Pancreas & Gallbladder Practice Questions

A nurse cares for a client who is recovering from laparoscopic cholecystectomy surgery. The client reports pain in the shoulder blades. How should the nurse respond? a. Ambulating in the hallway twice a day will help. b. I will apply a cold compress to the painful area on your back. c. Drinking a warm beverage can relieve this referred pain. d. You should cough and deep breathe every hour.

a. Ambulating in the hallway twice a day will help.

A nurse assesses a client who is recovering from an open Whipple procedure. Which action should the nurse perform first? a. Assess the clients endotracheal tube with 40% FiO2. b. Insert an indwelling Foley catheter to gravity drainage. c. Place the clients nasogastric tube to low intermittent suction. d. Start lactated Ringers solution through an intravenous catheter.

a. Assess the clients endotracheal tube with 40% FiO2.

The nurse and a CNA are caring for clients on an oncology floor. Which interventions should the nurse delegate to the CNA? a. Assist the client with abdominal pain to turn to the side and flex the knees. b. Monitor the Jackson Pratt drainage tube to ensure it is draining properly. c. Check to see if the client is sleeping after pain medication is administered. d. Empty the bedside commode of the client who has been having melena.

a. Assist the client with abdominal pain to turn to the side and flex the knees.

The client is diagnosed with cancer of the head of the pancreas. Which signs and symptoms should the nurse expect to assess? a. Clay-colored stools and dark urine b. Night sweats and fever c. LLQ abdominal cramps and tenesmus d. Nausea and coffee-ground emesis

a. Clay-colored stools and dark urine

A nurse prepares to discharge a client with chronic pancreatitis. Which question should the nurse ask to ensure safety upon discharge? a. Do you have a one- or two-story home? b. Can you check your own pulse rate? c. Do you have any alcohol in your home? d. Can you prepare your own meals?

a. Do you have a one- or two-story home?

A nurse assesses a client who is recovering from a Whipple procedure. Which assessment finding alerts the nurse to urgently contact the health care provider? a. Drainage from a fistula b. Absent bowel sounds c. Pain at the incision site d. Nasogastric (NG) tube drainage

a. Drainage from a fistula

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? SATA: a. Fever b. Positive Cullen's Sign c. Complains of indigestion d. Palpable mass in the LUQ e. Pain in the RUQ after a fatty meal f. Vague LRQ abdominal discomfort

a. Fever c. Complains of indigestion e. Pain in the RUQ after a fatty meal

A nurse cares for a client with end-stage pancreatic cancer. The client asks, Why is this happening to me? How should the nurse respond? a. I dont know. I wish I had an answer for you, but I dont. b. Its important to keep a positive attitude for your family right now. c. Scientists have not determined why cancer develops in certain people. d. I think that this is a trial so you can become a better person because of it.

a. I dont know. I wish I had an answer for you, but I dont.

The nurse is administering a pancreatic enzyme to the client diagnosed with chronic pancreatitis. Which statement best explains the rationale for administering the medication? a. It is an exogenous source of protease, amylase, and lipase. b. The enzyme increases the number of bowel movements. c. This medication breaks down in the stomach to help with digestion. d. Pancreatic enzymes help break down fat in the small intestines.

a. It is an exogenous source of protease, amylase, and lipase.

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed to the client? SATA: a. Maintain NPO status b. Encourage coughing and deep breathing c. Give small, frequent high-calorie feedings. d. Maintain the client in a supine and flat position e. GIve hydromorphone IV as prescribed for pain. f. Maintain IV fluids at 10 mL/hr to keep the vein open

a. Maintain NPO status b. Encourage coughing and deep breathing e. GIve hydromorphone IV as prescribed for pain.

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which of the following? a. Malaise b. Dark stools c. Weight gain d. Left upper quadrant discomfort

a. Malaise

The client with an acute exacerbation of chronic pancreatitis has an NG tube. Which interventions should the nurse implement? SATA: a. Monitor the client's bowel sounds. b. Monitor the client's food intake. c. Assess the client's IV site. d. Provide oral and nasal care. e. Monitor the client's blood glucose.

a. Monitor the client's bowel sounds. c. Assess the client's IV site. d. Provide oral and nasal care. e. Monitor the client's blood glucose.

