Quiz 8: Biliary & Pancreas; GI & Hepatic

The nurse is assessing a pale patient with cirrhosis. Which male-specific characteristics does the nurse expect to find? SATA a. Gynecomastia b. Testicular atrophy c. Ascites d. Impotence e. Spider angiomas f. Petechiae

a. Gynecomastia b. Testicular atrophy d. Impotence

What is the priority focus in caring for a patient with advanced liver cancer? a. Hospice and end-of-life care b. Getting placed on the liver transplant list c. Hepatic arterial infusion of chemotherapy d. Cryotherapy to freeze and destroy liver tumors

a. Hospice and end-of-life care

A patient with decompensated cirrhosis is at risk for which complications? SATA a. Jaundice b. Esophageal varices c. Coagulation defects d. Hepatitis A virus (HAV) e. Spontaneous bacterial peritonitis f. Ascites

a. Jaundice b. Esophageal varices c. Coagulation defects e. Spontaneous bacterial peritonitis f. Ascites

The nurse is caring for a patient with pancreatic cancer who had a Whipple procedure. Which interventions and assessments does the nurse implement? SATA a. Place the patient in semi-Fowler's position b. Place the NG tube on intermittent suction c. Monitor NG drainage, which should be bile-tinged and contain blood d. Keep the patient NPO e. Check blood glucose often f. Monitor for signs of hypovolemia to prevent shock

a. Place the patient in semi-fowler's position b. Place the NG tube on intermittent suction d. Keep the patient NPO e. Check blood glucose often f. Monitor for signs of hypovolemia to prevent shock

The nurse is collaborating with the dietician to provide diet teaching for a patient with chronic pancreatitis and his family wish. Which are important teaching points for this teaching plan? SATA a. The patient will need increased calorie intake per day to maintain weight b. Be sure to include foods that are high in fat because they are essential for healing c. Alcohol intake should be avoided d. Provide a bland diet with frequent meals e. Avoid irritating substances such as caffeinated beverages which stimulate GI system f. Add rich foods to the diet to help meet the caloric requirements

a. The patient will need increased calorie intake per day to maintain weight c. Alcohol intake should be avoided d. Provide a bland diet with frequent meals e. Avoid irritating substances such as caffeinated beverages which stimulate GI system

When admitting the patient with cirrhosis, the nurse assesses for which conditions related to splenomegaly as possible complications of the disease? a. Thrombocytopenia b. Bleeding esophageal varices c. Hepatorenal syndrome d. Portal hypertensive gastropathy

a. Thrombocytopenia

Which are potential cardiovascular complications for a patient after surgery for a Whipple procedure? SATA a. Thrombophlebitis b. Pulmonary embolism c. Myocardial infarction d. Heart failure e. Renal failure f. Hemorrhage at anastomosis sites with hypovolemia

a. Thrombophlebitis c. Myocaridal infarction d. Heart failure f. Hemorrhage at anastamosis sites with hypovolemia

Which statements about pancreatic cancer are accurate? SATA a. Venous thromboembolism (VTE) is a common complication of pancreatic cancer b. Pancreatic cancer often presents in a slow and vague manner c. Severe pain is an early feature of this disease d. There are no specific blood tests to diagnose pancreatic cancer e. Chemotherapy is the treatment of choice for pancreatic cancer f. Chronic pancreatitis predisposes a patient to pancreatic cancer

a. Venous thromboembolism (VTE) is a common complication of pancreatic cancer b. Pancreatic cancer often presents in a slow and vague manner d. There are no specific blood tests to diagnose pancreatic cancer f. Chronic pancreatitis predisposes a patient to pancreatic cancer

A nurse is caring for a client with cirrhosis of the liver. Which laboratory test should the nurse monitor that, when abnormal, might identify a client who may benefit from neomycin enemas? a. Ammonia level b. Culture and sensitivity c. White blood cell count d. Alanine aminotransferase level

a. ammonia level

When preparing a patient for paracentesis, what does the nurse do? SATA a. Ask the patient to void before the procedure b. Place the patient in the supine position c. Weigh the patient before the procedure d. Obtain the patient's heart rate e. Assess the patient's respiratory rate f. Obtain the patient's blood pressure

a. ask the patient to void before the procedure c. weigh the patient before the procedure d. obtain the patient's heart rate e. assess the patient's respiratory rate f. obtain the patient's blood pressure

The nurse is providing care for a patient with cirrhosis who has massive ascites and has developed hepatopulmonary syndrome. Which elements of nursing care are appropriate for this patient? SATA a. Auscultate lungs every 4-8 hours for crackles b. Monitor the patient's oxygen saturation c. Elevate the head of the bed 15 degrees d. Apply oxygen therapy e. Weigh the patient every day f. Lower the patient's legs and feet

a. auscultate lungs every 4-8 hours for crackles b. monitor the patient's oxygen saturation d. apply oxygen therapy e. weigh the patient every day

The nurse is teaching a patient with cirrhosis about nutrition therapy. Which key points must the nurse include? SATA a. Do not use table salt b. Adding salt when cooking is acceptable c. Eat small frequent meals d. Drink supplemental liquids such as Ensure e. Be sure to take a multivitamin every day f. Avoid foods that are rich in vitamin K

a. do not use table salt c. eat small frequent meals d. drink supplemental liquids such as Ensure e. Be sure to take a multivitamin every day

The nurse is administering ketorolac to a 78-year-old patient for mild to moderate biliary pain management. Which assessment finding indicates the patient is experiencing a side effect of this drug? a. Gastrointestinal upset b. Ventricular cardiac dysrhythmias c. Decreased urinary output d. Jaundice

a. gastrointestinal upset

To provide good continuity of care for Mr. A (appendectomy), who is homeless, which members of the interdisciplinary team should routinely have access to Mr. A's medical records? SATA a. Hospital social worker who is helping Mr. A to locate resources b. Surgeon who performed Mr. A's appendectomy c. An epidemiologist who is collecting data on the homeless d. All of the UAPs who work in the med-surg area e. Administrator of the shelter where Mr. A frequently stays f. Nurse who works at the shelter where Mr. A frequently stays

a. hospital social worker who is helping Mr. A to locate resources b. surgeon who performed Mr. A's appendectomy f. nurse who works at the shelter where Mr. A frequently stays

