sequestration of 4 L
4)Partial pressure of oxygen of 40 mm Hg
5)Blood urea nitrogen of 1.0 mmol/L

Question 25

Which suggestions does the nurse provide to a client with chronic pancreatitis? Select all that apply.
1)"You should consume low-fat food."
2)"You can drink sweetened beverages."
3)"You should drink plenty of fluids."
4)"You should take fat-soluble vitamins."
5)"You need to eliminate your alcohol intake."