The nurse is preparing to administer AM medications to clients. Which medication should the nurse question before administering? a. Pancreatic enzymes to the client who has finished breakfast. b. The pain medication, morphine, to the client who has a RR of 20. c. The loop diuretic to the client who has a serum potassium level of 3.9 d. The beta-blocker to the client who has an apical pulse of 68.

a. Pancreatic enzymes to the client who has finished breakfast. Rationale: Pancreatic enzymes must be administered with food/meals to enhance the digestion of starches and fats in the GI tract.

A nurse plans care for a client who has acute pancreatitis and is prescribed nothing by mouth (NPO). With which health care team members should the nurse collaborate to provide appropriate nutrition to this client? (Select all that apply.) a. Registered dietitian b. Nursing assistant c. Clinical pharmacist d. Certified herbalist e. Health care provider

a. Registered dietitian c. Clinical pharmacist e. Health care provider

The client diagnosed with cancer of the pancreas is being discharged to start chemotherapy in the HCP's office. Which statement made by the client indicates the client understands the discharge instructions? a. "I will have to see the HCP everyday for 6 weeks for my treatments." b. "I should write down all of my questions so I can ask them when I see the HCP." c. "I am sure that this is not going to be a serious problem for me to deal with." d. "The nurse will give me an injection in my leg and I will get to go home."

b. "I should write down all of my questions so I can ask them when I see the HCP."

Which client problem has priority for the client diagnosed with acute pancreatitis? a. Risk for fluid volume deficit b. Alteration in comfort c. Imbalanced nutrition: less than body requirements d. Knowledge deficit

b. Alteration in comfort

The home healthcare nurse is admitting a client diagnosed with cancer of the pancreas. Which information is the most important for the nurse to discuss with the client? a. Determine the client's food preferences. b. Ask the client if there is an advance directive. c. Find out about insurance/Medicare reimbursement. d. Explain the client should eat as much as possible.

b. Ask the client if there is an advance directive.

A nurse teaches a client who is recovering from acute pancreatitis. Which statements should the nurse include in this clients teaching? (Select all that apply.) a. Take a 20-minute walk at least 5 days each week. b. Attend local Alcoholics Anonymous (AA) meetings weekly. c. Choose whole grains rather than foods with simple sugars. d. Use cooking spray when you cook rather than margarine or butter. e. Stay away from milk and dairy products that contain lactose. f. We can talk to your doctor about a prescription for nicotine patches.

b. Attend local Alcoholics Anonymous (AA) meetings weekly. d. Use cooking spray when you cook rather than margarine or butter. f. We can talk to your doctor about a prescription for nicotine patches.

After teaching a client who is recovering from laparoscopic cholecystectomy surgery, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching? a. Drinking at least 2 liters of water each day is suggested. b. I will decrease the amount of fatty foods in my diet. c. Drinking fluids with my meals will increase bloating. d. I will avoid concentrated sweets and simple carbohydrates.

b. I will decrease the amount of fatty foods in my diet.

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food." Which instruction should the nurse give the client to provide adequate nutrition? A. Select foods high in fat b. Increase intake of fluids, including juices c. Eat a good supper when anorexia is not as severe d. Eat less often, preferably only 3 large meals a day.

b. Increase intake of fluids, including juices

A nurse collaborates with an unlicensed assistive personnel (UAP) to provide care for a client who is in the healing phase of acute pancreatitis. Which statements focused on nutritional requirements should the nurse include when delegating care for this client? (Select all that apply.) a. Do not allow the client to eat between meals. b. Make sure the client receives a protein shake. c. Do not allow caffeine-containing beverages. d. Make sure the foods are bland with little spice. e. Do not allow high-carbohydrate food items.

b. Make sure the client receives a protein shake. c. Do not allow caffeine-containing beverages. d. Make sure the foods are bland with little spice.

