NURS 321 Practice Questions for Hepatobiliary

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect? a. Fatty stools b. Straw-colored urine c. Tenderness in the left upper abdomen d. Ecchymosis of the extremities

A rationale: Chronic cholecystitis occurs following several bouts of acute cholecystitis. The repeated episodes of inflammation result in fibrotic and contracted gallbladder. Because of inflammation in the gallbladder, bile needed to absorb fat-soluble vitamins is unable to enter the bowel, resulting in steatorrhea (fatty stools)

A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse identify as the primary cause of liver cirrhosis? a. Alcohol b. Caffeine c. Cocaine d. Inhalants

A rationale: Primary cause of liver cirrhosis

A nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history? a. Gallstones b. Hypolipidemia c. COPD d. Diabetes mellitus

A rationale: The client's history might reveal biliary obstruction from a gallstone causing bile to inflame the pancreas

A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include int he plan of care? a. Decrease the client's fluid intake b. Increase the client's saturated fat intake c. Increase the client's sodium intake d. Decrease the client's carbohydrate intake

A rationale: The nurse should restrict fluids for a client who has cirrhosis and ascites due to the client's risk for increased fluid retention

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply) a. Administer furosemide b. Administer Warfarin c. Implement a low-sodium diet d. Measure the client's abdominal girth e. Encourage weight lifting during physical therapy

A,C,D rationale: A: The nurse should administer furosemide to the client to reduce fluid accumulation in the abdomen, C: To control fluid accumulation in the abdomen, D: Daily weights are even more reliable indicator of fluid accumulation

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see? a. Decreased WBC b. Increased serum amylase c. Decreased serum lipase d. Increased serum calcium

B

A nurse is assessing client in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C? a. A client who eats raw shellfish b. A client who has multiple tattoos c. A client who works in a child care center d. A client who has recently traveled to a underdeveloped country

B

A nurse is planning care for a client who has a decreased level of consciousness. The client is receiving continuous enteral feedings via a gastrostomy tube due to an inability to swallow. Which of the following is the priority action by the nurse? a. Observe client's respiratory status b. Elevate the head of the client's bed 30° to 45° c. Monitor intake and output every 8 hr d. Check residual volume every 4 to 6 hr

B

A nurse is providing discharge teaching for a client who has chronic pancreatitis. Which of the following statements should the nurse make? a. "You should decrease your caloric intake when abdominal pain is present" b. "You should increase your daily intake of protein" c. "You should increase fat intake when experiencing loose stools" d. "You should limit alcohol intake to 2-3 drinks per week"

B rationale: Clients who have chronic pancreatitis should consume a diet that is high in protein

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in client who have cirrhosis, lactulose is used to decreased levels of which of the following components in the bloodstream? a. Glucose b. Ammonia c. Potassium d. Bicarbonate

B rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the CNS, causing hepatic encephalopathy or coma

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client? a. Moist skin b. Spider angiomas c. Tarry stools d. Blood in urine

B rationale: Spider angiomas are lesions with a red center and numerous extensions that spread out like a spider web. This is an expected finding for a client who has cirrhosis

A nurse is caring for a client who has hepatitis A. The client asks the nurse how he might have contracted the virus. Which of the following is a question the nurse should ask the client? a. "Have you eaten any fresh water fish lately?" b. "Have you received a blood transfusion recently?" c. "Have you been to a third world country in the past?" d. "Do you take any recreational drugs?"

C

A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level? a. Administer diuretics b. Restrict the client's intake of fluids c. Reduce the client's intake of protein d. Administer vitamin K

C rationale: Ammonia is formed in the GI tract by the action of bacteria on protein. Limiting dietary intake can assist with decreasing the client's ammonia level. Protein is necessary for healing, so strict limitation of dietary protein is not recommended

A nurse is teaching a client who has hepatitis A about preventing transmission of the virus. Which of the following strategies should the nurse include in the teaching? a. Avoid eating at fast food restaurants b. Avoid serving raw foods c. Practice effective hand hygiene d. Wear barrier protection during vaginal intercourse

C rationale: Effective hand hygiene - along with immunization, sewer sanitation, and a safe water supply - are the most effective strategies for preventing the transmission of hepatitis A

A nurse is teaching self-management to a client who has hepatitis B. Which of the following instructions should the nurse include in the teaching? a. You may donate blood 6 months after completing the medication regimen b. Consume a high-protein diet c. Rest frequently throughout the day d. Take acetaminophen every 4 hr, as needed, for discomfort

C rationale: Rest frequently throughout the day to reduce the metabolic demands upon the liver and decrease energy demands; not B bc liver's ability yo metabolize protein by-products is impaired so diet high in carbs and moderate in fat & protein

A nurse is caring for a client who has suspected cholecystitis. The nurse should expect the client's urine to appear which of the following colors? a. Pale yellow b. Green-sh brown c. Red d. Dark and foamy

D

A nurse is preparing to administer the hepatitis B vaccine to a client. Which of the following techniques should the nurse use to locate the deltoid muscle? a. Locate the center of the arm between the elbow and the shoulder b. Find the center of the anterior aspect of the thigh c. Locate the middle third of the anterior thigh between the greater trochanter fo the femur and the lateral femoral condyle d. Place one finger across the acromion process and measure 3 fingerbreadths below to the midpoint and center of the lateral aspect of the upper arm

D

A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following values? a. Calcium b. RBC count c. Magnesium d. Amylase

D

A nurse is teaching a client about causes of biliary cirrhosis. Which of the following information should the nurse include in the teaching? a. Excessive alcohol consumption b. Hepatitis C c. Hepatotoxic medications d. Obstruction of the bile duct

D rationale: Prolonged obstruction of the common bile duct is the most common cause of biliary cirrhosis

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan? a. Administer antibiotics b. Provide a diet high in fat c. Restrict fluids d. Encourage short periods of ambulation

D rationale: The nurse should encourage a client who has hepatitis B to alternate between activity and rest

A nurse is administering an IM injection to a client who has hepatitis C. Before placing the syringe and needle in a puncture-resistant container, which of the following actions should the nurse take? a. Recap the needle b. Place the cap on the bedside table and slide the needle into the cap c. Wrap the needle with gauze d. Dispose of the needle uncapped

D rationale: The nurse should immediately place the uncapped needle in a puncture-resistant container to prevent a needle stick with the contaminated needle

A nurse is caring for a client who has acute pancreatitis. After treating the client's pain, which of the following should the nurse address as the priority intervention? a. Auscultate the client's lungs b. Assist the client to a side-lying position c. Provide oral hygiene d. Withhold oral fluids and food

D rationale: To rest the pancreas and reduce secretion of pancreatic enzyme, NPO status must be initiated and maintained during the acute phase of pancreatitis. This is the priority intervention to address after the client's pain has been treated