A nurse is concerned that a client with a diagnosis of cirrhosis of the liver may experience the complication of hepatic coma. For which clinical indicator should the nurse assess this client? a. Icterus b. Urticaria c. Uremic frost d. Hemangioma

a. icterus

A client is admitted to the hospital with a diagnosis of cirrhosis of the liver. For which classic signs of hepatic coma should the nurse assess this client? SATA a. Mental confusion b. Increased cholesterol c. Brown-colored stools d. Flapping hand tremors e. Hyperactive deep tendon reflexes

a. mental confusion d. flapping hand tremors

The nurse on a medical-surgical unit is caring for several patients with acute cholecystitis. Which task is best to delegate to the unlicensed assistive personnel (UAP)? a. Obtain the patients' vital signs b. Determine if any foods are not tolerated c. Assess what measures relieve the abdominal pain d. Ask the patients to describe their daily activity or exercise routines

a. obtain the patient's vital signs

The RN is observing the nursing student perform an abdominal assessment on Ms. D who was admitted for a bowel obstruction. For which actions will the supervising nurse intervene? SATA a. Palpating for abdominal distention with the index fingertip b. Auscultating for bowel sounds with the NG tube attached to low wall suction c. Performing the physical assessment before asking about pain d. Checking the NG collection canister for quantity and quality of drainage e. Inspecting for visible signs of peristaltic waves or abdominal distention f. Checking for skin turgor over the lower abdominal area

a. palpating for abdominal distention with the index fingertip b. auscultating for bowel sounds with the NG tube attached to low suction c.performing the physical assessment before asking about pain f. checking for skin turgor over the lower abdominal area

Which patients would not be considered candidates for a liver transplant? SATA a. Patient with metastatic tumors b. Patient with type 2 diabetes c. Patient with severe respiratory disease d. Patient with chronic liver disease e. Patient with advanced cardiac disease f. Patient who is unable to follow instructions

a. patient with metastatic tumors c. patient with severe respiratory disease e. patient with advanced cardiac disease f. patient who is unable to follow instructions

Which people need immunization against hepatitis B (HBV)? SATA a. People who have unprotected sex with more than one partner b. Men who have sex with men c. Any patient scheduled for a surgical procedure d. Firefighters e. Health care providers f. Patients prescribed immunosuppressant drugs

a. people who have unprotected sex with more than one partner b. men who have sex with men d. firefighters e. health care providers f. patients prescribed immunosuppressant drugs

A patient is admitted with obstructive jaundice. Which sign/symptom does the nurse expect to find upon assessment of the patient? a. Pruritus b. Pale urine in increased amounts c. Pink discoloration of sclera d. Dark, tarry stools

a. pruritus

In performing an assessment on a patient with liver trauma, what does the nurse expect to find? SATA a. Right upper quadrant pain b. Increased blood pressure c. Guarding of the abdomen d. Bradypnea e. Kehr's sign f. Abdominal rigidity

a. right upper quadrant pain c. guarding of the abdomen e. Kehr's sign f. abdominal rigidity

In the care of Mr. K (PEG tube), which health care team members are demonstrating the roles and responsibilities that support interprofessional collaboration? SATA a. The UAP tells Mr. K's family that she will be in at 10AM to assist Mr. K with hygiene b. The RN gives the UAP specific instructions about how to clean around Mr. K's PEG tube c. The RN acknowledges that the UAP has the best working relationship with Mr. K's daughter d. The enterostomal therapist performs care for Mr. K, but staff and family are unsure about followup e. The nursing student recognizes that dealing with Mr. K's family dynamics exceeds her abilities f. The surgeon does mini-grand rounds with nursing student to explain the purpose of Mr. K's PEG tube

a. the UAP tells Mr. K's family that she will be in at 10AM to assist Mr. K with hygiene b. The RN gives the UAP specific instructions about how to clean around Mr. K's PEG tube c. The RN acknowledges that the UAP has the best working relationship with Mr. K's daughter e. The nursing student recognizes that dealing with Mr. K's family dynamics exceeds her abilities f. The surgeon does mini-grand rounds with nursing student to explain the purpose of Mr. K's PEG tube

The student nurse is caring for a patient with cirrhosis. Which action by the student nurse causes the supervising nurse to intervene? a. Uses a straight-edge razor to shave the patient b. Monitors for orthostatic changes of blood pressure c. Avoids intramuscular injections d. Uses a toothette for oral care

a. uses a straight-edge razor to shave the patient

Which laboratory test result indicates permanent immunity to hepatitis A? a. Immunoglobulin G (IgG) antibodies b. Immunoglobulin M (IgM) antibodies c. A positive enzyme-linked immunosorbent assay (ELISA) d. The presence of anti-HAV antibodies

a.Immunoglobulin G (IgG) antibodies

Which statements are true regarding laparoscopic cholecystectomy? SATA a. Laparoscopic cholecystectomy is considered the "gold standard" and is performed far more often than the traditional open approach b. Patients with chronic lung disease or heart failure who are unable to tolerate the oxygen used in the laparoscopic procedure are examples of patients who have the open surgical approach (abdominal laparotomy) c. Removing the gallbladder with the laparoscopic technique reduces the risk of wound complications d. Patients who have their gallbladders removed by the laparoscopic technique should be taught the importance of early ambulation to promote absorption of carbon dioxide e. Use of laparoscopic cholecystectomy puts the patient at increased risk for bile duct injuries f. After a laparoscopic cholecystectomy, assess the patient's oxygen saturation level frequently until the effects of the anesthesia have passed

a laparoscopic cholecystectomy is considered the "gold standard" and is performed far more often than the traditional open approach c Removing the gallbladder with the laparoscopic technique reduces the risk of wound complications d Patients who have their gallbladders removed by the laparoscopic technique should be taught the importance of early ambulation to promote absorption of carbon dioxide f after a laparoscopic cholecystectomy, assess the patient's oxygen saturation level frequently until the effects of the anesthesia have passed

Which key points does the nurse include when teaching the patient with cirrhosis and his family about drug therapy before discharge? SATA a. "Do not take over-the-counter medications unless approved by your health care provider." b. "The beta-blocker called propranolol will cause your heart rate to increase." c. "The lactulose syrup should cause you to have two to three bowel movements every day." d. "Take your furosemide early in the day so that it does not keep you up at night." e. "Report any muscle weakness or lightheadedness to your health care provider right away." f. "Your health care provider may prescribe a potassium supplement to replace losses."

