Deck 39: Disorders of the Liver, gallbladder, and Pancreas

Question 1

The nurse includes in the teaching plan for a patient with hepatitis A to avoid sharing:

A) Food
B) Bodies
C) Needles
D) Housing

Answer 1

Food

Question 2

The sign that would be a contraindication for the need of increased fluid intake for the patient with a hepatic disorder is:

A) Low blood pressure
B) Increased urinary output
C) Signs of edema
D) Bradycardia

Answer 2

Signs of edema

Question 3

The nurse assesses a dropping bilirubin level in a patient with hepatitis to mean that the:

A) Red blood cell destruction is decreasing.
B) Liver function is improving.
C) Kidneys are compensating for liver dysfunction.
D) Kupffer cell damage is continuing.

Answer 3

Liver function is improving.

Question 4

The patient with ascites is scheduled for a LeVeen peritoneal-venous shunt.The patient asks why this needs to be done instead of the paracentesis.The nurse replies:

A) "It helps the kidneys retain needed sodium."
B) "It will decrease the need for analgesics."
C) "This procedure will prevent the loss of protein."
D) "The risk of infection is lessened with this procedure."

Question 5

The nurse explains to a patient with pancreatitis that the drug Pancrease (lipase,protease,amylase),a pancreatic enzyme,should be:

A) Taken before meals.
B) Sprinkled on warm food.
C) Mixed with juice.
D) Taken 1 hour after eating.

Question 6

The complication for which the nurse would monitor after a liver biopsy is:

A) Headache
B) Muscle cramps
C) Bleeding
D) Respiratory distress

Question 7

In assessing the patient with jaundice,who has been diagnosed for impaired skin integrity,the nurse should:

A) Sedate the patient.
B) Apply mittens or socks to the hands.
C) Restrain the hands.
D) Distract the patient with conversation.

Question 8

The nursing measure that takes priority in relation to the care of a patient with an gastroesophageal balloon tube is to:

A) Deflate the balloon periodically.
B) Advance the tube as instructed.
C) Monitor respirator status.
D) Withhold medications that could decrease restlessness.

Question 9

The nurse will evaluate whether the dietary teaching is successful when the patient on a low-sodium diet selects:

A) Bologna sandwich with tomato juice
B) Hot dog on a bun with pickle relish and skim milk
C) Baked chicken, white rice, and apple juice
D) Peanut butter and jelly sandwich with tomato soup

Question 10

The nurse explains that with the continued rise in ammonia levels in the patient with cirrhosis,the diet will be modified to restrict:

A) Protein
B) Carbohydrates
C) Fats
D) Water-soluble vitamins

Question 11

The nurse explains that pruritus in the patient with hepatitis is related to:

A) Decreased fat intake
B) Poor appetite and therefore poor protein intake
C) Accumulation of bile salts under the skin
D) Altered urinary output of bile

Question 12

The young woman with severe jaundice has a nursing diagnosis of "Altered body image,related to jaundice." When the patient says,"Will I always be this horrible color?" the nurse replies:

A) "Yes, but your sclera will return to their previous white color."
B) "No. The color will fade gradually as liver inflammation decreases."
C) "Yes, but cosmetics can disguise the color."
D) "No, the color will change to freckles."

Question 13

To prevent complications in a patient with hepatitis who has been prescribed bedrest,the nurse would plan to:

A) Raise the knee gatch to prevent the patient from sliding down in bed.
B) Provide undisturbed periods of 6 hours to encourage rest.
C) Restrict fluids.
D) Encourage turning, coughing, and deep breathing every 2 hours.

Question 14

The instruction that should be given to the patient with portal hypertension to reduce the threat of hemorrhage is to:

A) Eat bland foods.
B) Avoid straining to have a bowel movement.
C) Increase fluid intake.
D) Use an electric razor to shave.

Question 15

The goal of medical treatment for patients with cirrhosis is to prevent complications and limit cell damage.A major approach is to promote rest.The reason for this is to:

A) Allow time for a transplant.
B) Allow the liver to regenerate.
C) Prevent red cell destruction.
D) Decrease the risk of trauma.

Question 16

The nurse assures the patient that the Occupational Health and Safety Administration (OSHA)has a requirement that all health care providers have the vaccination for:

A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) All strains of hepatitis.

Question 17

A high ammonia level contributes to hepatic encephalopathy.As this level increases,the nursing implementation that needs to be added to the nursing care plan is:

A) Mouth care
B) Seizure precautions
C) Oxygen saturation monitoring
D) Intake and output

Question 18

The nurse caring for a patient with hepatitis B should initiate the precaution of:

A) Reverse isolation
B) Standard precautions
C) Respiratory precautions
D) Enteric precautions

Question 19

The nurse would assess the progress of ascites on a daily basis by:

A) Daily weights and abdominal girth measurements.
B) Intake-output and electrolyte levels.
C) Blood pressure and pulse.
D) Daily temperatures and oxygen levels.

Question 20

The patient was positive for hepatitis B virus,although she had the disease 4 years ago and now is symptom-free.The nurse explains that the patient:

A) Is likely to have hepatitis B again.
B) Now has noninfectious hepatitis.
C) Is an infectious carrier and always will be.
D) Is at risk for hepatitis E.

Question 21

The nurse reminds the patient with liver disease that the level of ____________________ in the blood is an indicator of the how well the liver is functioning.

Question 22

In planning the care for the patient with pancreatitis,the nurse assigns the highest priority to:

A) Patient claims satisfaction with pain control.
B) Patient states an understanding of medications needed on discharge.
C) Patient's activity level tolerance shows an increase.
D) Patient can maintain a normal bowel pattern.

Question 23

The nurse reports the observation that would indicate blocked flow of bile from the liver to the intestine,which is:

A) Clay-colored stools
B) Jaundice
C) High blood pressure
D) Tachycardia

Question 24

A patient in acute pain is admitted with pancreatitis.The nurse sees a laboratory report showing an elevation that is diagnostic for acute pancreatitis,which is:

A) Serum bilirubin
B) Serum calcium
C) Serum lipids
D) Serum amylase

Question 25

The nurse takes into consideration that persons with liver disease are at an increased risk for:

A) Urinary infections
B) Systemic infection
C) Drug toxicity
D) Drug allergy

Question 26

The nurse is alert for bleeding in a patient with hepatic disorders because the inflamed liver may not be able to synthesize two clotting factors,which are ____________________ and ____________________.

Question 27

The nurse explains to the patient that when the blood sugar level drops,the liver is capable of converting the stored glycogen to glucose by the process of ____________________.

Question 28

Patients with pancreatic disease often have a history of:

A) Liver disorders
B) Drug abuse
C) Alcohol abuse
D) Excessive sugar intake

Question 29

Before discharge after a laparoscopic procedure for cholelithiasis,the patient is advised to:

A) Take water-soluble vitamins.
B) Follow a low-fat diet.
C) Expect light-colored stools for several days.
D) Keep dressing over T-tube dry.

Question 30

The nurse is alert to another chronic condition related to the presence of chronic pancreatitis,which is:

A) Chronic obstructive pulmonary disease (COPD)
B) Urinary tract infection (UTI)
C) Diabetes mellitus (DM)
D) Arteriosclerotic heart disease (ASD)

Question 31

The nurse makes a list of drugs and herbal remedies that are harmful to the liver,which includes:

A) Comfrey (herbal remedy)
B) Promethazine (Phenergan)
C) Acetaminophen (Tylenol)
D) Oral contraceptive (Yaz)
E) Lavender (herbal remedy)

Question 32

In assessing a dark-skinned patient for jaundice,the nurse would assess the ____________________ for a yellow color.