Question 1

A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?
A) Hepatitis B is transmitted primarily by the oral-fecal route.
B) Hepatitis A is frequently spread by sexual contact.
C) Hepatitis C increases a person's risk for liver cancer.
D) Infection with hepatitis G is similar to hepatitis

Accepted Answer

Hepatitis C is known to increase a person's risk for liver cancer. Option A is incorrect because hepatitis B is typically spread through blood, semen, or other bodily fluids, not through the oral-fecal route. Option B is incorrect because hepatitis A is primarily spread through contaminated food and water, not through sexual contact. Option D is incorrect because hepatitis G is a relatively uncommon virus and its clinical significance is not well established.

Question 2

The nurse would expect to observe which of the following when assessing a client with cholelithiasis?
A) Stools that contain blood and mucus.
B) Bowel sounds that are absent.
C) Stools that appear small and dry.
D) Urine that appears dark brown.

Accepted Answer

Cholelithiasis, or gallstones, can lead to bile duct obstruction, causing bilirubin to build up in the bloodstream and be excreted in the urine, making it dark brown. The other options are not typical symptoms of cholelithiasis.

Question 3

Which of the following would be most appropriate for a client who is experiencing biliary colic?
A) Ensure that the client rests.
B) Ensure that the client has eaten a full meal.
C) Avoid administering antispasmodics.
D) Avoid administering analgesics.

Accepted Answer

Rest is important for clients experiencing biliary colic to reduce discomfort and prevent exacerbation of symptoms. Eating a full meal may actually worsen symptoms, and administering antispasmodics or analgesics may be necessary to alleviate pain. However, specific medications should be prescribed by a healthcare provider.

Question 4

Which of the following symptoms would indicate that a client with chronic pancreatitis has developed secondary diabetes?
A) Increased appetite and thirst
B) Vomiting and diarrhea
C) Low blood pressure and pulse
D) Decreased urination and constipation

Accepted Answer

Increased appetite and thirst are classic symptoms of diabetes, which can develop as a complication of chronic pancreatitis. Vomiting and diarrhea, low blood pressure and pulse, and decreased urination and constipation are not typically associated with the development of diabetes in this scenario.

Question 5

A female client with chronic hepatitis B has been prescribed recombinant interferon alpha-2b in combination with ribavirin. Which of the following instructions should a nurse provide this client?
A) Avoid calcium-rich foods.
B) Maintain an exercise regimen.
C) Use strict birth control methods.
D) Avoid hot water baths or soaks.

Accepted Answer

Ribavirin can cause birth defects and is teratogenic. Therefore, women of childbearing age should use strict birth control methods to prevent pregnancy while taking ribavirin, and for some time after treatment ends.

Question 6

A client returns to the nursing unit after an open cholecystectomy. During the surgery a T-tube was inserted. The nurse measures the bile drainage and calculates the daily output for the T-tube. The nurse would notify the physician if the daily amount was which of the following?
A) 125 mL
B) 310 mL
C) 450 mL
D) 575 mL

Accepted Answer

After an open cholecystectomy with a T-tube inserted, it's expected to have some bile drainage, but excessive amounts can indicate a problem. Normal daily bile output from a T-tube typically ranges from 200 to 300 mL. Therefore, a daily output of 575 mL is significantly higher than normal and would warrant notifying the physician.

Question 7

A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation of the disorder?
A) Coagulation studies
B) Magnetic resonance imaging
C) Radioisotope liver scan
D) Liver biopsy

Accepted Answer

A liver biopsy is the definitive test for confirming a diagnosis of cirrhosis. It involves taking a small sample of liver tissue that can then be examined for the presence of fibrosis or scarring, which is characteristic of cirrhosis. Coagulation studies, magnetic resonance imaging, and radioisotope liver scans may be useful in helping to diagnose cirrhosis, but they do not provide definitive confirmation of the disorder.

Question 8

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk?
A) Monitor pulse oximetry every hour.
B) Withhold oral feedings for the client.
C) Instruct the client to avoid coughing.
D) Reposition the client every 2 hours.

Accepted Answer

Repositioning the client every 2 hours helps to prevent atelectasis by promoting lung expansion and improving ventilation and perfusion in different areas of the lungs.