a. "Do not take over-the-counter medications unless approved by your health care provider" c. "The lactulose syrup should cause you to have two to three bowel movements every day." d "Take your furosemide early in the day so that it does not keep you up at night" e. "report any muscle weakness or light headedness to your health care provider right away" f. " your health care provider may prescribe a potassium supplement to replace losses"

A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. With this evidence of impending hepatic coma, which diet can the nurse expect will be ordered for this client? a. 20 g of protein, 2000 calories b. 70 g of protein, 1200 calories c. 80 g of protein, 2500 calories d. 100 g of protein, 1500 calories

a. 20 g of protein, 2000 calories

Which elevated laboratory test results indicate hepatic cell destruction? SATA a. Elevated serum aspartate aminotransferase (AST) b. Elevated serum alanine aminotransferase (ALT) c. Elevated lactate dehydrogenase (LDH) d. Decreased serum total bilirubin e. Increased fecal urobilinogen f. Increased International Normalized Ratio (INR)

a. AST b. ALT c. LDH f. INR

Which statements about a patient with cirrhosis and esophageal varices are accurate? SATA a. All patients with cirrhosis should be screened for esophageal varices to detect them before they bleed b. Bleeding esophageal varices are a medical emergency c. Esophageal balloon tamponade is often used to control bleeding esophageal varices d. A nonselective beta blocker such as propranolol is prescribed to prevent varices from bleeding e. Bleeding esophageal varices can be managed by use of endoscopic variceal ligation f. The bleeding appears as dark coffee grounds in emesis or stool

a. All patients with cirrhosis should be screened for esophageal varices to detect them before they bleed b. bleeding esophageal varices are a medical emergency d. a nonselective beta blocker such as propranolol is prescribed to prevent varices from bleeding e. bleeding esophageal varices can be managed by use of endoscopic variceal ligation

Which tasks can be delegated to the UAP? SATA a. Assisting Ms. T with perineal care after diarrheal episodes b. Measuring vital signs every 2 hours for Mr. R c. Transporting Ms. H off the unit for a procedure d. Gently cleansing the nares around Ms. D's NG tube e. Removing Mr. A's dressing f. Helping Mr. K to brush his teeth

a. Assisting Ms. T with perineal care after diarrheal episodes b. measuring vital signs every 2 hours for Mr. R c. Transporting Ms. H off the unit for a procedure d. gently cleansing the nares around Ms. D's NG tube f. helping Mr. K to brush his teeth

Which are advantages of minimally-invasive surgery (MIS) laparoscopic cholecystectomy? SATA a. Complications are uncommon b. Mortality is similar to traditional cholecystectomy c. Patients recover more rapidly d. Postop pain is less severe e. Bile duct injuries are rare f. IV antibiotics are never needed because of decreased infection rates

a. Complications are uncommon c. Patients recover more rapidly d. Postop pain is less severe e. Bile duct injuries are rare

For which clinical indicators should the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice? SATA a. Dark urine b. Yellow skin c. Pain on urination d. Clay-colored stool e. Coffee-ground vomitus

a. Dark urine b. Yellow skin d. Clay-colored stool

A nurse is caring for a client with cholelithiasis and obstructive jaundice. When assessing this client, the nurse should be alert for which common clinical indicators associated with these conditions? SATA a. Ecchymosis b. Yellow sclera c. Dark brown stool d. Straw-colored urine e. Pain in right upper quadrant

a. Ecchymosis b. Yellow sclera e. Pain in right upper quadrant

Which abnormal laboratory findings are cardinal findings in acute pancreatitis? SATA a. Elevated serum lipase b. Increased serum amylase c. Decreased serum trypsin d. Elevated serum elastase e. Decreased serum glucose f. Elevated bilirubin

a. Elevated serum lipase b. Increased serum amylase d. Elevated serum elastase f. Elevated bilirubin

A client is diagnosed with cancer of the pancreas and is apprehensive and restless. Which nursing action should be included in the plan of care? a. Encouraging expression of concerns b. Administering antibiotics as prescribed c. Teaching the importance of getting rest d. Explaining that everything will be all right

a. Encouraging expression of concerns

The HCP has been paged and is en route to see Mr. R for complications related to acute pancreatitis. The client is increasingly agitated and confused. He pulls out his IV line and NG tube and removes the oxygen nasal cannula. His skin is pale and clammy. His pulse rate is 140 beats/min, and his blood pressure is 140/60 mmHg. List the following steps, in order of priority, in caring for Mr. R with 1 being the first and 6 being the last a. restart the IV line b. stay with the client and call for assistance c. replace the nasal cannula for supplemental oxygen d. have a colleague gather IV supplies, glucometer, pulse oximeter, and nonrebreather mask e. check the blood glucose level f. delegate UAP to take vital signs every 15 minutes

b, c, d, a, e, f

The patient is to continue pancreatic enzyme replacement therapy (PERT) after discharge. Which statement indicates that the patient understands teaching about this therapy? a. "I will take the enzymes before meals with a full glass of water." b. "I will take the enzymes after I take my ranitidine" c. "I will mix the enzymes with chopped meat" d. "I will chew the capsules before swallowing the enzymes"

b. "I will take the enzymes after I take my ranitidine"

The night nurse gives a brief and incomplete report. Which questions should the oncoming RN team leader pose to the night shift nurse to help determine the priority actions for Ms. H who was admitted for acute cholecystitis? a. "What are her vital signs" b. "Is she going to surgery or radiology this morning?" c. "Is she still having pain?" d. "Does she need any morning medications?"

b. "Is she going to surgery or radiology this morning?"

