Question 1

A patient admitted with acute pancreatitis has a nasogastric tube, is in pain, and is on bed rest. The patient says, "I don't understand why I can't eat." How should the nurse respond?

Accepted Answer

The nurse should explain the purpose of the nasogastric tube and the reasons for keeping the patient NPO to help the patient understand the importance of following the treatment plan.

Question 2

A patient with end-stage pancreatic cancer is admitted to the nursing unit. The patient is lethargic and jaundiced. What is the priority nursing care for this patient?

Accepted Answer

The priority nursing care for a patient with end-stage pancreatic cancer who is lethargic and jaundiced is to manage comfort. This patient is likely experiencing symptoms such as pain, nausea, and fatigue, which can be addressed through various comfort measures such as medication administration, positioning, and relaxation techniques. While managing nutrition is important, it is not the priority in this case as the patient's lethargy and jaundice suggest that they may not have a significant appetite or ability to tolerate food. Increasing activity is also not a priority as the patient's condition is likely causing significant fatigue and weakness. Understanding the effects of high bilirubin levels is important, but not the priority at this time.

Question 3

A patient arrives at the clinic for follow-up care for pancreatitis. The patient lives alone, has high cholesterol levels, and admits to alcoholism. What is the priority intervention for this patient?

Accepted Answer

The priority intervention for this patient is to provide information on alcohol cessation programs since the patient admits to being an alcoholic and this is a major risk factor for the development of pancreatitis. Alcohol cessation is necessary to prevent the recurrence of pancreatitis and to promote the healing process. While teaching about dietary needs, reminding the patient of the implications of recurring jaundice, and providing initial instruction on medication are important interventions for pancreatitis, they are not the priority in this case.

Question 4

The nurse is caring for a patient who has just returned from a humanitarian trip to Central America. The patient is jaundiced and is diagnosed with hepatitis A. The patient is the parent of three school-age children. Which statement by the patient is a priority for follow-up?

Accepted Answer

The patient's statement that they need to get home to take care of their children is a priority for follow-up as they have a highly contagious illness and may need to take precautions to prevent further transmission to their children and others.

Question 5

A patient with chronic pancreatitis is taking pancreatic enzymes. Which statement would indicate to the nurse that the patient correctly understands instruction about this medication?

Accepted Answer

Pancreatic enzymes should be taken with food to aid in digestion. Taking them before bedtime, only when the stomach is hurting, or assuming they are monitored by lab work are incorrect statements and demonstrate a lack of understanding about the medication.

Question 6

The nurse is caring for a patient with pancreatic cancer. The nurse closely monitors for jaundice, knowing that which assessments closely correlate with jaundice? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is caring for a patient...

Question 7

Often a patient with pancreatic cancer tends to lose weight due to the inability of the body to absorb nutrients. The nurse instructs the patient to be alert to which finding that may indicate malabsorption?

Accepted Answer

Steatorrhea refers to fatty, bulky, and foul-smelling stools that occur when the body is unable to absorb fats properly. This is a common finding in malabsorption syndromes, including pancreatic cancer. Vomiting may occur due to the obstruction of the bile duct or the stomach by the tumor, but it is not a specific finding for malabsorption. Jaundice refers to the yellowing of the skin and eyes due to the buildup of bilirubin in the blood, which may occur in cases of pancreatic cancer that obstruct the bile duct. Pain is a common symptom of pancreatic cancer but is not specifically related to malabsorption.

Question 8

The nurse is preparing a patient with pancreatitis for discharge to home. The nurse is instructing the patient about decreasing pancreatic stimulation to reduce pain. What method should the nurse suggest?

Accepted Answer

Instructing the patient to avoid the smell of food will decrease pancreatic stimulation and reduce pain in pancreatitis patients. Exposure to light, staying in an upright position, and increasing household noise and stimulation do not affect pancreatic stimulation.

Question 9

A patient is admitted with acute pancreatitis. The nurse recognizes that nutritional outcomes have been met after assessing which finding regarding the patient's weight?

Accepted Answer

An increase in weight indicates improvement in nutritional status. Option B is incorrect because a weight gain of 1 pound over a day is not a significant improvement. Option C and D are incorrect because a decrease in weight indicates a decline in nutritional status.

Question 10

A patient with liver cancer has been admitted to hospice. The patient asks why he developed this disease. The nurse knows there is a high likelihood this patient has which medical history?

Accepted Answer

Liver cancer is often associated with alcohol consumption, as chronic alcohol abuse can damage liver cells and lead to the development of cancer. Frequent nausea and vomiting, H. pylori, and sexually transmitted infections are not commonly associated with the development of liver cancer.

Question 11

The nurse is presenting a community education session on the prevention of liver cancer. Which information should the nurse include?

Accepted Answer

The most effective way to prevent liver cancer is by avoiding known risk factors such as heavy alcohol consumption and exposure to hepatitis B and C. Early detection through physical exam is important, but prevention through behavior modification is key. Avoiding public restaurants and exercising regularly do not directly affect the risk of liver cancer.

Question 12

The nurse is teaching a patient about modifiable risk factors for cholelithiasis. Which specific factors would the nurse discuss? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Modifiable risk factors for cholelithiasis include obesity, alternating rapid weight loss with rapid regaining of weight, and elevated serum cholesterol. Age and family history are non-modifiable risk factors.

Question 13

The nurse is caring for a patient with hepatitis C who is treating the illness with licorice root. Which statement by the patient requires follow-up regarding this medication?

Accepted Answer

Licorice root can cause fluid retention and electrolyte imbalances, leading to symptoms like swelling in the fingers. This would require follow-up to address potential side effects or complications from the use of licorice root.

Question 14

A patient in the icteric phase of hepatitis asks the nurse, "Why are my stools no longer brown?" How should the nurse respond?

Accepted Answer

The answer of A patient in the icteric phase of...

Question 15

A patient is scheduled for a laparoscopic cholecystectomy. The health care provider has indicated that there is a chance that the procedure may need to be done as an open cholecystectomy. The nurse knows that if the patient has an open procedure, what is more likely?

Accepted Answer

If the patient has an open cholecystectomy, they are more likely to have a T-tube inserted to allow for drainage of bile. Open cholecystectomy is a more invasive procedure that often requires a T-tube to be placed temporarily to prevent blockage of the common bile duct. Bowel movements, fatty food intolerance, and recovery time are not typically affected by the type of procedure performed.

Quiz 38: Caring for the Patient With Hepatic and Biliary Disorders