Deck 44: Structure and Function of the Female Reproductive System

Question 1

When explaining the role of liver Kupffer cells to a group of nursing students, which of the following statements about the function of these cells is most accurate?

A) The primary function of Kupffer cells is to secrete bile.
B) These cells are the functional unit of the liver and are responsible for all liver secretions.
C) The cells are capable of removing and phagocytizing old and defective blood cells.
D) The role of the Kupffer cells is to provide at least 50% of cardiac output each minute to each lobular of the liver.

Answer 1

The cells are capable of removing and phagocytizing old and defective blood cells.

Question 2

A 51-year-old male has been diagnosed with alcohol-induced liver disease. He admits to the nurse providing his care that, "I know what the lungs do, and I know what the heart does, but honestly I have no idea what the liver does in the body." Which of the following statements would best underlie the explanation that the nurse provides?

A) The liver is responsible for the absorption of most dietary nutrients as well as the production of growth hormones.
B) The liver contributes to the metabolism of ingested food and provides the fluids that the GI tract requires.
C) The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.
D) The liver maintains a balanced level of electrolytes and pH in the body and stores glucose, minerals, and vitamins.

Answer 2

The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.

Question 3

A patient being seen in the clinic has just received his routine lab results. The patient has been told that his cholesterol level is extremely elevated. The physician plans to give the patient a prescription for medication to help control this condition. Which of the following medications should the nurse prepare to educate the patient on?

A) Atorvastatin (Lipitor)
B) Abilify (aripiprazole)
C) Pancrecarb (Pancrelipase)
D) Pancrelipase (Ultrase)

Answer 3

Atorvastatin (Lipitor)

Question 4

A 48-year-old woman has been diagnosed with extrahepatic cholestasis following a thorough history, ultrasound, and blood work. Which of the following symptoms most likely caused her to seek medical treatment, and what consequence to her health problem would the medical team anticipate?

A) Complaints of lower flank pain with consequences of impaired fat metabolism
B) Anorexia with consequences of impaired drug metabolism and blood filtration
C) Skin xanthomas (focal accumulations of cholesterol) with consequences of increased risk of bleeding due to deficient clotting factors
D) Pruritus with consequences of deficient levels of fat-soluble vitamins

Question 5

A male infant who is 48 hours postpartum is undergoing phototherapy for the treatment of jaundice and accompanying high levels of bilirubin. Place the following components of the production of bilirubin in the correct chronological order. Use all the options.

A) Conjugated bilirubin
B) Urobilinogen
C) Red blood cells
D) Biliverdin
E) Free bilirubin

Question 6

A patient has just been admitted to a nursing unit with the diagnosis of obstructive jaundice. Which of the following assessment findings would the nurse expect to see in this patient? Select all that apply.

A) Clay-colored stools
B) Dark urine
C) Elevated conjugated bilirubin levels
D) Decreased serum alkaline phosphatase levels
E) Severe itching

Question 7

A 29-year-old female has been admitted to the emergency department following a suicide attempt by overdose of acetaminophen. What changes in the client's liver and diagnostic results would the care team most likely anticipate?

A) Hepatocellular necrosis evidenced by increased ALT and AST levels
B) Allergic inflammation accompanied by an increase in serum IgE and basophils
C) Cholestatic reaction with increased bilirubin count
D) Rapid onset of hepatitis and increased GGT, ALT, and bilirubin

Question 8

Four weeks after returning from a tropical vacation, a 40-year-old man has presented to the emergency department with malaise, nausea, and "yellow eyes." Serology has confirmed a diagnosis of hepatitis A (HAV), to the shock of the client. What teaching is most appropriate for this client?

A) "You can expect these symptoms to disappear after about 2 months, but you'll be a carrier of the disease indefinitely."
B) "A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time."
C) "You likely came in contact with blood or body fluids at some point, and you'll have to ensure no one is subsequently exposed to your own blood or body fluids."
D) "You likely got this by way of what we call the 'fecal-oral' route; you will have chronic hepatitis now, but the symptoms can be controlled with medication."

Question 9

A 53-year-old woman with a history of chronic alcohol abuse but without visible jaundice comes to the clinic complaining of nausea and weakness. She admits to taking acetaminophen for persistent headaches but denies exceeding the recommended daily dose; she has not taken any other medications. She is suspected of having acetaminophen toxicity. Which of the following diagnostic test findings would implicate a different cause of her symptoms?

A) Normal serum acetaminophen level
B) Elevated serum HBsAg level
C) Evidence of steatosis on liver biopsy tissue sample
D) Hypoglycemia

Question 10

A male patient comes to the clinic asking to speak to a health care provider privately. He reveals that he had shared a needle/syringe with a prostitute (shooting up cocaine) and then had unprotected sex. Upon questioning, it was revealed that the patient had not had any immunization for hepatitis B. Which of the following medications would the nurse anticipate administering today to this patient?