The UAP asks, "Why can't Ms. T (ulcerative colitis) get out of bed and do things for herself? She's only 29 years old." What is the team leader's best response? a. "The HCP ordered bed rest for a few days" b. "Decreasing activity helps to decrease the diarrhea" c. "I see you're frustrated; just do your best to help" d. "She is too depressed to get out of bed"

b. "decreasing activity helps to decrease the diarrhea"

A client is admitted with a tentative diagnosis of pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolyte balance, and decreasing anxiety. Which interventions should the nurse implement? SATA a. Provide a low-fat diet b. Administer analgesics c. Teach relaxation exercises d. Encourage walking in the hall e. Monitor cardiac rate and rhythm f. Observe for signs of hypercalcemia

b. Administer analgesics c. Teach relaxation exercises e. Monitor cardiac rate and rhythm

Which are manifestations of pancreatic cancer? SATA a. Light-colored urine and dark-colored stools b. Anorexia and weight loss c. Splenomegaly d. Ascites e. Leg or calf pain f. Weakness and fatigue

b. Anorexia and weight loss c. Splenomegaly d. Ascites e. Leg or calf pain f. Weakness and fatigue

Which assessment finding indicates neurologic function deterioration in a patient with stage II cirrhosis? a. Fetor hepaticus b. Asterixis c. Palmar erythema d. Icterus

b. Asterixis

The nurse is teaching a patient and family how to prevent exacerbations of chronic pancreatitis. Which teaching point does the nurse include? a. Moderation in the use of caffeinated beverages b. Avoidance of alcohol and nicotine c. Consume a bland, high-fat, low-protein diet d. Regular exercise, emphasizing aerobic activities

b. Avoidance of alcohol and nicotine

A nurse is preparing a teaching plan for a client with a history of cholelithiasis. Which information about why the ingestion of fatty foods will cause fatty foods will cause discomfort should the nurse include in the teaching plan? a. Fatty foods are hard to digest b. Bile flow into the intestine is obscured c. The liver is manufacturing inadequate bile d. There is inadequate closure of the amulla of Vater

b. Bile flow into the intestine is obscured

Which statements about hepatitis are accurate? SATA a. Hepatitis D is the leading cause of cirrhosis and liver failure in the US b. Hepatitis A is spread through the fecal-oral route c. Hepatitis B can be transmitted through unprotected sexual intercourse d. Hepatitis carriers have chronic obvious signs of hepatitis B e. Hepatitis C is transmitted by casual contact or intimate household contact f. Hepatitis D only occurs with hepatitis B to cause viral replication

b. Hepatitis A is spread through the fecal-oral route c. Hepatitis B can be transmitted through unprotected sexual intercourse f. Hepatitis D only occurs with Hepatitis B to cause viral replication

The patient with liver cancer will be discharged with a tunneled ascites drain. What statements by the patient indicate an understanding of the purpose of this device? SATA a. "I will have this drain until I am able to get the tumor removed." b. "I will not remove more than 2000 mL of fluid at a time." c. "The drain will make breathing more comfortable for me after some fluid is removed." d. "After I drain off the extra fluid, I can remove the drain." e. "This drain will be useful to remove fluid from my belly when there is too much." f. "I will flush the tunneled ascites drain twice a day with normal saline."

b. I will not remove more than 2000 mL of fluid at a time c. The drain will make breathing more comfortable for me after some fluid is removed e. This drain will be useful to remove fluid from my belly when there is too much

What instructions will the nurse give to the UAP about how to reposition Mr. R to relieve discomfort related to acute pancreatitis? a. place him in a high fowler position b. help him to lie in a side-lying "fetal" position c. lay the bed flat and put the client's legs on a pillow d. help him to sit on edge of bed and dangle his legs

b. help him to lie in a side-lying "fetal" position

The nurse is assessing a patient with liver trauma and finds that the patient is confused, with a blood pressure of 86/50 mmHg, heart rate of 128/minute, and cool, clammy skin. What does the nurse suspect? a. Septic shock b. Liver hemorrhage c. Liver cancer d. GI bleeding

b. liver hemorrhage

Mr. K (PEG tube) needs 1200 kcals/day. The enteral feeding fomula provides 1 kcal/mL. Yesterdays formula feedings were 100mL at 7am, 50 mL at 11am, 200mL at 3pm, and 100mL at 7pm. What should the nurse do first? a. give additional feedings to catch up on nutritional needs b. look at the original prescription to determine frequency and amount c. look at weight trends to see if client is losing or maintaining weight d. call the nurse who cared for Mr. K yesterday and ask what happened

b. look at the original prescription to determine frequency and amount

What is the major source of hepatitis B transmission to health care workers? a. Improper handwashing b. Needle sticks c. Touching contaminated surfaces d. Contact with infected stool

b. needle sticks

Mr. R (acute pancreatitis) demonstrates a dry cough. He reports left-sided chest pain when breathing deeply and shortness of breath. He also has a low-grade fever. Which potential complication does the nurse suspect? a. hypovolemic shock b. pleural effusion c. paralythic ileus d. acute respiratory distress syndrome

b. pleural effusion

A patient is scheduled for tests to verify the medical diagnosis of cholecystitis. For which diagnostic test does the nurse provide patient teaching? a. Extracorporeal shock wave lithotripsy (ESWL) b. Ultrasonography of the right upper quadrant c. Endoscopic retrograde cholangiopancreatography (ERCP) d. Serum level of aspartate aminotransferase (AST)

b. ultrasonography of the right upper quadrant

The nurse has instructed a patient in the recovery phase of acute pancreatitis about diet therapy. Which statement by the patient indicates that teaching has been successful? a. "I will eat the usual three meals a day that I am used to." b. " I am eating tacos for my first meal back home." c. "I will avoid eating chocolate and drinking coffee." d. "I will limit the amount of protein in my diet."

c "I will avoid eating chocolate and drinking coffee"

A female patient is to have her gallbladder removed by natural orifice transluminal endoscopic surgery. What does the nurse teach about this surgery? a. The surgeon will use powerful shock waves to break up the gallstones b. The surgeon will insert a transhepatic biliary catheter to open blocked bile ducts c. The surgeon will use a vaginal approach to remove the gallbladder d. The surgeon will inject ursodeoxycholic acid to dissolve any remaining gallstone fragments

c The surgeon will use a vaginal approach to remove the gallbladder

A patient with acute pancreatitits is at risk for the development of paralytic (adynamic) ileus. Which action provides the nurse with the best indication of bowel function? a. Observing contents of the nasogastric drainage b. Weighing the patient every day at the same time c. Asking the patient if he or she has passed flatus or had a stool d. Obtaining a computed tomography (CT) scan of the abdomen with contrast medium

c asking the patient if he or she has passed flatus or had a stool

The nurse notes that Mr. R (acute pancreatitis) has a small amount of blood oozing from the IV insertion site, and there is a palm-shaped bruise on his anterior lateral humerus. What action should the nurse take first? a. remove the IV line and restart it at different site b. remind the UAP to handle Mr. R very gently c. assess for other signs of obvious or occult bleeding d. obtain an order for coagulation studies