A nurse cares for a client who is recovering from an open Whipple procedure. Which action should the nurse take? a. Clamp the nasogastric tube. b. Place the client in semi-Fowlers position. c. Assess vital signs once every shift. d. Provide oral rehydration.

b. Place the client in semi-Fowlers position.

A nurse assesses a client who is recovering from a Whipple procedure. Which clinical manifestations alert the nurse to a complication from this procedure? (Select all that apply.) a. Clay-colored stools b. Substernal chest pain c. Shortness of breath d. Lack of bowel sounds or flatus e. Urine output of 20 mL/6 hr

b. Substernal chest pain c. Shortness of breath d. Lack of bowel sounds or flatus e. Urine output of 20 mL/6 hr

The client had a total pancreatectomy and splenectomy for cancer of the body of the pancreas. Which discharge instruction should the nurse teach? SATA: a. Keep a careful record of intake and output. b. Use a stool softener or bulk laxative regularly. c. Use correct insulin injection technique. d. Take the pain medication before the pain gets too bad. e. Sleep with the HOB on blocks.

b. Use a stool softener or bulk laxative regularly. c. Use correct insulin injection technique. d. Take the pain medication before the pain gets too bad.

The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs further information if the client makes which statement? a. "I know I must sign the consent form." b. "I hope that the throat spray keeps me from gagging." c. "I'm glad I don't have to lie still for this procedure." d. "I am glad some IV medication will be given to relax me."

c. "I'm glad I don't have to lie still for this procedure."

A nurse assesses clients at a community health center. Which client is at highest risk for pancreatic cancer? a. A 32-year-old with hypothyroidism b. A 44-year-old with cholelithiasis c. A 50-year-old who has the BRCA2 gene mutation d. A 68-year-old who is of African-American ethnicity

c. A 50-year-old who has the BRCA2 gene mutation

A nurse prepares to assess the emotional state of a client with end-stage pancreatic cancer. Which action should the nurse take first? a. Bring the client to a quiet room for privacy. b. Pull up a chair and sit next to the clients bed. c. Determine whether the client feels like talking about his or her feelings. d. Review the health care providers notes about the prognosis for the client.

c. Determine whether the client feels like talking about his or her feelings.

The nurse is completing discharge teaching to the client diagnosed with acute pancreatitis. Which instruction should the nurse discuss with the client? a. Instruct the client to decrease alcohol intake. b. Explain the need to avoid all stress. c. Discuss the importance of stopping smoking. d. Teach the correct way to take the pancreatic enzymes.

c. Discuss the importance of stopping smoking. Rationale: Smoking stimulates the pancreas to release pancreatic enzymes and should be stopped.

The client is being admitted to the outpatient department prior to an endoscopic retrograde cholangiopancreatogram to rule out cancer of the pancreas. Which pre procedure instruction should the nurse teach? a. Prepare to be admitted to the hospital after the procedure for observation. b. If something happens during the procedure, then emergency surgery will be done. c. Do not eat or drink anything after midnight the night before the test. d. If done correctly, this procedure will correct the blockage of the stomach.

c. Do not eat or drink anything after midnight the night before the test.

A nurse cares for a client with acute pancreatitis. The client states, I am hungry. How should the nurse reply? a. Is your stomach rumbling or do you have bowel sounds? b. I need to check your gag reflex before you can eat. c. Have you passed any flatus or moved your bowels? d. You will not be able to eat until the pain subsides.

c. Have you passed any flatus or moved your bowels?

A nurse assesses a client who has cholecystitis. Which clinical manifestation indicates that the condition is chronic rather than acute? a. Temperature of 100.1 F (37.8 C) b. Positive Murphys sign c. Light-colored stools d. Upper abdominal pain after eating

c. Light-colored stools

The nurse is reviewing the lab results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL. Which dietary selection does the nurse suggest to the client? a. Roast pork b. Cheese omelet c. Pasta with sauce d. Tuna fish sandwich

c. Pasta with sauce

The client admitted to rule out pancreatic islet tumors complains of feeling weak, shaky, and sweaty. Which priority intervention should be implemented by the nurse? a. Start an IV with D5W b. Notify the HCP c. Perform a bedside glucose check. d. Give the client some orange juice

c. Perform a bedside glucose check.

