Question 1

A 49-year-old female patient with cirrhosis and esophageal varices has a new prescription for propranolol (Inderal).Which finding is the best indicator that the medication has been effective?

Accepted Answer

A)  The patient reports no chest pain. 
B)  Blood pressure is 140/90 mm Hg. 
C)  Stools test negative for occult blood. 
D)  The apical pulse rate is 68 beats/minute.

Question 2

A nurse is considering which patient to admit to the same room as a patient who had a liver transplant 3 weeks ago and is now hospitalized with acute rejection.Which patient would be the best choice?

Accepted Answer

A)  Patient who is receiving chemotherapy for liver cancer 
B)  Patient who is receiving treatment for acute hepatitis C 
C)  Patient who has a wound infection after cholecystectomy 
D)  Patient who requires pain management for chronic pancreatitis

Question 3

A 51-year-old woman had an incisional cholecystectomy 6 hours ago.The nurse will place the highest priority on assisting the patient to

Accepted Answer

A)  choose low-fat foods from the menu. 
B)  perform leg exercises hourly while awake. 
C)  ambulate the evening of the operative day. 
D)  turn, cough, and deep breathe every 2 hours.

Question 4

Which action should the nurse in the emergency department take first for a new patient who is vomiting blood?

Accepted Answer

A)  Insert a large-gauge IV catheter. 
B)  Draw blood for coagulation studies. 
C)  Check blood pressure (BP), heart rate, and respirations. 
D)  Place the patient in the supine position.

Question 5

To detect possible complications in a patient with severe cirrhosis who has bleeding esophageal varices,it is most important for the nurse to monitor

Accepted Answer

A)  bilirubin levels. 
B)  ammonia levels. 
C)  potassium levels. 
D)  prothrombin time.

Question 6

The nurse will teach a patient with chronic pancreatitis to take the prescribed pancrelipase (Viokase)

Accepted Answer

A)  at bedtime. 
B)  in the morning. 
C)  with each meal. 
D)  for abdominal pain.

Question 7

A 53-year-old patient is being treated for bleeding esophageal varices with balloon tamponade.Which nursing action will be included in the plan of care?

Accepted Answer

A)  Instruct the patient to cough every hour. 
B)  Monitor the patient for shortness of breath. 
C)  Verify the position of the balloon every 4 hours. 
D)  Deflate the gastric balloon if the patient reports nausea.

Question 8

The nurse administering a-interferon and ribavirin (Rebetol)to a patient with chronic hepatitis C will plan to monitor for

Accepted Answer

A)  leukopenia. 
B)  hypokalemia. 
C)  polycythemia. 
D)  hypoglycemia.

Question 9

The nurse is caring for a 73-year-old man who has cirrhosis.Which data obtained by the nurse during the assessment will be of most concern?

Accepted Answer

A)  The patient complains of right upper-quadrant pain with palpation. 
B)  The patient's hands flap back and forth when the arms are extended. 
C)  The patient has ascites and a 2-kg weight gain from the previous day. 
D)  The patient's skin has multiple spider-shaped blood vessels on the abdomen.

Question 10

Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic encephalopathy?

Accepted Answer

A)  Request that the patient stand on one foot. 
B)  Ask the patient to extend both arms forward. 
C)  Request that the patient walk with eyes closed. 
D)  Ask the patient to perform the Valsalva maneuver.

Question 11

Which finding is most important for the nurse to communicate to the health care provider about a patient who received a liver transplant 1 week ago?

Accepted Answer

A)  Dry palpebral and oral mucosa 
B)  Crackles at bilateral lung bases 
C)  Temperature 100.8° F (38.2° 
C)  
D)  No bowel movement for 4 days

Question 12

Which action will be included in the care for a patient who has recently been diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD)?

Accepted Answer

A)  Teach symptoms of variceal bleeding. 
B)  Draw blood for hepatitis serology testing. 
C)  Discuss the need to increase caloric intake. 
D)  Review the patient's current medication list.

Question 13

Which laboratory test result will the nurse monitor when evaluating the effects of therapy for a 62-year-old female patient who has acute pancreatitis?

Accepted Answer

A)  Calcium 
B)  Bilirubin 
C)  Amylase 
D)  Potassium

Question 14

During change-of-shift report,the nurse learns about the following four patients.Which patient requires assessment first?

