Question 1

The nurse is teaching a patient about the effects of liver failure. The nurse knows the patient understands teaching when the patient identifies which of the following as effects of liver failure? Select all that apply.  Select all that apply.

Accepted Answer

Liver failure can lead to ascites, causing the abdomen to become very large (A). It can also affect glucose metabolism, leading to fluctuations in blood sugar levels (B). Hormonal imbalances can result in irregular menstrual cycles (D). Jaundice, a condition where the skin appears yellow, is a common symptom of liver failure (E). The red and swollen lower leg (C) is more indicative of a localized issue like a blood clot or infection, not directly related to liver failure.

Question 2

A nurse should include which of these teaching points when planning discharge for a patient who has a T-tube following a cholecystectomy?  Select all that apply.

Accepted Answer

B) Reporting drainage of more than 500 mL per day is important as it may indicate a complication or excessive bile leakage. D) Reporting skin redness or irritation around the drain site is crucial for preventing infection and ensuring proper healing.

Question 3

The nurse is teaching a patient with an acute attack of cholecystitis about nutritional interventions. Which of these statements, if made by the patient would indicate that the patient needs further instruction?

Accepted Answer

The answer of The nurse is teaching a patient with...

Question 4

A patient with cholithiasis had an extracorporeal shock wave lithotripsy. Which of the following statements, if made by the patient would indicate that the patient remembered the procedure accurately?  Select all that apply.

Accepted Answer

The patient was given medication through an IV to reduce discomfort, the nurses monitored the patient's pain and nausea, and a machine was used to guide the shock waves to the stones.

Question 5

The nurse assesses the nutritional status of a patient who has cholelithiasis and a body mass index of 3

Accepted Answer

The nurse should initially ask the patient to discuss the patient's typical daily menu choices to assess the patient's nutritional status.

Question 6

The nurse is caring for a hospitalized patient with an acutely inflamed gallbladder who states, "Suddenly, the pain is just gone. Can I go home?" What is the nurse's best response?

Accepted Answer

The sudden relief of pain could be a sign of a serious complication, such as a rupture of the gallbladder or obstruction of the bile ducts. It is important for the healthcare provider to be informed of this change in symptoms in order to assess the patient's condition and adjust the treatment plan accordingly. Options A and D are not appropriate as they do not address the potential underlying complication, and option B may not be necessary depending on the provider's assessment.

Question 7

The nurse is observing a nursing student who is caring for a patient with liver failure and jaundice. The student asks the patient each of the following questions. Which question is helpful in determining if the cause of the jaundice is hemolytic?

Accepted Answer

Asking about sickle cell anemia is helpful because it is a condition that can cause hemolytic jaundice due to increased breakdown of red blood cells.

Question 8

The patient in the icteric phase of hepatitis asks the nurse, "Why are my stools no longer brown?" The nurse most correctly answers with which of the following?

Accepted Answer

The answer of The patient in the icteric phase of...

Question 9

The home care patient who is scheduled for a laparoscopic cholecystectomy in four days asks a nurse, "How can I best promote comfort?" Which of these responses would be most appropriate for the nurse to make?

Accepted Answer

The nurse's response in option A is most appropriate as it suggests sitting in a recliner, drinking water, and avoiding eating, especially fatty foods, which can help manage symptoms and promote comfort before a cholecystectomy.

Question 10

A nurse assesses a patient who is taking chenodiol (Chenix). Which of the following patient statements indicates that immediate follow-up by the nurse is required?  Select all that apply.

Accepted Answer

The answer of A nurse assesses a patient who is...

Question 11

A nurse should instruct a patient who wishes to reduce the incidence of gallstone and cholecystitis to do which of the following? Select all that apply.  Select all that apply.

Accepted Answer

The answer of A nurse should instruct a patient who...

Question 12

The patient with acute cholecystitis has an oral temperature of 101.8° F. The patient tells the nurse, "I must have the flu." The nurse's best response is which of the following?

Accepted Answer

Acute cholecystitis often involves bacterial infection secondary to obstruction caused by gallstones (cholelithiasis). The patient's fever is more indicative of infection related to the cholecystitis rather than the flu.

Question 13

A patient has been given instructions about a laparoscopic cholecystectomy. Which of these statements, if made by the patient, would indicate further teaching is needed?

Accepted Answer

The answer of A patient has been given instructions about...

Question 14

The patient with acute cholithiasis has an order for an NG tube insertion. The patient asks, "Why do I need to have a tube placed from my nose to my stomach?" The nurse's best answer is which of the following?

Accepted Answer

The insertion of an NG tube is typically done to keep the patient's stomach empty, allowing the gallbladder to rest and hopefully reducing pain. It is not related to the patient's ability or inability to follow a prescribed diet or exercise plan, nor is it about sucking bile out through the nose. While early insertion of an NG tube may be beneficial in some cases, preventing pancreatitis is not the primary reason for this intervention in patients with acute cholithiasis.

Question 15

The nurse is caring for a patient who has liver failure and is taking lactulose (Chronulac). Which of these laboratory data would indicate that the medication is having the desired effect?

