Question 1

The nurse is preparing to instruct a person with pruritus caused by jaundice about the care of the skin. Which of the following should be included in these instructions?&#10;A)Take another antihistamine if the itching continues.&#10;B)Use soap when bathing.&#10;C)Apply lotion to keep the skin moist.&#10;D)Bathe with hot water.

Accepted Answer

Applying lotion can help keep the skin moist, which can reduce itching. Antihistamines may be used to treat pruritus, but the instructions do not recommend taking another one. Soap should not be used as it can further irritate the skin, and hot water can also worsen itching. Therefore, options B and D are incorrect.

Question 2

What result would the nurse expect to see in a liver function test for a person with an obstructive biliary disease?&#10;A)Decreased lactic dehydrogenase (LDH)&#10;B)Decreased serum bilirubin&#10;C)Increased aspartate aminotransferase (AST)&#10;D)Increased gamma-glutamyltransferase (GGT)

Accepted Answer

Obstructive biliary disease causes damage to the biliary system, resulting in impaired bile flow and accumulation of bile in the liver. This leads to increased levels of GGT, which is an enzyme found predominantly in the biliary system and liver cells. The other options are not typically associated with obstructive biliary disease.

Question 3

During a physical assessment, the nurse learns that a person has pain in the right shoulder and scapula most evenings after eating dinner. Which assessment question would help the nurse to obtain pertinent data to further assess these findings?

A)'Are you drinking lots of water?'
B)'Do you drink lots of coffee or tea?'
C)'What are you eating for dinner?'
D)'Are you experiencing constipation?'

Accepted Answer

Asking what the person is eating for dinner can help the nurse to identify if there is a pattern or specific food that may be contributing to the pain.

Question 4

A person with acute pancreatitis is uncomfortable in bed. Which of the following positions might improve this person's comfort level?&#10;A)Assist to a standing position and ambulate.&#10;B)Elevate the head of the bed 45 degrees.&#10;C)Lay flat in bed.&#10;D)Sit up in bed.

Accepted Answer

Elevating the head of the bed 45 degrees can help reduce abdominal pressure and discomfort in a person with acute pancreatitis.

Question 5

Which of the following is a risk factor for the development of gallstones?&#10;A)Tobacco smoking&#10;B)Heavy alcohol consumption&#10;C)Pregnancy&#10;D)High-fibre diet

Accepted Answer

Pregnancy increases the risk of developing gallstones due to the increased hormone levels and decreased gallbladder motility. Tobacco smoking and heavy alcohol consumption may increase the risk of other health conditions but have not been directly linked to gallstone development. A high-fiber diet may actually decrease the risk of gallstones.

Question 6

A person comes into the clinic complaining of 'gaining weight only in the stomach.' This person is exhibiting signs of which condition?&#10;A)Haemolytic jaundice&#10;B)Hepatic encephalopathy&#10;C)Oesophageal varices&#10;D)Portal hypertension

Accepted Answer

Portal hypertension causes increased pressure in the veins entering the liver, leading to fluid accumulation in the abdomen (ascites) and/or enlargement of the spleen, both of which can give the appearance of weight gain in the stomach area.

Question 7

The family and friends of a person who recently had a liver transplant are upset because they have not been permitted to see the person after surgery. What would be the nurse's best response concerning the significance of this issue?

A)'These types of visiting restrictions are common after transplants.'
B)'You can't visit because the person is susceptible to infections and are in isolation.'
C)'I am sorry but the person is too unstable to have visitors right now.'
D)'The person's condition is critical post-transplant, so visitors are not advisable.'

Accepted Answer

The answer of The family and friends of a person...

Question 8

A person with hepatitis is complaining of 'itchy skin' and 'odd-coloured bowel movements.' The nurse realises that this person is in which phase of acute hepatitis?&#10;A)Prodromal&#10;B)Preicteric&#10;C)Icteric&#10;D)Posticteric

Accepted Answer

The icteric phase is characterized by jaundice (yellowing of the skin and whites of the eyes), pruritus (itchy skin), and clay-coloured stools (odd-coloured bowel movements). This phase occurs 1-2 weeks after the onset of symptoms and can last for several weeks. The prodromal phase is the earliest phase of acute hepatitis and is characterized by non-specific symptoms like fatigue, malaise, and nausea. The preicteric phase occurs between the prodromal and icteric phases and is characterized by symptoms like abdominal pain, fever, and joint pain. The posticteric phase occurs after the icteric phase and is marked by resolution of jaundice and improvement in other symptoms.

Question 9

The family of a person with acute pancreatitis arrives to the care area with a large bag of personal items and food. What should the nurse instruct this family about the care of the person?&#10;A)Bring high-calorie foods to support the person's increased energy needs.&#10;B)Avoid bringing food to the person.&#10;C)Bring plenty of fresh fruits.&#10;D)Only bring foods the person requests.

