Question 1

Which factors are most commonly associated with pancreatitis?

Accepted Answer

Alcoholism and biliary tract disease are the two factors most commonly associated with pancreatitis.

Question 2

A family member of a patient asks the nurse about the protein-restricted diet ordered because of advanced liver disease with hepatic encephalopathy.What statement by the nurse would best explain the purpose of the diet?

Accepted Answer

The patient with hepatic encephalopathy is on a very low-protein to no-protein diet.The goal of management of hepatic encephalopathy is the reduction of ammonia formation in the intestines.

Question 3

Which medical interventions and management systems control the bleeding of esophageal varices? (Select all that apply. )

Accepted Answer

Band ligation,insertion of the S/B tube,and various shunting surgeries are helpful in stopping the hemorrhage.Transfusions and water-soluble vitamins are not beneficial.

Question 4

The nurse is aware that the hepatitis A immunization provides immunity in:

Accepted Answer

Primary immunization with hepatitis A vaccine provides immunity within 30 days.

Question 5

What should the nurse monitor in caring for the patient undergoing a paracentesis?

Accepted Answer

The fluid removed during a paracentesis is removed over a period of 30 to 90 minutes to prevent sudden changes in blood pressure leading to syncope.The bed should be in a high Fowler position.Food and fluid restriction is usually not necessary.

Question 6

What is the challenge in encouraging coughing and deep breathing for a postoperative patient who had an open cholecystectomy?

Accepted Answer

The high placement of the incision of the cholecystectomy makes the patient reluctant to cough.Splinting the incision is beneficial.

Question 7

What are the indications for a liver transplant? (Select all that apply. )

Accepted Answer

Indications for liver transplantation include congenital biliary abnormalities,inborn errors of metabolism,hepatic malignancy (confined to the liver),sclerosing cholangitis,and chronic end-stage liver disease.

Question 8

The nurse is aware that an elevated serum amylase is diagnostic of pancreatitis at an early stage as an elevation can be assessed as early as _____ after the onset of pancreatic disease.

Accepted Answer

An increase in the serum amylase can be detected as early as 2 hours after the onset of pancreatic disease.In simple acute pancreatitis,the level returns to normal in about 36 hours.In chronic disease it remains elevated.

Question 9

Dietary teaching for a patient who is treated conservatively for cholecystitis is necessary to keep the patient comfortable.Which foods should be avoided? (Select all that apply. )

Accepted Answer

Peanut butter,nuts,chocolate,whole milk,fried foods,and cream and other fatty foods should be avoided.

Question 10

A male patient states that he returned from a 2-week camping trip a few days ago.He complains of nausea and anorexia,and dark urine.What additional information would assist in diagnosing hepatitis A?

Accepted Answer

Hepatitis A spreads by direct contact through the oral-fecal route,usually by food and water contaminated with feces.

Question 11

The nurse would make provisions in the plan of care for a person who has had a liver transplant to prevent:

Accepted Answer

A critical aspect of nursing care following liver transplantation is monitoring for infection.
The major postoperative complications of a liver transplant are rejection and infection.

Question 12

The nurse explains that the use of cyclosporine as an immunosuppressant has been successful in the reduction of rejection of liver transplants because the drug:

Accepted Answer

Cyclosporine is an immunosuppressant that does not cause bone marrow suppression nor does it impede healing.

Question 13

When caring for an extremely jaundiced patient with cirrhosis,what should the nurse include provisions for in the plan of care?

Accepted Answer

Jaundice causes pruritus and can lead to skin lesions and pressure ulcers.

Question 14

A patient with pancreatitis is NPO.The patient asks the nurse why he is unable to have anything by mouth.Which of the following is the best response?

Accepted Answer

Food and fluids are withheld to avoid stimulating pancreatic activity,and IV fluids are administered.

Question 15

Why is morphine contraindicated in the patient with pancreatitis?

Accepted Answer

A common complaint is constant,severe pain;in such cases,meperidine (Demerol)PCA is often administered.Morphine may cause spasms of the sphincter of Oddi.

Question 16

Which assessment would indicate possible gallbladder disease in an older adult?

Accepted Answer

The incidence of cholelithiasis increases with aging.Assess older adults for history of changes in stool or urine color.Cirrhosis of the liver may cause distention in veins in the upper part of the body.

Question 17

Which factors may increase a patient's risk of developing cancer of the pancreas?

Accepted Answer

The cause of cancer of the pancreas is unknown,but it is diagnosed more often in cigarette smokers,people exposed to chemical carcinogens,and people with diabetes mellitus and pancreatitis.

Question 18

The 100 lb patient who has been exposed to hepatitis A is to receive an injection of immune serum globulin.What should the dose (.02 mL/kg)be?

Accepted Answer

100 lb/2.2 = 45.4.45.4 × 0.02 = 0.90

Question 19

A patient with a T-tube for an open cholecystectomy has resumed oral intake.The T-tube is clamped 2 hours before meals and unclamped 2 hours after meals to aid in the digestion of fat.During the time the tube is clamped the patient complains of abdominal pain and nausea.Which intervention is most appropriate?

Accepted Answer

While the tube is clamped,the patient may show signs of abdominal pain,nausea,vomiting,etc.Unclamp the tube immediately to allow for drainage and relief of both nausea and pain.

Question 20

Why is it advantageous for a live person to be a liver donor?

Accepted Answer

A live donor may donate only a portion of their liver and within weeks the donor's liver has grown to the size to meet the body's needs.The same is true for the recipient.

Quiz 6: Care of the Patient with a Gallbladder, Liver, Biliary Tract, or Exocrine Pancreatic Disorder