Accepted Answer

Lactulose works by decreasing the amount of ammonia produced by the intestines, which is then excreted in the feces. Therefore, a decreased serum ammonia level would indicate that the medication is working as intended. An increased serum ammonia level would indicate that the medication is not working or that there is another issue causing elevated ammonia levels. The serum ALT level is not directly affected by lactulose, so it is not a reliable indicator of whether the medication is having the desired effect.

Question 16

The nurse is teaching a patient about modifiable risk factors for cholelithiasis. Which of these statements, if made by the patient would indicate the patient has the correct understanding of modifiable risk factors?  Select all that apply.

Accepted Answer

Age and family history are non-modifiable risk factors for cholelithiasis, while obesity, alternating weight loss and gain, and elevated serum cholesterol are modifiable risk factors. Therefore, options B, C, and E indicate a correct understanding of modifiable risk factors.

Question 17

A patient scheduled for a laparoscopic cholecystectomy asks the nurse why a surgical consent for a laparotomy must also be completed. The nurse's best answer is which of the following?

Accepted Answer

The surgeon may need to convert to an open procedure if complications arise during the laparoscopic cholecystectomy, so consent for both procedures is necessary.

Question 18

Which of these questions would be most important for a nurse to ask when assessing a patient who is taking the herb goldenseal for cholecystitis?

Accepted Answer

Goldenseal has the potential to cause uterine contractions and stimulate menstrual flow, which can be harmful to a developing fetus. Therefore, it is important for the nurse to ask if the patient is pregnant or planning to become pregnant soon before continuing the use of goldenseal.

Question 19

Which of these factors in a patient's history are likely related to liver failure?  Select all that apply.

Accepted Answer

The answer of Which of these factors in a patient's...

Question 20

The nurse is teaching a patient who has portal hypertension. The nurse knows teaching has been effective when the patient states, "Portal hypertension means

Accepted Answer

Portal hypertension is characterized by increased pressure in the portal vein, which carries blood from the digestive organs to the liver. This increased pressure can cause blood to back up in the liver, leading to swelling and enlargement of blood vessels in the esophagus and stomach.

Quiz 25: Nursing Care of Patients with Gall Bladder, Liver, & Pancreatic Disorders

The nurse is teaching a patient about the effects of liver failure. The nurse knows the patient understands teaching when the patient identifies which of the following as effects of liver failure? Select all that apply. Select all that apply.

A nurse should include which of these teaching points when planning discharge for a patient who has a T-tube following a cholecystectomy? Select all that apply.

The nurse is teaching a patient with an acute attack of cholecystitis about nutritional interventions. Which of these statements, if made by the patient would indicate that the patient needs further instruction?

A patient with cholithiasis had an extracorporeal shock wave lithotripsy. Which of the following statements, if made by the patient would indicate that the patient remembered the procedure accurately? Select all that apply.

The nurse assesses the nutritional status of a patient who has cholelithiasis and a body mass index of 3

The nurse is caring for a hospitalized patient with an acutely inflamed gallbladder who states, "Suddenly, the pain is just gone. Can I go home?" What is the nurse's best response?

The nurse is observing a nursing student who is caring for a patient with liver failure and jaundice. The student asks the patient each of the following questions. Which question is helpful in determining if the cause of the jaundice is hemolytic?

The patient in the icteric phase of hepatitis asks the nurse, "Why are my stools no longer brown?" The nurse most correctly answers with which of the following?

The home care patient who is scheduled for a laparoscopic cholecystectomy in four days asks a nurse, "How can I best promote comfort?" Which of these responses would be most appropriate for the nurse to make?

A nurse assesses a patient who is taking chenodiol (Chenix) . Which of the following patient statements indicates that immediate follow-up by the nurse is required? Select all that apply.

A nurse should instruct a patient who wishes to reduce the incidence of gallstone and cholecystitis to do which of the following? Select all that apply. Select all that apply.

The patient with acute cholecystitis has an oral temperature of 101.8° F. The patient tells the nurse, "I must have the flu." The nurse's best response is which of the following?

A patient has been given instructions about a laparoscopic cholecystectomy. Which of these statements, if made by the patient, would indicate further teaching is needed?

The patient with acute cholithiasis has an order for an NG tube insertion. The patient asks, "Why do I need to have a tube placed from my nose to my stomach?" The nurse's best answer is which of the following?

The nurse is caring for a patient who has liver failure and is taking lactulose (Chronulac) . Which of these laboratory data would indicate that the medication is having the desired effect?

The nurse is teaching a patient about modifiable risk factors for cholelithiasis. Which of these statements, if made by the patient would indicate the patient has the correct understanding of modifiable risk factors? Select all that apply.

A patient scheduled for a laparoscopic cholecystectomy asks the nurse why a surgical consent for a laparotomy must also be completed. The nurse's best answer is which of the following?

Which of these questions would be most important for a nurse to ask when assessing a patient who is taking the herb goldenseal for cholecystitis?

Which of these factors in a patient's history are likely related to liver failure? Select all that apply.

The nurse is teaching a patient who has portal hypertension. The nurse knows teaching has been effective when the patient states, "Portal hypertension means