The client diagnosed with acute pancreatitis is in pain. Which position should the nurse assist the client to assume to help decrease the pain? a. Recommend lying in the prone position with the legs extended. b. Maintain a tripod position over the bedside table.c c. Place in a side-lying position with knees flexed. d. Encourage a supine position with a pillow under the knees.

c. Place in a side-lying position with knees flexed.

A nurse assesses clients on the medical-surgical unit. Which client should the nurse identify as at high risk for pancreatic cancer? a. A 26-year-old with a body mass index of 21 b. A 33-year-old who frequently eats sushi c. A 48-year-old who often drinks wine d. A 66-year-old who smokes cigarettes

d. A 66-year-old who smokes cigarettes

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? SATA: a. Diarrhea b. Black, tarry stools c. Hyperactive bowel sounds d. Gray-blue color at the flank e. Abdominal guarding and tenderness f. LUQ pain with radiation to the back

d. Gray-blue color at the flank e. Abdominal guarding and tenderness f. LUQ pain with radiation to the back

The nurse caring for a client diagnosed with cancer of the pancreas write the nursing diagnosis of "risk for altered skin integrity related to pruritus." Which intervention should the nurse implement? a. Assess tissue turgor. b. Apply antifungal creams c. Monitor bony prominences for skin breakdown. d. Have the client keep the fingernails short.

d. Have the client keep the fingernails short.

The client is diagnosed with acute pancreatitis. Which health-care provider's admitting order should the nurse question? a. Bedrest with bathroom privileges. b. Initiate IV therapy of D5W at 125 mL/hour c. Weigh the client daily. d. Low-fat, low-carb diet

d. Low-fat, low-carb diet

A nurse assesses a client with cholelithiasis. Which assessment findings should the nurse identify as contributors to this clients condition? (Select all that apply.) a. Body mass index of 46 b. Vegetarian diet c. Drinking 4 ounces of red wine nightly d. Pregnant with twins e. History of metabolic syndrome f. Glycosylated hemoglobin level of 15%

a. Body mass index of 46 d. Pregnant with twins f. Glycosylated hemoglobin level of 15%

The client diagnosed with acute pancreatitis is being discharged home. Which statement by the client indicates the teaching has been effective? a. "I should decrease my intake of coffee, tea, and cola." b. "I will eat a low-fat diet and avoid spicy foods." c. "I will check my amylase and lipase levels daily." d. "I will return to work tomorrow but take it easy."

b. "I will eat a low-fat diet and avoid spicy foods."

A nurse cares for a client who is prescribed patient-controlled analgesia (PCA) after a cholecystectomy. The client states, When I wake up I am in pain. Which action should the nurse take? a. Administer intravenous morphine while the client sleeps. b. Encourage the client to use the PCA pump upon awakening. c. Contact the provider and request a different analgesic. d. Ask a family member to initiate the PCA pump for the client.

b. Encourage the client to use the PCA pump upon awakening.

The client diagnosed with cancer of the head of the pancreas is 2 days post-pancreatoduodenectomy (Whipple's procedure). Which nursing problem has the highest priority? a. Anticipatory grieving b. Fluid volume imbalance c. Alteration in comfort d. Altered nutrition

b. Fluid volume imbalance

The male client diagnosed with chronic pancreatitis calls and reports to the client nurse he has been having a lot of "gas", along with frothy and very-foul smelling stools. Which intervention should the nurse implement? a. Explain that this is common for chronic pancreatitis. b. Ask the client to bring a stool specimen to the clinic. c. Arrange for an appointment with the HCP for today. d. Discuss the need to decrease fat in the diet so that this will not happen.

c. Arrange for an appointment with the HCP for today.