Question 9

A central venous catheter is inserted for a client being treated for acute pancreatitis. Which of the following would the nurse need to monitor closely?
A) Serum electrolyte values
B) Urine volume
C) Pressure measurements
D) Lung sounds

Accepted Answer

Central venous catheters are used to measure central venous pressure, which is an important indicator of fluid status and cardiac function in clients with acute pancreatitis. Monitoring pressure measurements can help the nurse assess for fluid overload or dehydration, both of which are potential complications in this client population. While serum electrolyte values, urine volume, and lung sounds are important to monitor as well, they are not directly related to the use of a central venous catheter.

Question 10

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider?
A) Report the condition to the physician immediately.
B) Measure abdominal girth according to a set routine.
C) Provide the client with nonprescription laxatives.
D) Ask the client about food intake.Add Question Here

Accepted Answer

Enlargement of the abdomen in a client with cirrhosis is due to the accumulation of fluid in the peritoneal cavity, a condition known as ascites. Measuring abdominal girth routinely can help monitor the progression of ascites and allow for timely intervention. Reporting the condition to the physician is necessary, but not the immediate intervention in this case. Providing nonprescription laxatives may worsen the condition by increasing fluid loss and dehydration, and asking about food intake does not address the current issue of ascites.

Question 11

A client with esophageal varices is scheduled to undergo injection sclerotherapy. Which of the following client statements indicates that the teaching was successful?
A) "The physician will use a balloon to compress the vessels."
B) "I might need to have this procedure done again."
C) "It's seems odd that a rubber band can block off the vessels."
D) "A catheter will be inserted through my belly to fix the vessels."

Accepted Answer

Option B indicates that the client understands that injection sclerotherapy may not be a one-time procedure and may need to be repeated. Options A, C, and D contain misunderstandings or inaccuracies about the procedure.

Question 12

The physician orders cholestyramine (Questran) for a client with cirrhosis. The nurse determines that the drug is effective when the clientexhibits which of the following?
A) Reduced serum ammonia levels
B) Improved clotting ability
C) Decreased complaints of pruritus
D) Improved serum protein levels

Accepted Answer

Cholestyramine is a bile acid sequestrant that helps to reduce itching (pruritus) in clients with liver disease by binding to bile acids in the intestine and preventing their reabsorption. It does not affect serum ammonia levels, clotting ability, or serum protein levels.

Question 13

When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following as a possible risk factor?
A) History of pancreatitis
B) Ingestion of a low fat diet
C) One-time exposure to petrochemicals
D) Ingestion of caffeinated coffee

Accepted Answer

History of pancreatitis is a known risk factor for pancreatic cancer.

Question 14

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?
A) Potassium
B) Vitamin K
C) Vitamin B
D) Oral bile acids

Accepted Answer

Vitamin K should be administered before surgery to decrease the risk of bleeding during and after the procedure. Carcinoma of the head of the pancreas can cause obstruction of the common bile duct, which can lead to a deficiency in vitamin K, making the client at an increased risk for bleeding. Potassium, vitamin B, and oral bile acids would not be necessary before surgery for a client with carcinoma of the head of the pancreas.

Question 15

Which of the following interventions would be most appropriate for a client who has undergone surgery for a liver disorder and has started shivering?
A) Provide the client with warm fluids.
B) Cover the client with a light blanket.
C) Ensure that the room temperature is below 70°F.
D) Place the client on a hypothermia blanket.

Accepted Answer

Shivering is one of the signs of hypothermia, which can occur after surgery due to the body's response to anesthesia and exposure to cold temperatures in the operating room. The most appropriate intervention would be to cover the client with a light blanket in order to provide warmth and prevent further heat loss. Providing warm fluids can also help, but covering the client is the first priority. Ensuring that the room temperature is below 70°F would be inappropriate as it would make the client even colder. Placing the client on a hypothermia blanket would be an extreme measure and typically not indicated unless the client's body temperature is significantly decreased.

Question 16

When inspecting the abdomen of a client with cirrhosis, the nurse observes that the veins over the abdomen are dilated. The nurse documents this finding as which of the following?
A) Gynecomastia
B) Cutaneous spider angiomata
C) Caput medusae
D) Palmar erythema

Accepted Answer

Dilated veins over the abdomen are known as caput medusae and are a common manifestation of portal hypertension in clients with cirrhosis. Gynecomastia is the enlargement of breast tissue in males. Cutaneous spider angiomata are small, red, spider-like blood vessels that are commonly found on the face, neck, chest, and arms. Palmar erythema is the reddening of the palms of the hands that can occur with liver disease but is not specific to cirrhosis.

