Deck 32: Gallbladder, Pancreatic, and Bile Duct Dysfunction

Question 1

Where does the liver release its bile?
1) Cystic duct
2) Hepatic duct
3) Pancreatic duct
4) All of the above

Answer 1

2

Question 2

A nurse is administering cholestyramine (Questran) to a client who is diagnosed with biliary disease. Which test should the primary health-care provider prescribe for the client to ensure safety in the client?
1) Liver function test
2) Serum cholesterol
3) Both A and B
4) None of the above

Answer 2

3

Question 3

A client is brought to the hospital because of severe abdominal pain, nausea, and vomiting. The client reports increased pain in the abdomen and in the epigastric region radiating to the back when lying supine. Upon physical assessment, the nurse finds that the client has fever and hypotension. What should the nurse infer from these findings?
1) The client has cholelithiasis.
2) The client has cholecystitis.
3) The client has acute pancreatitis.
4) The client has chronic pancreatitis.

Answer 3

3

Question 4

Which hormone is released by the pancreas?
1) Glucagon
2) Secretin
3) Both A and B
4) None of the above

Question 5

After providing a volume replacement in a client, a nurse still finds the client to be hypotensive. Which action should the nurse perform in the client to provide effective care?
1) Initiate use of a nasogastric suction
2) Initiate use of a central catheter
3) Initiate use of a transhepatic T-tube
4) Initiate use of a percutaneous transhepatic biliary catheter

Question 6

Which hormone produced by the intestine triggers the release of pancreatic enzymes?
1) Secretin
2) Somatostatin
3) Insulin
4) All of the above

Question 7

A nurse is caring for a client who reports abdominal distention and pain in the right upper quadrant. The nurse suspects a biliary disorder in the client. Which medication should the nurse expect the health-care provider to prescribe for the client to relieve pain?
1) Morphine
2) Codeine
3) Dilaudid
4) None of the above

Question 8

Which client will benefit from early endoscopic retrograde cholangiopancreatography (ERCP)?
1) A client who has cholelithiasis
2) A client who has cholecystitis
3) A client who has acute pancreatitis
4) A client who has severe gallstone pancreatitis

Question 9

Which is a common risk factor that leads one susceptible to forming gallstones?
1) Estrogen level
2) Obesity
3) Oral contraceptives
4) Liver enzymes
5) All of the above

Question 10

A nurse instructor is teaching a group of nursing students about laparoscopic cholecystectomy. Which statement of a student nurse indicates effective learning?
1) "The client should be on bed rest for 2 weeks."
2) "The client will have severe pain after the surgery."
3) "The procedure has a high risk of complications."
4) "The client has to stay in the health care setting for less than 24 hours after the surgery."

Question 11

Which complication should be suspected in a client who has an obstruction of the common bile duct?
1) Cholecystitis
2) Pancreatic cancer
3) Jaundice
4) All the above

Question 12

A nurse is assessing a client who has episodic abdominal pain, constipation, and flatulence. Upon physical assessment and review of the laboratory findings, the nurse concludes that the client has jaundice and elevated serum amylase. Which condition should the nurse suspect in the client?
1) Cholelithiasis
2) Cholecystitis
3) Acute pancreatitis
4) Chronic pancreatitis

Question 13

A nurse instructor is teaching a group of nursing students about the pathophysiology of cholecystitis. The nursing instructor asks, "What happens during chronic cholecystitis?" Which statement of a student nurse indicates effective learning?
1) "The gallbladder is filled with purulent effusion."
2) "Perforation and gangrene are developed on the wall of the gallbladder."
3) "The gallstone passes from the cystic duct into the common bile duct."
4) "The gallbladder becomes thickened and functions poorly."

Question 14

A nurse is assessing a client who has had pain in the right upper quadrant for4 hours. The client reports that the pain is radiating to the upper thoracic region. A laboratory report suggests elevated liver enzymes and serum bilirubin. What condition should the nurse suspect from the findings?
1) Biliary tract disorder
2) Biliary colic
3) Cholecystitis
4) Acute pancreatitis

Question 15

A nurse is caring for a client who has cholecystitis and was diagnosed with pruritus. Which medication should the nurse expect the health-care provider to prescribe for the client?
1) Urosodiol (Actigall)
2) Dilaudid
3) Chenodiol (Chenix)
4) Cholestyramine (Questran)

Question 16

A nurse finds increased glucose levels in a client who has chronic pancreatitis. What should the nurse interpret from the finding?
1) The client's beta cells are damaged.
2) The client has decreased pancreatic enzymes.
3) The client has high bile salts in the blood.
4) The client's gallbladder was surgically removed.

Question 17

The clinical reports of a client indicate high levels of bilirubin. What should the nurse infer from the report?
1) The client has stones in the common bile duct.
2) The client has decreased pancreatic enzymes.
3) Both A and B
4) None of the above

Question 18

A physical examination of a client exhibits Cullen sign and Grey-Turner sign. Which condition should the nurse suspect in the client?
1) Acute cholecystitis
2) Biliary disorders
3) Acute pancreatitis
4) Emphysematous cholecystitis

Question 19

Which diagnostic procedure would a primary health-care provider use to confirm advanced chronic pancreatitis with exocrine insufficiency in a client?
1) Ultrasound
2) Cholecystogram
3) Fecal chymotrypsin
4) Endoscopic retrograde cholangiopancreatography (ERCP)

Question 20

A primary health-care provider prescribes dilaudid to a client who has cholecystitis. What should the nurse anticipate from this finding?
1) The client has itching.
2) The client has gallstones.
3) Both A and B
4) The client has epigastric pain.

Question 21

A nurse is reviewing Ranson's criteria to assess the severity of pancreatitis in a client. Which findings observed in the client by the nurse within a 48-hour period indicate that the client has chronic pancreatitis?
1) Glucose of 10 mmol/L
2) White blood cell count of 15,000 mm³
3) Fluid sequestration of 4 L
4) Partial pressure of oxygen of 40 mmHg
5) Blood urea nitrogen of 1.0 mmol/L

Question 22

Which suggestions should a nurse provide to a client who has chronic pancreatitis?
1) "You should consume low-fat food."
2) "You can drink sweetened beverages."
3) "You should drink plenty of fluids."
4) "You should take fat-soluble vitamins."
5) None of the above

Question 23

Which complications should a nurse suspect in a client when bile is obstructed from flowing into the intestine?
1) Steatorrhea
2) Calculus
3) Jaundice
4) Pruritus
5) Autodigestion

Question 24

The radiographic investigation reports of a client show the presence of stones in the common bile duct. Which complications should a nurse suspect in the client?
1) Increase in blood glucose levels
2) Increase in bilirubin levels
3) Increase in bile salts
4) Increase in lipase levels
5) Increase in amylase levels

Question 25

Which factors may lead to an acute inflammation of the pancreas?
1) Excessive alcohol intake
2) High triglyceride level
3) Both A and B
4) None of the above