c. assess for other signs of obvious or occult bleeding

The patient who had a liver transplant develops a heart rate of 134/minute, temperature of 102 F, jaundiced skin, and right upper quadrant pain. What does the nurse suspect? a. Liver infection b. Hypovolemic shock c. Liver transplant rejection d. Liver trauma from the transplant surgery

c. liver transplant rejection

A client with chronic hepatic failure is soon to be discharged from the hospital. Which diet should the nurse encourage the client to follow based on the health care provider/s order? a. High-fat b. Low-calorie c. Low-protein d. High-sodium

c. low-protein

What is one of the main advantages of cholecystectomy by the natural orifice transluminal endoscopic sugery (NOTES) procedure? a. Very small visible incisions b. Jackson-Pratt drain removes excess fluid c. No visible incision lines d. Resumption of normal activities the day of surgery

c. no visible incision lines

What test result is the tumor marker for cancers of the liver? a. Decreased alkaline phosphatase b. Increased serum ammonia c. Decreased serum total bilirubin d. Increased alpha-fetoprotein (AFP)

d. increased alpha-fetoprotein (AFP)

Which type of drug is used to treat acute severe biliary pain? a. Acetaminophen b. Nonsteroidal antiinflammatory drugs (NSAIDs) c. Antiemetics d. Opioids

d. opioids

Which intervention should the nurse delegate to the unlicensed assistive personnel (UAP) when caring for a patient with cirrhosis experiencing pruritus? a. Apply lotion to soothe the patient's skin b. Use lots of soap and hot water to cleanse the skin c. Assess the patient for signs of skin infection d. Encourage the patient to use distraction to avoid scratching

a. Apply lotion to soothe the patient's skin

The nurse is teaching a young woman about cirrhosis prevention by limiting alcohol intake. What is the nurse's best advice? a. "As few as two or three drinks per day over 10 years can lead to cirrhosis." b. "You could be all right as long as you drink less than five drinks per day." c. "Binge drinking, rather than drinking every day, reduces your risk for hepatitis or fatty liver." d. "The amount of alcohol that causes cirrhosis does not vary by gender."

a. As few as two or three drinks per day over 10 years can lead to cirrhosis

Which clients would be best to assign to the new RN? SATA a. Ms. H b. Ms. D c. Ms. T d. Mr. A e. Mr. K f. Mr. R

a. Ms. H b. Ms. D d. Mr. A

When teaching a group of adult patients about measures for preventing hepatitis A (HAV), which information does the nurse include? SATA a. Perform proper handwashing, especially after handling shellfish b. Receive immune globulin within 14 days if exposed to the virus c. Receive the HAV vaccine before traveling to Mexico or the Caribbean d. After exposure, HAV symptoms always let the patient know something is wrong e. Receive the vaccine if working in a long-term care facility f. Avoid unprotected sex with a person who has HAV

a. Perform proper handwashing especially after handling shellfish b. Receive immune globulin within 14 days if exposed to the virus c. Receive the HAV vaccine before traveling to Mexico or the Caribbean e. Receive the vaccine if working in a long-term care facility

Which is a key feature of pancreatic cancer? a. Anorexia b. Weight gain c. Pale urine d. Dark-colored stools

a. anorexia

Which factors may lead to hepatic encephalopathy in patients with cirrhosis? SATA a. High-protein diet b. Hypervolemia c. Infection d. Constipation e. Hyperkalemia f. Use of illicit drugs

a. high-protein diet c. infection d. constipation f. use of illicit drugs

Because of Mr. K's (PED tube) advanced age, which complications of enteral feedings may occur? SATA a. hyperglycemia b. hypotension c. aspiration d. diarrhea e. fluid overload f. weight loss

a. hyperglycemia c. aspiration d. diarrhea e. fluid overload

The nurse is evaluating electrolyte values for a patient with acute pancreatitis and notes that the serum calcium is 6.8 mEq/L. How does the nurse interpret this finding? a. Within normal limits considering the diagnosis of acute pancreatitis b. A result of the body not being able to use bound calcium c. A protective measure that will reduce the risk of complications d. Full compensation of the parathyroid gland

b a result of the body not being able to use bound calcium

Which diagnostic test is the most accurate in verifying a diagnosis of acute pancreatitis? a. Trypsin b. Lipase c. Alkaline phosphatase d. Alanine aminotransferase

b lipase

The patient with acute cholecystitis has a pacemaker. Which diagnostic test is contraindicated? a. Extracorporeal shock wave lithotripsy (ESWL) b. Magnetic resonance cholangiopancreatography (MRCP) c. Ultrasonography of the right upper quadrant d. Hepatobiliary (HIDA) scan

b magnetic resonance cholangiopancreatography (MRCP)

The nurse is teaching a patient with cirrhosis about nutrition therapy. Which statement by the patient indicates teaching has been effective? a. "I will only use table salt with my dinner meal." b. "I will read the sodium content labels on all food and beverages." c. "I will avoid the use of vinegar." d. "I will not take vitamin supplements."

b. I will read the sodium content labels on all food and beverages

The nurse is caring for a patient with acute viral hepatitis. What is the major care concern at this time? a. Providing three small meals a day b. Alternating periods of activity with periods of rest c. Monitoring for the development of jaundiced skin d. Teaching the patient the importance of avoiding alcohol intake

b. alternating periods of activity with periods of rest

The patient with acute necrotizing pancreatitis experiences a temperature spike to 104 F. What does the nurse suspect? a. Pancreatic pseudocyst b. Pancreatic abscess c. Chronic pancreatitis d. Pancreatic cancer

b. pancreatic abscess

The RN is teaching the nursing student about enteral feedings for clients such as Mr. K, who has a PEG tube. In the postoperative period, when can enteral feedings be started? a. Within 6-8 hours after the procedure b. When bowel sounds occur, usually within 24 hours c. When the client reports feeling hungry d. On a schedule determined by the pharmacy

b. when bowel sounds occur, usually within 24 hours

The patient comes to the emergency department with severe abdominal pain in the midepigastric area. The patient states that the pain began suddenly, is continuous, radiates to his back, and is worst when he lies flat on his back. What condition does the nurse suspect? a. Acute cholecystitis b. Pancreatic cancer c. Acute pancreatitis d. Pancreatic pseudocyst

c acute pancreatitis

How many vaccine injections does a health care worker usually need to be protected with the hepatitis B vaccine? a. 1 b. 2 c. 3 d. 4

c. 3

The daughter of a patient with cholelithiasis has heard that there is a genetic disposition for cholelithiasis. The daughter asks the nurse about the risk factors. How does the nurse respond? a. "There is no evidence that first-degree relatives have an increased risk for this disease." b. "Cholelithiasis is seen more frequently in patients whoa re underweight." c. "Hormone replacement therapy has been associated with increased risk for cholelithiasis." d. "Patients with diabetes mellitus are at increased risk for cholelithiasis."

