Deck 43: Disorders of the Exocrine Pancreatic and Hepatobiliary Systems

Question 1

The nurse palpates a client's abdomen and notes the liver below the costal margin. What does this finding indicate?

A) Hepatomegaly
B) Atrophy of the liver
C) Normal liver placement
D) Portal hypertension

Answer 1

Hepatomegaly

Question 2

When palpating an infant's liver, what does the nurse understand is true?

A) The infant's liver is located deeper than an adult.
B) Palpation of the infant's liver is easier than palpation of an adult.
C) The infant's liver is small in comparison to other abdominal organs.
D) Palpation of the infant's liver is not recommended.

Answer 2

Palpation of the infant's liver is easier than palpation of an adult.

Question 3

The nurse cares for a client with impaired liver function. Impaired metabolism of which substances may occur based on the client's condition? Select all that apply.

A) Carbohydrates
B) Vitamins
C) Minerals
D) Proteins
E) Fats

Answer 3

Carbohydrates
Proteins
Fats

Question 4

A client with end-stage liver failure is admitted with severe cirrhosis. What is the nurse's understanding of the pathophysiology of cirrhosis?

A) Increased oncotic pressure
B) Impaired removal of bilirubin
C) Impaired conversion of ammonia to urea
D) Increased vascular permeability

Question 5

A client with liver failure is diagnosed with malnutrition. Which vitamin deficiencies does the nurse understand the client is at greatest risk for developing? Select all that apply.

A) C
B) K
C) A
D) D
E) E

Question 6

A client with liver disease displays alterations in coagulation. Which coagulation factors does the nurse understand may be impaired due to the client's liver dysfunction of clotting factor synthesis? Select all that apply.

A) I
B) II
C) VIII
D) VII
E) X

Question 7

The nurse cares for a client with chronic alcohol abuse. Which laboratory finding does the nurse recognize as evidence of liver damage?

A) Albumin 3.5 g/dL
B) ALT 50 unit/L
C) ALP 45 unit/L
D) AST/SGOT 30 unit/dL

Question 8

A client with cholelithiasis asks the nurse, "What caused this?" Which factors might the nurse include in the response? Select all that apply.

A) Diet
B) Culture
C) Gender
D) Body weight
E) Age

Question 9

A nurse working in oncology notes an overall increase in clients with pancreatic cancer. What does the nurse associate with the overall increase in pancreatic cancer? Select all that apply.

A) Multicultural population
B) Diabetes mellitus
C) Obesity
D) Aging population
E) Hypercholesterolemia

Question 10

The nurse cares for a client with liver failure and monitors the client for hepatic encephalopathy. Which findings does the nurse recognize as the earliest signs of hepatic encephalopathy? Select all that apply.

A) Restlessness
B) Confusion
C) Disorientation
D) Agitation
E) Impaired judgment

Question 11

The nurse cares for a client with portal hypertension who is diagnosed with asterixis. Which assessment finding corresponds with the client's diagnosis of asterixis?

A) Muscle tremor and downward flap of the hand
B) Flaccid muscles and upward flexion of the hand
C) Discoloration of the abdominal skin
D) Increased abdominal circumference

Question 12

A client with portal hypertension has bluish veins just under the skin of the abdomen that radiate out across the umbilicus. Which pathophysiological factors does the nurse recognize causes this condition? Select all that apply.

A) Elevated bilirubin levels
B) Impaired clearance of ammonia
C) Increased fluid in the abdomen
D) Impaired metabolism of estrogens
E) Increased abdominal pressure

Question 13

A nurse cares for a client diagnosed with a serous cystadenoma of the pancreas. What statement will the nurse include when teaching the client about the condition?

A) "This type of cyst usually causes pain and nausea."
B) "This type of cyst is usually surgically removed."
C) "This type of cyst is rarely cancerous."
D) "This type of cyst may be cancerous."

Question 14

The nurse reviews the health care provider prescriptions for a client diagnosed with acute pancreatitis. Which prescription will the nurse question?

A) Oxygen as needed
B) Opioid analgesic as needed
C) Intravenous colloid infusion
D) Clear liquid diet as tolerated

Question 15

A public health nurse is examining the incidence rates of gallbladder cancer in the United States. Which population does the nurse learn is at greatest risk for developing this type of cancer?

A) Infants
B) Children
C) Adults
D) Older adults

Question 16

The nurse cares for a client with liver failure and impaired bilirubin clearance. What does the nurse know is true regarding bilirubin?

A) It is the waste product of red blood cell destruction.
B) It is the by-product of protein metabolism.
C) It is produced in the small bile ducts.
D) It is produced in the hepatic duct.

Question 17

A nurse cares for a client with alcoholic hepatitis. Which early manifestations of liver impairment does the nurse recognize on assessment? Select all that apply.

A) Indigestion
B) Jaundice
C) Diffuse abdominal pain
D) Ascites
E) Bleeding impairment

Question 18

The nurse researcher is examining the factors that lead to liver cancer. What does the nurse recognize begins the process of cellular transformation in liver cancer?

A) Autoimmunity
B) Allergic reaction
C) Infection
D) Inflammation

Question 19

A client with liver failure is diagnosed with cirrhosis. What is the nurse's understanding of the primary dysfunction related to this condition?

A) Fatty deposits lead to thrombi and obstructed blood flow.
B) Fatty deposits lead to impaired metabolism and malnutrition.
C) Fibrosis leads to constriction and increased vessel pressures.
D) Fibrosis leads to impaired absorption of electrolytes and acid-base dysfunction.

Question 20

The nurse is caring for a client with liver cancer whose diagnosis was delayed after months of non-specific complaints. What leads to delayed diagnosis of liver damage? Select all that apply.

A) The deeper location of the liver in the abdomen.
B) The superficial location of the liver in the abdomen.
C) The regenerative properties of the liver.
D) The vascular nature of the liver.
E) The size of the liver.