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? a. Dorsiflex the client's foot b. Measure the abdominal girth c. Ask the client to extend the arms d. Instruct the client to lean forward

c. Ask the client to extend the arms

The client is immediate postprocedure endoscopic retrograde cholangiopancreatogram. Which intervention should the nurse implement? a. Assess for rectal bleeding. b. Increase fluid intake. c. Assess gag reflex d. Keep in supine position.

c. Assess gag reflex

The nurse is planning a program for clients at a health fair regarding the prevention and early detection of cancer and the pancreas. Which self-care activity should the nurse discuss as an example of a primary nursing intervention? a. Monitor for elevated blood glucose at random intervals. b. Inspect the skin and the sclera of the eyes for a yellow tint. c. Limit meat in the diet and eat a diet low in fat. d. Instruct the client with hyperglycemia about insulin injections.

c. Limit meat in the diet and eat a diet low in fat.

The nurse caring for a client diagnosed with cancer of the pancreas writes the problem of "altered nutrition: less than body requirements." Which collaborative intervention should the nurse include in the plan of care? a. Continuous feedings via PEG tube b. Have the family bring in foods from home c. Assess for food preferences. d. Refer to the dietician.

d. Refer to the dietician.

After teaching a client who has a history of cholelithiasis, the nurse assesses the clients understanding. Which menu selection made by the client indicates the client clearly understands the dietary teaching? a. Lasagna, tossed salad with Italian dressing, and low-fat milk b. Grilled cheese sandwich, tomato soup, and coffee with cream c. Cream of potato soup, Caesar salad with chicken, and a diet cola d. Roasted chicken breast, baked potato with chives, and orange juice

d. Roasted chicken breast, baked potato with chives, and orange juice

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is most appropriate? a. Clamp the T-tube b. Irrigate the T-tube c. Document the findings d. Notify the HCP

c. Document the findings

A nurse plans care for a client with acute pancreatitis. Which intervention should the nurse include in this clients plan of care to reduce discomfort? a. Administer morphine sulfate intravenously every 4 hours as needed. b. Maintain nothing by mouth (NPO) and administer intravenous fluids. c. Provide small, frequent feedings with no concentrated sweets. d. Place the client in semi-Fowlers position with the head of bed elevated.

b. Maintain nothing by mouth (NPO) and administer intravenous fluids.

The nurse is assessing a client with complaints of vague upper abdominal pain worse at night but relieved by sitting up and leaning forward. Which assessment question should the nurse ask next? a. "Have you noticed a yellow haze when you look at things?" b. "Does the pain get worse when you eat a meal or snack?" c. "Have you had your amylase and lipase checked recently?" d. "How much weight have you gained since you saw an HCP?"

b. "Does the pain get worse when you eat a meal or snack?"

The HCP has determined that a client has contracted hepatitis A based on flulike symptoms and jaundice. Which statement made by the client supports this medical diagnosis? a. "I have had unprotected sex with multiple partners." b. "I ate shellfish about 2 weeks ago at a local restaurant." c. "I was an intravenous drug abuser in the past and shared needles." d. "I had a blood transfusion 30 years after major abdominal surgery."

b. "I ate shellfish about 2 weeks ago at a local restaurant."

The nurse is discussing complications of chronic pancreatitis with a client diagnosed with the disease. Which complication should the nurse discuss with the client? a. Diabetes insipidus b. Crohn's Disease c. Narcotic addiction d. Peritonitis

c. Narcotic addiction Rationale: Narcotic addiction is related to the frequent, severe pain episodes often occurring with chronic pancreatitis, which require narcotics for relief.

The client is admitted to the medical department with a diagnosis of rule-out acute pancreatitis. Which laboratory values should the nurse monitor to confirm this diagnosis? a. Creatinine and BUN b. Troponin and CK-MB c. Serum amylase and lipase. d. Serum bilirubin and calcium

c. Serum amylase and lipase.

After teaching a client who is prescribed pancreatic enzyme replacement therapy, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching? a. The capsules can be opened and the powder sprinkled on applesauce if needed. b. I will wipe my lips carefully after I drink the enzyme preparation. c. The best time to take the enzymes is immediately after I have a meal or a snack. d. I will not mix the enzyme powder with food or liquids that contain protein.

c. The best time to take the enzymes is immediately after I have a meal or a snack.