c. Hormone replacement therapy has been associated with increased risk for cholelithiasis

The nurse is assessing a patient with massive ascites. What related complication must the nurse monitor for with this patient? a. Bleeding due to fragile, thin-walled veins b. Hematemesis due to absence of clotting factors c. Increased ascites due to sodium and water retention d. Bruising due to low platelet count

c. Increased ascites due to sodium and water retention

Which patient would the nurse assess as low risk for the development of gallbladder disorders? a. Patient with sickle cell anemia b. Patient who is Mexican American c. Patient who is 20 years old and male d. Patient with a history of prolonged parenteral nutrition

c. Patient who is 20 years old and male

The health care provider told Ms. H (acute cholecystitis) that she would probably need a laparoscopic cholecystectomy.; however, the hepatobiliary iminodiacetic acid (HIDA) scan and laboratory results are still pending. Ms. H asks, "What should I expect?" What is the best intervention at this point? a. Describe the surgical procedure b. Call the HCP to come and speak with her c. Provide some written material about gallbladder disease and options d. Explain general postoperative care, such as coughing and deep breathing exercises

c. Provide some written material about gallbladder disease and options

The HCP arrives while the RN team leader is caring for Mr. R. Because of Mr. R's deteriorating status, the team leader would advocate for which intervention? a. Perform additional laboratory tests and continue monitoring b. Prepare Mr. R for emergency surgery c. Prepare Mr. R for transfer to the ICU d. Reestablish NG suction and apply restraints or use one-on-one observation

c. prepare Mr. R for transfer to the ICU

Which reporting tasks are appropriate to delegate to the UAP? SATA a. Reporting on the condition of Ms. T's perineal area after application of ointment b. Reporting the quality and color of NG drainage for Ms. D c. Reporting whether Mr. R's blood pressure is below 100/60 mmHg d. Reporting if any of the clients indicate pain e. Reporting if Mr. A is seen leaving the unit to smoke a cigarette f. Reporting that Mr. K's family has questions

c. reporting whether Mr. R's blood pressure is below 100/60 mmHg d. reporting if any of the clients indicate pain e. reporting if Mr. A is seen leaving the unit to smoke a cigarette f. reporting that Mr. K's family has questions

Which condition is most likely to be treated with antibiotics? a. Cancer of the gallbladder b. Acute cholelithiasis c. Chronic pancreatitis d. Acute necrotizing pancreatitis

d acute necrotizing pancreatitis

Disseminated intravascular coagulation (DIC) is a complication of pancreatitis. What pathophysiology leads to this complication? a. Hypovolemia b. Peritoneal irritation and seepage of pancreatic enzymes c. Disruption of alveolar-capillary membrane d. Consumption of clotting factors and formation of microthrombi

d consumption of clotting factors and formation of microthrombi

Administration of which drug has greatly improved the success of organ transplants? a. Telaprevir b. Entecavir c. Tenofovir d. Cyclosporine

d. cyclosporine

A patient will undergo an abdominal paracentesis. Which factor provides an additional safety measure? a. The procedure is performed using ultrasound b. The procedure is performed at the bedside c. A trocar is inserted into the peritoneal cavity d. General anesthesia is administered

a. the procedure is performed using ultrasound

Which treatment offers the patient with liver cancer the possibility of long-term survival? a. Chemotherapy b. Selective internal radiation therapy c. Liver transplantation d. Hepatic arterial embolization

c. Liver transplantation

Ms. T is receiving an oral dose of sulfasalazine 500 mg every 6 hours for treatment of ulcerative colitis. Which assessment finding is cause for greatest concern? a. decreased appetitie b. nausea and vomiting c. decreased urine output d. headache

c. decreased urine output

Ms. H's (acute cholecystitis) HIDA scan shows a decreased bile flow with gallbladder disease and obstruction. Because of the obstruction, the nurse is vigilant for the complication of biliary colic. What are the key signs and symptoms that the nurse will watch for? a. Rebound tenderness and sausage-shaped mass in the right upper quadrant b. Flatulence, dyspepsia, and eructation after eating or drinking c. Right upper quadrant abdominal pain that radiates to the right shoulder or scapula d. Severe abdominal pain with tachycardia, pallor, diaphoresis, and prostration

.d. severe abdominal pain with tachycardia, pallor, diaphoresis, and prostration

What is the most common and serious complication after a Whipple procedure? a. Diabetes mellitus b. Wound infection c. Fistula development d. Bowel obstruction

c. Fistula development

The patient with acute pancreatitis experiences abdominal pain. What is the best intervention to begin managing this pain? a. IV opioids by means of patient-controlled analgesia (PCA) b. Oral opioids such as morphine sulfate given as needed c. Intramuscular opioids given every 6 hours d. Oral hydromorphone (Dilaudid) given twice a day

a IV opioids by means of patient-controlled analgesia (PCA)

Which are common manifestations of acute cholecystitis? SATA a. Anorexia b. Ascites c. Eructation d. Steatorrhea e. Jaundice f. Rebound tenderness

a anorexia c eructation e jaundice f rebound tenderness

Which antiviral drugs are given to patients with chronic hepatitis B virus? SATA a. Lamivudine b. Entecavir c. Tenofovir d. Oral ribavirin e. Adefovir f. Telaprevir

a. Lamivudine b. Entecavir c. Tenofovir e. Adefovir

The nurse is caring for an older adult patient with acute biliary pain. Which drug order does the nurse question? a. Ketorolac b. Meperidine c. Morphine d. Hydromorphone

b. meperidine

Ms. D (bowel obstruction) reports feeling weak. She seems more confused compared with her baseline. The NG drainage container has a large amount of water bile-colored fluid. Which laboratory values should be checked first? a. Blood urea nitrogen and creatinine levels b. Platelet count and WBC count c. Sodium level, potassium level, and pH of blood d. Bilirubin level, hematocrit, and hemoglobin level

c. sodium level, potassium level, and pH of blood

For Mr. K (PEG tube0 several new medications and a change in the enteral feeding solution are included in the discharge plan. Which team member is the nurse most likely to consult before teaching the client and family about these new medications and enteral solution? a. nutritionist to verify that the calories and other nutrients are sufficient b. home health nurse to verify that follow-up teaching will be performed c. social worker to verify that medications and formula are covered by insurance d. pharmacist to verify that medications are compatible with the feeding solution

d. pharmacist to verify that medications are compatible with the feeding solution

