Deck 40: Liver, Gallbladder, and Pancreatic Disorders

Question 1

What is pruritus related to in the patient diagnosed with hepatitis?

A) Decreased fat intake
B) Poor appetite and therefore poor protein intake
C) Accumulation of bile salts under the skin
D) Altered urinary output of bile

Answer 1

Accumulation of bile salts under the skin

Question 2

A patient was positive for hepatitis B virus, although she had the disease 4 years ago and now is symptom free.What is the nurse aware is true regarding this patient?

A) Is likely to have hepatitis B again
B) Now has noninfectious hepatitis
C) Is an infectious carrier and always will be
D) Is at risk for hepatitis E

Answer 2

Is an infectious carrier and always will be

Question 3

A patient in acute pain is admitted with pancreatitis.A nurse reviews a laboratory report showing an elevation that is diagnostic for acute pancreatitis.Which laboratory report did the nurse most likely review?

A) Serum bilirubin
B) Serum calcium
C) Serum lipids
D) Serum amylase

Answer 3

Serum amylase

Question 4

Which sign indicates that the need for increased fluid intake would be contraindicated in a patient diagnosed with a hepatic disorder?

A) Low blood pressure
B) Increased urinary output
C) Signs of edema
D) Bradycardia

Question 5

A patient with ascites is scheduled for a LeVeen peritoneal-venous shunt.The patient asks why this needs to be done instead of a paracentesis.What is the best response by the nurse?

A) "It helps the kidneys retain needed sodium."
B) "It will decrease the need for analgesics."
C) "This procedure will prevent the loss of protein."
D) "The risk of infection is lessened with this procedure."

Question 6

What actions should a nurse implement to correctly assess the progress of ascites on a daily basis?

A) Daily weights and abdominal girth measurements
B) Intake-output and electrolyte levels
C) Blood pressure and pulse
D) Daily temperatures and oxygen levels

Question 7

A goal of medical treatment for patients with cirrhosis is to prevent complications and limit cell damage.A major approach is to promote rest.What rationale supports this approach?

A) Allows time for a transplant
B) Allows the liver to regenerate
C) Prevents red cell destruction
D) Decreases the risk of trauma

Question 8

A nurse is educating a patient diagnosed with hepatitis A.What should the nurse instruct this patient to avoid sharing?

A) Food
B) Bodies
C) Needles
D) Housing

Question 9

What is necessary to restrict when the ammonia level of a patient diagnosed with cirrhosis continues to rise?

A) Protein
B) Carbohydrates
C) Fats
D) Water-soluble vitamins

Question 10

Which vaccination does the Occupational Health and Safety Administration (OSHA)require all health care providers to receive?

A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) All strains of hepatitis

Question 11

Which instruction should be given to a patient with portal hypertension to reduce the threat of hemorrhage?

A) Eat bland foods.
B) Avoid straining to have a bowel movement.
C) Increase fluid intake.
D) Use an electric razor to shave.

Question 12

What is the meaning of a dropping bilirubin level in a patient diagnosed with hepatitis?

A) Red blood cell destruction is decreasing.
B) Liver function is improving.
C) Kidneys are compensating for liver dysfunction.
D) Kupffer cell damage is continuing.

Question 13

Which dietary selection should lead the nurse to conclude that the dietary teaching is successful for a patient on a low-sodium diet?

A) Bologna sandwich with tomato juice
B) Hotdog on a bun with pickle relish and skim milk
C) Baked chicken, white rice, and apple juice
D) Peanut butter and jelly sandwich with tomato soup

Question 14

A young woman with severe jaundice has an altered body image.The patient says, "Will I always be this horrible color?" What is the best response by the nurse?

A) "Yes, but your sclera will return to their previous white color."
B) "No.The color will fade gradually as liver inflammation decreases."
C) "Yes, but cosmetics can disguise the color."
D) "No.The color will change to freckles."

Question 15

For which complication should a nurse be careful to monitor a patient after a liver biopsy?

A) Headache
B) Muscle cramps
C) Bleeding
D) Respiratory distress

Question 16

A high ammonia level contributes to hepatic encephalopathy.Which nursing implementation needs to be added to the nursing care plan as this level continues to increase?

A) Mouth care
B) Increased frequency of neurologic checks
C) Oxygen saturation monitoring
D) Intake and output

Question 17

What precaution should a nurse initiate when caring for a patient with hepatitis B?

A) Reverse isolation
B) Standard Precautions
C) Respiratory precautions
D) Enteric precautions

Question 18

What intervention should a nurse implement when assessing a patient with jaundice who has been given the nursing diagnosis of disrupted skin integrity?

A) Sedate the patient.
B) Apply mittens or socks to the hands.
C) Restrain the hands.
D) Distract the patient with conversation.

Question 19

What action should a nurse implement to prevent complications in a patient with hepatitis who has been prescribed bed rest?

A) Raise the knee gatch to prevent the patient from sliding down in bed.
B) Provide undisturbed periods of 6 hours to encourage rest.
C) Restrict fluids.
D) Encourage turning, coughing, and deep breathing every 2 hours.

Question 20

Which nursing measure takes priority in relation to the care of a patient with a gastroesophageal balloon tube?

A) Deflate the balloon periodically.
B) Advance the tube as instructed.
C) Monitor respiratory status.
D) Withhold medications that could decrease restlessness.

Question 21

In assessing a dark-skinned patient for jaundice, the nurse would assess the ______ for a yellow color.

Question 22

Which risk is significantly increased in patients diagnosed with liver disease?

A) Urinary infections
B) Systemic infection
C) Drug toxicity
D) Drug allergy

Question 23

Which observation by a nurse would indicate blocked flow of bile from the liver to the intestine?

A) Clay-colored stools
B) Jaundice
C) High blood pressure
D) Tachycardia

Question 24

What should a nurse often find in the medical history of a patient diagnosed with pancreatic disease?

A) Liver disorders
B) Drug abuse
C) Alcohol abuse
D) Excessive sugar intake

Question 25

What should a nurse include in the discharge teaching for a patient after a laparoscopic procedure for cholelithiasis?

A) Take water-soluble vitamins.
B) Follow a low-fat diet.
C) Expect light-colored stools for several days.
D) Keep dressing over the T-tube dry.

Question 26

A nurse reminds a patient with liver disease that the level of ______ in the blood is an indicator of the how well the liver is functioning.

Question 27

Which chronic condition is related to the presence of chronic pancreatitis?

A) Chronic obstructive pulmonary disease (COPD)
B) Urinary tract infection (UTI)
C) Diabetes mellitus (DM)
D) Arteriosclerotic heart disease (ASD)

Question 28

What is the highest nursing priority outcome when planning the care for the patient with pancreatitis?

A) Patient claims satisfaction with pain control.
B) Patient states an understanding of medications needed on discharge.
C) Patient's activity level tolerance shows an increase.
D) Patient can maintain a normal bowel pattern.