A) Tenofovir disoproxil fumarate plus emtricitabine
B) Hepatitis B immunoglobulin (HBIG)
C) Hepatitis C immunoglobulin (HCIG)
D) Hepatitis A vaccine

Question 11

A 40-year-old man who uses heroin intravenously was diagnosed with hepatitis C (HCV) 1 year ago and is now considered to have chronic viral hepatitis. Which of the following statements by the client to his care provider would warrant correction?

A) "I know the medications to treat this aren't fantastic, but at least there are some options for controlling the virus."
B) "It's at least a bit reassuring that my liver isn't undergoing damage when I'm not experiencing symptoms."
C) "Even though I'm sick, at least I won't feel sick most of the time."
D) "I'm not looking forward to all the side effects of the drug treatments for my HCV, but I hope I don't end up needing a liver transplant."

Question 12

A 24-year-old woman undergoing a premarital screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which of the following treatments is most likely to be effective for her?

A) Lamivudine
B) Peginterferon and ribavirin
C) Interferon alfa-2b
D) Corticosteroids and immunosuppressant drugs

Question 13

A 51-year-old male professional is in the habit of consuming six to eight rum and cokes each evening after work. He assures the nurse practitioner who is performing his regular physical exam that his drinking is under control and does not have negative implications for his work or family life. How could the nurse best respond to the client's statement?

A) "You are more than likely inflicting damage on your liver, but this damage would cease as soon as you quit drinking."
B) "That may be the case, but you are still creating a high risk of hepatitis A or B or liver cancer."
C) "In spite of that, the amount of alcohol you are drinking is likely to result first in cirrhosis and, if you continue, in hepatitis or fatty liver changes."
D) "When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic byproducts."

Question 14

For several years, a 39-year-old female has been averaging two to three bottles of wine each night after her children go to sleep and has included several ounces of brandy in recent years as well. Despite negative consequences to her career and the dissolution of her marriage, her drinking has culminated in a diagnosis of cirrhosis. Which of the following physical manifestations of the health problem would her care team anticipate? Select all that apply.

A) Ascites
B) Anorexia
C) Fever
D) Bleeding tendencies
E) Epigastric pain F) Obesity

Question 15

A patient with pancreatic cancer is admitted for portal hypertension in which he is symptomatic with ascites. Following paracentesis and removal of 7.5 L of ascitic fluid, the nurse should anticipate that the physician will order which of the following medications to assist in maintaining an effective circulating fluid volume?

A) Bumetanide (Bumex)
B) Furosemide (Lasix)
C) Albumin (human) 5%
D) Epogen (epoetin alfa)

Question 16

To reduce hepatic blood flow and decrease portal pressures in persons with cirrhosis, the nurse should be prepared to administer which of the following medications?

A) Bevacizumab, an angiogenesis inhibitor
B) Octreotide, a long-acting synthetic analog of somatostatin
C) Filgrastim, granulocyte colony-stimulating factor (G-CSF) analog
D) Diltiazem (Cardizem), a calcium channel blocker

Question 17

Which of the following clients in a hospital medical unit is most clearly demonstrating the signs and symptoms of liver failure? An adult with

A) low hemoglobin levels, low platelet levels, and spider angiomas present.
B) blood pressure of 189/103, jaundice, and multiple thromboses.
C) sudden onset of confusion, a history of alcohol abuse, and low levels of serum AST and ALT.
D) ascites, fever, and recent onset of atrial fibrillation.

Question 18

Following several days of intermittent upper right quadrant pain, a 29-year-old obese, Native American woman has been diagnosed with cholelithiasis. The nurse at the clinic has taught the client about the pathophysiology and contributing factors to her health problem, as well as some of the likely treatment options. Which of the following statements by the client demonstrates a sound understanding of her diagnosis?

A) "All in all, I guess this is a result of the fact that I've been eating a diet too high in cholesterol for too long."
B) "Several factors like my genetics and gender may have contributed to this, but I'm glad that medications can cure it."
C) "This explains why my skin was yellow-tinged lately and why I had those pains that spread to my upper back and right shoulder."
D) "I suppose the fever and vomiting I had this week was probably a sign of my gallstones too."

Question 19

While on tour, a 32-year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8°C (101.8°F), blood pressure 89/48 mm Hg, and heart rate 116 beats/minute. Blood work indicates that his serum levels of C-reactive protein, amylase, and lipase are all elevated. Which of the following diagnoses would the care team suspect first?

A) Hepatitis C
B) Cholecystitis
C) Liver cirrhosis
D) Acute pancreatitis

Question 20

A 70-year-old male with a 40 pack-year history of smoking and long-standing non- insulin-dependent diabetes has been diagnosed with pancreatic cancer. Which ofthe following teaching points should the physician provide?

A) "While this is indeed serious, you should know that you have a good chance of beating this disease with appropriate treatment."
B) "Most likely your pattern of high alcohol intake over the years contributed to your cancer."
C) "You will likely be facing surgery in the near future, but know that this is very unlikely to eliminate your cancer."
D) "I know it may seem trivial at this point, but the levels of pain that accompany cancer of the pancreas are normally quite low."