Which procedure uses energy waves to heat cancer cells and kill them? a. Cryotherapy b. Selective internal radiation therapy (SIRT) c. Hepatic artery embolization d. Radiofrequency ablation (RFA)

d. radiofrequency ablation (RFA)

A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count. A regular diet is ordered. What should the nurse instruct the client to do considering the client's condition? a. Avoid foods high in vitamin K b. Check the pulse several times a day c. Drink a glass of milk when taking aspirin d. Report signs of bleeding no matter how slight

d. report signs of bleeding no matter how slight

Because of Ms. T's (ulcerative colitis) diarrhea, the nurse is reviewing the laboratory results. Which laboratory results are cause for greatest concern? a. The WBC count is slightly increased b. The hemoglobin and hematocrit are slightly decreased c. The erythrocyte sedimentation rate (ESR) is increased d. The serum sodium and potassium levels are decreased

d. the serum sodium and potassium levels are decreased

The RN is supervising the nursing student in administering Ms. D's (bowel obstruction) medications through the NG tube. When would the nurse intervene? a. The student compares medication administration record with the original prescription b. The student draws up 30 mL of water for flush in a large-bore syringe c. The student performs three checks of the medication names and dosages d. The student crushes tablets and puts all medications in the same cup

d. the student crushes tablets and puts all medications in the same cup

The night shift nurse has just finished giving the RN team leader a report on the six clients. Which client has the highest acuity level and is at greatest risk for shock during the shift? a. Ms. H (acute cholecystitis) b. Ms. D (bowel obstruction) c. Ms. T (ulcerative colitis) d. Mr. A (appendectomy) e. Mr. K (PEG tube) f. Mr. R (acute pancreatitis)

f. Mr. R

Which conditions place a patient at high risk for the development of fatty liver (steatosis)? SATA a. Hypertension b. Diabetes mellitus c. Obesity d. Elevated lipid profile e. Alcohol abuse f. Hepatitiis A

b. Diabetes mellitus c. obesity d. elevated lipid profile e. alcohol abuse

A patient is scheduled for a procedure to place a stent in the biliary tract. For which procedure does the nurse provide patient teaching? a. Esophagogastroduodenoscopy (EGD) b. Endoscopic retrograde cholangiopancreatography (ERCP) c. Upper gastrointestinal (GI) series d. Cholangiogram

b. ERCP

The nurse identifies which laboratory value as the usual indication of hepatic encephalopathy? a. Elevated sodium level b. Elevated ammonia level c. Increased blood urea nitrogen (BUN) d. Increased clotting time

b. Elevated ammonia level

The nurse detects an epigastric mass while assessing a patient with acute pancreatitis. The patient describes epigastric pain that radiates to his back. What does the nurse suspect? a. Liver cirrhosis b. Pancreatic pseudocyst c. Gallstones d. Chronic pancreatitis

b. Pancreatic pseudocyst

All of these clients must receive their routine morning medications. Which client should receive his or her medication last? a. Ms. H (acute cholecystitis) b. Ms. D (bowel obstruction) c. Ms. T (ulcerative colitis) d. Mr K (PEG-tube)

d. Mr. K (PEG-tube)

The nurse who is assessing a patient with portal-systemic encephalopathy finds that the patient has fetor hepaticus, a positive Babinski's sign, and seizures, but no asterixis. The nurse identifies the patient as being in which stage of portal-systemic encephalopathy? a. Stage I prodromal b. Stage II impending c. Stage III stuporous d. Stage IV comatose

d. Stage IV comatose

Patients with cirrhosis are susceptible to bleeding and easy bruising because there is a decrease in the production of bile in the liver, preventing the absorption of which vitamin? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K

d. Vitamin K

Toward the end of the shift, the team leader finds the new RN in the bathroom crying. The new nurse says "I'm a terrible nurse. I'm so disorganized, and I'm so far behind. I'm going to quit. I hate this job." What is the best thing to do? a. Have her take a short break off the unit b. Offer to take one of her clients c. Ask the UAP to help her d. Calm her down and help her prioritize

d. calm her down and help her prioritize

The patient with cirrhosis is prescribed furosemide 60 mg orally each morning. Which patient care concept is at risk for this patient? a. Comfort b. Cellular regulation c. Immunity d. Fluid and electrolyte balance

d. fluid and electrolyte balance

For which clinical indicator associated with a complication of portal hypertension should the nurse assess the client? a. Liver abscess b. Intestinal obstruction c. Perforation of the duodenum d. Hemorrhage from esophageal varices

d. hemmorhage from esophageal varices

The patient who just had a liver transplant develops oozing around two IV sites as well as some new bruising. What is the nurse's best first action? a. Apply pressure to the IV sites b. Measure the size of the bruises c. Document these findings as the only action d. Notify the surgeon immediately

d. notify the surgeon immediately

The nurse is teaching a patient with cirrhosis about lactulose therapy. Which statement by the patient indicates the teaching has been effective? a. "This therapy will promote the removal of ammonia in my stool." b. "Constipation is a frequent side effect of this therapy." c. "I will know the therapy is working when I am less itchy." d. "The drug tastes bitter and is watery."

a. "this therapy will promote the removal of ammonia in my stool"