Question 17

A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find?
A) Increased serum calcium levels
B) Elevated urine amylase levels
C) Decreased liver enzyme levels
D) Decreased white blood cell count

Accepted Answer

Elevated urine amylase levels are a hallmark finding in acute pancreatitis. Serum calcium levels may be decreased, not increased. Liver enzyme levels may be elevated, not decreased. White blood cell count may be increased, not decreased.

Question 18

Which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension?
A) Spironolactone (Aldactone)
B) Kanamycin (Kantrex)
C) Lactulose (Cephulac)
D) Cyclosporine (Sandimmune)

Accepted Answer

Spironolactone (Aldactone) is a diuretic medication that is commonly used to reduce fluid overload and edema in clients with cirrhosis and portal hypertension. It works by blocking the effects of aldosterone, which is a hormone that contributes to fluid retention. Kanamycin (Kantrex) is an antibiotic that is not typically used to treat portal hypertension. Lactulose (Cephulac) is a medication that is used to treat hepatic encephalopathy, which can be a complication of cirrhosis, but it is not typically used to treat portal hypertension. Cyclosporine (Sandimmune) is an immunosuppressant medication that is not typically used to treat portal hypertension.

Question 19

Which of the following laboratory test results would the nurse associate with obstructive jaundice?
A) Increased indirect bilirubin
B) Decreased unconjugated bilirubin
C) Decreased conjugated bilirubin
D) Increased direct bilirubin

Accepted Answer

Obstructive jaundice is often caused by a blockage of the bile ducts, leading to an inability for bilirubin (a breakdown product of hemoglobin) to be excreted into the intestine. As a result, bilirubin backs up into the bloodstream and is converted into direct (conjugated) bilirubin by the liver. Therefore, increased levels of direct bilirubin would be seen in obstructive jaundice.

Question 20

The nurse is caring for a client with hepatitis. Which of the following would lead the nurse to suspect that the client is in the prodromal phase?
A) Jaundice
B) Clay -colored stools
C) Liver function tests approaching normal
D) Rash

Accepted Answer

The prodromal phase of hepatitis, which occurs before jaundice develops, can include symptoms such as rash, along with fatigue, fever, and gastrointestinal symptoms. Jaundice, clay-colored stools, and normalization of liver function tests typically occur in later phases of the disease.

Quiz 47: Caring for Clients With Disorders Oftheliver, Gallbladder, or Pancreas

A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?

The nurse would expect to observe which of the following when assessing a client with cholelithiasis?

Which of the following would be most appropriate for a client who is experiencing biliary colic?

Which of the following symptoms would indicate that a client with chronic pancreatitis has developed secondary diabetes?

A female client with chronic hepatitis B has been prescribed recombinant interferon alpha-2b in combination with ribavirin. Which of the following instructions should a nurse provide this client?

A client returns to the nursing unit after an open cholecystectomy. During the surgery a T-tube was inserted. The nurse measures the bile drainage and calculates the daily output for the T-tube. The nurse would notify the physician if the daily amount was which of the following?

A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation of the disorder?

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk?

A central venous catheter is inserted for a client being treated for acute pancreatitis. Which of the following would the nurse need to monitor closely?

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider?

A client with esophageal varices is scheduled to undergo injection sclerotherapy. Which of the following client statements indicates that the teaching was successful?

The physician orders cholestyramine (Questran) for a client with cirrhosis. The nurse determines that the drug is effective when the clientexhibits which of the following?

When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following as a possible risk factor?

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?

Which of the following interventions would be most appropriate for a client who has undergone surgery for a liver disorder and has started shivering?

When inspecting the abdomen of a client with cirrhosis, the nurse observes that the veins over the abdomen are dilated. The nurse documents this finding as which of the following?

A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find?

Which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension?

Which of the following laboratory test results would the nurse associate with obstructive jaundice?

The nurse is caring for a client with hepatitis. Which of the following would lead the nurse to suspect that the client is in the prodromal phase?