Question 1

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 upper part of body.

Question 2

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. The best intervention would be to

Accepted Answer

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

Question 3

What instructions should the patient receive before undergoing a paracentesis?

Accepted Answer

When paracentesis is done, the nurse must have the patient void immediately before the procedure to prevent puncture of the bladder.

Question 4

Which medication would the nurse expect the physician to order postoperatively for a patient who has had a liver transplant?

Accepted Answer

Cyclosporine is an effective immunosuppressant drug. The use of cyclosporine has been a major factor in the success rates of liver transplantation. It does not cause bone marrow suppression and does not impede wound healing.

Question 5

Which would be a major nursing concern to monitor postoperatively in a patient who has had a liver transplant?

Accepted Answer

A critical aspect of nursing care following liver transplantation is monitoring for infection.

Question 6

A patient with pancreatitis is NPO. The patient asks the nurse why he is unable to have anything by mouth. The best response would be

Accepted Answer

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

Question 7

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 8

Esophageal varices can rupture as a result of increases in abdominal venous pressure. Which would increase the abdominal venous pressure? (Select all that apply.)

Accepted Answer

Coughing, vomiting and performing the Valsalva maneuver will increase abdominal venous pressure.

Question 9

A nursing diagnosis of: Knowledge, deficient, related to relationship of infection to nutritional needs is critical because:

Accepted Answer

In addition to the relationship of infection and nutrition, the nurse may need to teach preoperative and postoperative procedures if the patient requires percutaneous or open surgical drainage.

Question 10

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 11

The major focus of nursing intervention for the patient with pancreatitis is

Accepted Answer

The presence and location of pain are important to determine, as well as what aggravates or relieves the pain. Nursing Intervention: Administer medications as prescribed and monitor relief.

Question 12

The nurse explains that morphine contraindicated in the patient with pancreatitis because:

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 13

In preparing the patient for a paracentesis, the nurse must be sure

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's position. Food and fluid restriction is usually not necessary.

Question 14

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 15

Which serum test would a physician order if jaundice was suspected?

Accepted Answer

Jaundice is the discoloration of body tissues caused by abnormally high blood levels of bilirubin. This yellow discoloration is recognized when the total serum bilirubin exceeds 2.5 mg/dL.

Question 16

A 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 17

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 18

A patient has been admitted with right upper quadrant pain. Which would most likely be a source of her pain?

Accepted Answer

The pain of acute cholecystitis (inflammation of the gallbladder) is abrupt and localizes in the right upper quadrant epigastric region.

Question 19

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 20

Carefully monitoring the patient for signs that may indicate the development of pancreatitis (abdominal pain, nausea, and vomiting) is essential after a(n)

Accepted Answer

Assess for signs and symptoms of pancreatitis, which is the most common ERCP complication. These signs and symptoms include increasingly intense abdominal pain, nausea, vomiting, and diminished or absent bowel sounds.

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