Accepted Answer

In acute pancreatitis, the person is often placed on a strict diet that is low-fat or no-fat, and may also involve fasting or being on total parenteral nutrition (TPN). Bringing food to the person could lead to complications or hinder the treatment process. Additionally, the healthcare team can provide appropriate nutrition recommendations for the person based on their individual condition and needs.

Question 10

A person with hepatic cirrhosis begins to bleed. Which of the following is the first priority of treatment?&#10;A)Assessment of vital signs&#10;B)Administration of diuretics&#10;C)Restoration of haemodynamic stability&#10;D)Obtaining labs to determine level of blood loss

Accepted Answer

Restoration of haemodynamic stability is the first priority in a person with hepatic cirrhosis who begins to bleed. This is because bleeding can cause a decrease in blood pressure, which can lead to shock and death. Haemodynamic stability should be restored by administering intravenous fluids and blood products as needed, and potentially performing procedures such as endoscopy or surgical intervention to stop the bleeding. Assessment of vital signs and obtaining labs to determine the level of blood loss are important, but secondary to restoring haemodynamic stability. Administration of diuretics may be necessary in the long-term management of hepatic cirrhosis, but is not a priority in the treatment of bleeding.

Question 11

A person is scheduled for extracorporeal shock wave lithotripsy for gallstones. Which of the following should be included in the care of this person after the procedure?&#10;A)Assess the person for secondary haemorrhage.&#10;B)Admit the person to the hospital until the stones have passed.&#10;C)Instruct the person about the potential for nausea, vomiting and haematuria post-procedure.&#10;D)Monitor vital signs for 8 hours post-procedure.

Accepted Answer

The answer of A person is scheduled for extracorporeal shock...

Question 12

A person with acute pancreatitis is being discharged. Which of the following should the nurse include when providing discharge instructions to this person?&#10;A)Limit smoking.&#10;B)Resume a regular diet.&#10;C)Avoid all alcohol.&#10;D)Restrict caffeine intake.

Accepted Answer

The answer of A person with acute pancreatitis is being...

Question 13

A person who is admitted to the hospital with an acutely inflamed gallbladder says, 'I suddenly feel better. The pain was really bad, but then it completely stopped.' What should the nurse do?&#10;A)Prepare the person for discharge.&#10;B)Contact the doctor immediately.&#10;C)Continue with normal monitoring of the person.&#10;D)Check when the person last received any pain medication.

Accepted Answer

The answer of A person who is admitted to the...

Question 14

A person who is being evaluated for liver trauma that was sustained in a motor vehicle accident is found to have a negative peritoneal lavage. What is the person demonstrating?&#10;A)Haematoma formation&#10;B)Severe liver lacerations&#10;C)No abdominal bleeding&#10;D)Clotting factor malfunction

Accepted Answer

The answer of A person who is being evaluated for...

Question 15

A person presents to the emergency department with abrupt onset of severe left upper quadrant abdominal pain that radiates to the back. The person's serum amylase levels rise to two to three times normal over several hours. What condition does the nurse suspect the person has?

A)Fulminant hepatitis
B)Cholecystitis
C)Acute pancreatitis
D)Liver cirrhosis

Accepted Answer

The answer of A person presents to the emergency department...

Question 16

A person tells the nurse that his bowel movements are 'weird' in that they look 'soapy' and 'smell really bad.' What might this person be experiencing?&#10;A)Turner's sign&#10;B)Diarrhoea&#10;C)Steatorrhoea&#10;D)Cullen's sign

Accepted Answer

The answer of A person tells the nurse that his...

Question 17

A person who is prescribed lactulose is complaining of 'diarrhoea with cramps' throughout most of the day. What is this person demonstrating?&#10;A)An allergic response to the medication&#10;B)The expected outcome from taking the medication&#10;C)The need to adjust the dose of the medication&#10;D)An anticipated side effect of the medication

Accepted Answer

The answer of A person who is prescribed lactulose is...

Question 18

A person's indirect (unconjugated)bilirubin blood levels will rise with which condition?&#10;A)Biliary obstruction&#10;B)Pancreatitis&#10;C)Transfusion reaction&#10;D)Alcoholic cirrhosis of the liver

Accepted Answer

The answer of A person's indirect (unconjugated)bilirubin blood levels will...

Question 19

While providing care to a person with hepatitis B, the nurse is exposed to this person's blood. What should the nurse do?&#10;A)Prepare the person to be treated with interferon.&#10;B)Commence prophylactic antibiotic therapy.&#10;C)Report the exposure and prepare the person to receive hepatitis B immune globulin (HBIG).&#10;D)Administer a hepatitis B vaccine booster injection.

Accepted Answer

The answer of While providing care to a person with...

Question 20

The nurse recognises that a person is at an increased risk of developing ascites if the person is experiencing which of the following conditions?&#10;A)Hypoalbuminaemia&#10;B)Increased serum sodium&#10;C)Hypotension&#10;D)Decreased serum potassium

Accepted Answer

The answer of The nurse recognises that a person is...

Deck 24: Nursing Care of People With Gallbladder, Liver, and Pancreatic Disorders