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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

Accepted Answer

After extracorporeal shock wave lithotripsy for gallstones, it is important to instruct the person about potential post-procedure side effects such as nausea, vomiting, and haematuria. This will allow the person to know what to expect and when to seek medical attention if necessary. Assessment for secondary haemorrhage and monitoring vital signs for 8 hours post-procedure are not specific to the care of a person after lithotripsy. Admitting the person to the hospital until the stones have passed is not necessary as most people can go home the same day after the procedure.

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?

Accepted Answer

Avoiding all alcohol is important for those with pancreatitis as it can further damage the pancreas and worsen symptoms. Limiting smoking, resuming a regular diet, and restricting caffeine intake may also be recommended, but avoiding alcohol is the most important piece of advice to give.

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?

Accepted Answer

The sudden cessation of pain in the context of an acutely inflamed gallbladder could be an indication of a potentially life-threatening complication, such as perforation or rupture. The nurse should immediately contact the doctor to assess the person's condition and determine appropriate next steps.

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?

Accepted Answer

A negative peritoneal lavage indicates no abdominal bleeding, which is a good sign for the patient's health. Haematoma formation and severe liver lacerations would likely result in a positive lavage, indicating internal bleeding. Clotting factor malfunction may contribute to bleeding but would not necessarily be indicated by the results of a peritoneal lavage.

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?

Accepted Answer

The symptoms and elevated serum amylase levels suggest acute pancreatitis, which is characterized by sudden onset of severe upper abdominal pain that radiates to the back and elevated amylase levels. Fulminant hepatitis and liver cirrhosis typically have different symptoms and signs, such as jaundice, coagulopathy, or ascites. Cholecystitis may cause abdominal pain and nausea, but serum amylase levels are typically not elevated.

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?

Accepted Answer

The description of "soapy" and "bad smell" suggest that the person may be experiencing steatorrhoea. This is a condition in which there is an excess amount of fat in the stools, leading to a pale, greasy, foul-smelling appearance. It can be caused by malabsorption due to digestive issues or pancreatic insufficiency. Turner's sign and Cullen's sign are physical signs related to bleeding and are unlikely to be related to bowel movements. Diarrhoea may have a similar appearance but the presence of excess fat is what differentiates steatorrhoea.

Question 17

A person who is prescribed lactulose is complaining of 'diarrhoea with cramps' throughout most of the day. What is this person demonstrating?

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?

Accepted Answer

A transfusion reaction can lead to hemolysis (destruction of red blood cells), which increases the production of indirect (unconjugated) bilirubin as the body breaks down the hemoglobin from the destroyed cells.

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?

Accepted Answer

The nurse should report the exposure as soon as possible to the appropriate authority and prepare the person with hepatitis B to receive hepatitis B immune globulin (HBIG). This is because HBIG contains antibodies that can neutralize the virus and prevent transmission of the disease. It is also important for the nurse to receive prompt medical evaluation and follow-up after the exposure. While prophylactic antibiotic therapy or interferon may be used to treat hepatitis B, they are not indicated in this situation. Similarly, administering a hepatitis B vaccine booster injection is not sufficient to prevent transmission in this situation.

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?

Accepted Answer

Hypoalbuminaemia, which is a low level of albumin in the blood, is a common cause of ascites. Albumin helps to maintain fluid balance in the body, and a lack of this protein can lead to an accumulation of fluid in the abdomen. Increased serum sodium (B) and hypotension (C) are not directly associated with the development of ascites, although they may be seen in patients who have ascites as a result of liver disease or another underlying condition. Decreased serum potassium (D) is also not directly associated with ascites.

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