Accepted Answer

A)  40-year-old with chronic pancreatitis who has gnawing abdominal pain 
B)  58-year-old who has compensated cirrhosis and is complaining of anorexia 
C)  55-year-old with cirrhosis and ascites who has an oral temperature of 102° F (38.8° 
C)  
D)  36-year-old recovering from a laparoscopic cholecystectomy who has severe shoulder pain

Question 15

When taking the blood pressure (BP)on the right arm of a patient with severe acute pancreatitis,the nurse notices carpal spasms of the patient's right hand.Which action should the nurse take next?

Accepted Answer

A)  Ask the patient about any arm pain. 
B)  Retake the patient's blood pressure. 
C)  Check the calcium level in the chart. 
D)  Notify the health care provider immediately.

Question 16

Which finding indicates to the nurse that lactulose (Cephulac)is effective for a 72-year-old man who has advanced cirrhosis?

Accepted Answer

A)  The patient is alert and oriented. 
B)  The patient denies nausea or anorexia. 
C)  The patient's bilirubin level decreases. 
D)  The patient has at least one stool daily.

Question 17

A serum potassium level of 3.2 mEq/L (3.2 mmol/L)is reported for a patient with cirrhosis who has scheduled doses of spironolactone (Aldactone)and furosemide (Lasix).due.Which action should the nurse take?

Accepted Answer

A)  Administer both drugs. 
B)  Administer the spironolactone. 
C)  Withhold the spironolactone and administer the furosemide. 
D)  Withhold both drugs until discussed with the health care provider.

Question 18

A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV)infection.Which action by the nurse is appropriate?

Accepted Answer

A)  Schedule the patient for HCV genotype testing. 
B)  Administer the HCV vaccine and immune globulin. 
C)  Teach the patient about ribavirin (Rebetol) treatment. 
D)  Explain that the infection will resolve over a few months.

Question 19

Which assessment finding is of most concern for a 46-year-old woman with acute pancreatitis?

Accepted Answer

A)  Absent bowel sounds 
B)  Abdominal tenderness 
C)  Left upper quadrant pain 
D)  Palpable abdominal mass

Question 20

A 34-year old patient with chronic hepatitis C infection has several medications prescribed.Which medication requires further discussion with the health care provider before administration?

Accepted Answer

A)  Ribavirin (Rebetol, Copegus) 600 mg PO bid 
B)  Pegylated a-interferon (PEG-Intron, Pegasys) SQ daily 
C)  Diphenhydramine (Benadryl) 25 mg PO every 4 hours PRN itching 
D)  Dimenhydrinate (Dramamine) 50 mg PO every 6 hours PRN nausea

Exam 44: Nursing Management: Liver,Pancreas,and Biliary Tract Problems

A 49-year-old female patient with cirrhosis and esophageal varices has a new prescription for propranolol (Inderal) .Which finding is the best indicator that the medication has been effective?

A nurse is considering which patient to admit to the same room as a patient who had a liver transplant 3 weeks ago and is now hospitalized with acute rejection.Which patient would be the best choice?

A 51-year-old woman had an incisional cholecystectomy 6 hours ago.The nurse will place the highest priority on assisting the patient to

Which action should the nurse in the emergency department take first for a new patient who is vomiting blood?

To detect possible complications in a patient with severe cirrhosis who has bleeding esophageal varices,it is most important for the nurse to monitor

The nurse will teach a patient with chronic pancreatitis to take the prescribed pancrelipase (Viokase)

A 53-year-old patient is being treated for bleeding esophageal varices with balloon tamponade.Which nursing action will be included in the plan of care?

The nurse administering a-interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C will plan to monitor for

The nurse is caring for a 73-year-old man who has cirrhosis.Which data obtained by the nurse during the assessment will be of most concern?

Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic encephalopathy?

Which finding is most important for the nurse to communicate to the health care provider about a patient who received a liver transplant 1 week ago?

Which action will be included in the care for a patient who has recently been diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD) ?

Which laboratory test result will the nurse monitor when evaluating the effects of therapy for a 62-year-old female patient who has acute pancreatitis?

During change-of-shift report,the nurse learns about the following four patients.Which patient requires assessment first?

When taking the blood pressure (BP) on the right arm of a patient with severe acute pancreatitis,the nurse notices carpal spasms of the patient's right hand.Which action should the nurse take next?

Which finding indicates to the nurse that lactulose (Cephulac) is effective for a 72-year-old man who has advanced cirrhosis?

A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) .due.Which action should the nurse take?

A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection.Which action by the nurse is appropriate?

Which assessment finding is of most concern for a 46-year-old woman with acute pancreatitis?

A 34-year old patient with chronic hepatitis C infection has several medications prescribed.Which medication requires further discussion with the health care provider before administration?