Psychosocial assessment reveals that Mr. A (appendectomy) faces several financial and personal problems. Which finding has the most impact on discharge teaching for wound care and other follow up issues? a. he is homeless and has no family in the city b. he has no money for the prescribed medications c. he has no transportation to the follow-up appointment d. he cannot read or write very well

a. he is homeless and has no family in the city

Which factor renders a patient the least likely to benefit from extracorporeal shock wave lithotripsy (ESWL) for the treatment of gallstones? a. Height 5 feet 10 inches, 325 pounds b. Cholesterol-based stones c. Height 5 feet 7 inches, 138 pounds d. Small gallstones

a. height 5 feet 10 inches, 325 pounds

What information regarding Mr. R (acute pancreatitis) is appropriate to report to the HCP? SATA a. hematocrit is decreased by more than 10% b. calcium level is less than 9 mg/dL c. partial oxygen pressure (PO2) is less than 60 mmHg d. pain is unrelieved by medication e. blood type is O positive f. NG tube and IV line are intact

a. hematocrit is decreased by more than 10% b. calcium level is less than 9 mg/dL c. partial oxygen pressure (PO2) is less than 60 mmHg d. pain is unrelieved by medication

Which actions will help prevent viral hepatitis in health care workers? SATA a. Wash hands before and after each patient b. Use needleless systems c. Use contact and respiratory precautions d. After exposure to hepatitis A, get immunoglobulin (Ig) e. Report all cases of hepatitis to the health department f. Wear gloves during all patient contacts

a. wash hands before and after each patient b. use needleless systems d. after exposure to hepatitis A, get immunoglobulin (Ig) e. report all cases of hepatitis to the health department

The nurse is reviewing the medication administration record for Ms. T (ulcerative colitis) Which situation needs immediate investigation? a. Two tablets of senna were given yesterday morning b. One dose of atropine sulfate was given yesterday morning c. IV infusion of infliximab 5 mg/kg was given last evening d. IV hydrocortisone 100 mg was given last evening

a.. two tablets of senna were given yesterday morning

The nursing student is caring for a patient with chronic pancreatitis who is receiving pancreatic enzyme replacement therapy. Which statement by the student indicates the need for further study concerning this therapy? a. "The enzymes will be administered with meals." b. "The patient will take the drugs with a glass of water." c. "If the patient has difficulty swallowing the enzyme preparation, I will crush it and mix it with foods." d. "The effectiveness of pancreatic enzyme treatment is monitored by the frequency and fat content of stools."

c. "If the patient has difficulty swallowing the enzyme preparation, I will crush it and mix it with foods."

Mr. A (appendectomy) will be discharged with prescriptions for pain medication and an antibiotic. What is the most important point that the nurse will emphasize about the medications? a. "Take the pain medication before the pain becomes severe" b. "The pain medication may make you feel drowsy or sleepy c. "All of the antibiotics should be taken, even if you feel good" d. "The antibiotics should not be shared with any other person"

c. "all of the antibiotics should be taken, even if you feel good"

The new RN asks the team leader if it is okay to give Ms. D (bowel obstruction) a dose of psyllium using the HCP's standing orders. Ms. D says, "She feels constipated and takes psyllium on a regular basis at home" What is team leader's best response? a. "Call the HCP to see if the standing orders apply to Ms. D" b. "Give the psyllium according to the standing orders" c. "Laxatives can cause perforation if there is a bowel obstruction" d. "The client can't be constipated because she is NPO"

c. "laxatives can cause perforation if there is a bowel obstruction"

While the nurse is teaching Mr. A about dressing changes for his appendectomy wound, he says, "When you live on the street, you can't do everything the way you nurses do in the hospital" What is the most important thing to emphasize in helping him to accomplish self-care? a. "Change the dressing in the AM and the PM" b. "Use the gauze package to make a sterile field" c. "Wash your hands before a dressing change" d. "Discard any opened packages of unused gauze"

c. "wash your hand before a dressing change"

The patient who needs a liver transplant asks the nurse where the livers come from. What is the nurse's best response? a. "Most commonly they come from family members." b. "Often they are harvested from cadavers." c. "Trauma victims are where most donor livers come from." d. "It is best if the liver comes from a blood relative."

c. Trauma victims are where most donor livers come from

The nurse is assessing a patient with acute cholecystitis whose abdominal pain is severe. The patient is pale, is diaphoretic, and describes extreme fatigue. Vital signs are: heart rate of 118/minute, BP 95/70, respirations 32/min, temperature 101 F. What is the nurse's priority action at this time? a. Instruct the unlicensed assistive personnel (UAP) to reposition the patient for comfort b. Auscultate the patient's abdomen in all four quadrants c. Notify the patient's health care provider d. Administer the ordered opioid analgesic

c. notify the patient's health care provider

Which statement about the care of a patient with a Jackson-Pratt (JP) drain after a traditional cholecystectomy is true? a. The patient is maintained in the prone position b. When the patient is allowed to eat, the JP drain is clamped continuously c. The JP drain is irrigated every hour for the first 24 hours d. Serosanguineous drainage stained with bile is expected for 24 hours

d Serosanguineous drainage stained with bile is expected for 24 hours

After removal of the gallbladder, a patient experiences abdominal pain with vomiting for several weeks. What does the nurse recognize? a. Chronic cholecystitis b. Recurrence of acute cholecystitis c. Unremoved gallstones d. Postcholecystectomy syndrome

d postcholecystectomy syndrome

Ms. T is discouraged and dispirited about her ulcerative colitis. She is resistant to TPN because "I'm being kept alive with tubes" Which explanation will encourage Ms. T to continue with the TPN therapy? a. "it will help you regain your weight" b. "it will create a positive nitrogen balance" c. "your health care provider has ordered this important therapy for you" d. "your bowel can rest, and the diarrhea will decrease"

d. "your bowel can rest, and the diarrhea will decrease"

The health care provider has assessed a patient's abdomen and found rebound tenderness on deep palpation. What does the nurse recognize? a. Steatorrhea b. Eructation c. Biliary colic d. Blumberg's sign

d. Blumberg's sign

What is the most common cause for Laennec's cirrhosis? a. Hepatitis C virus (HPC) b. Chronic biliary obstruction c. Autoimmune disorders d. Chronic alcoholism

d. Chronic alcoholism

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding? a. Promotes the formation of calculi in the cystic duct b. Stimulates the pancreas to secrete more insulin than it can immediately produce c. Alters the composition of enzymes so they are capable of damaging the pancreas d. Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

d. Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

How is neomycin sulfate used to treat patients with cirrhosis? a. It treats the current infection the patient has b. It prevents future infections of the liver c. It restores normal function to the liver cells d. It decreases the rate of ammonia production

d. It decreases the rate of ammonia production