Question 1

A patient with hepatic encephalopathy is required to consume 50 grams of protein each day.Which item should be provided to the patient for a mid-afternoon snack?

Accepted Answer

A)   Apple
B)   Crackers
C)   Peanut butter
D)   Whole grain bread C

Question 2

A patient with biliary colic is prescribed an anticholinergic medication to help treat biliary colic.For which medical diagnosis should the nurse question the administration of this medication?

Accepted Answer

A)   Asthma
B)   Psoriasis
C)   Diabetes mellitus
D)   Prostatic hypertrophy D

Question 3

A patient with pancreatitis is receiving care to address the nursing diagnosis Imbalanced Nutrition: Less than required related to pain,NPO,and nasogastric suction.After 10 days of treatment,which findings should indicate to the nurse that the treatment plan has been effective? (Select all that apply.)

Accepted Answer

A)   The patient reports pain relief.
B)   The serum sodium is 130 mEq/L.
C)   The patient's albumin level is 3.8 g/L.
D)   The serum potassium level is 3.7 mEq/L.
E)   The patient has mild diarrhea and steatorrhea.F)  The patient has returned to baseline body weight. C,F

Question 4

A patient with cholecystitis is prescribed promethazine (Phenergan)for nausea.Which adverse effect of the medication should the nurse instruct the patient to report?

Accepted Answer

A)   Diarrhea
B)   Insomnia
C)   Dry mouth
D)   Urine retention

Question 5

A patient with liver failure takes acetaminophen (Tylenol)650 mg tablets by mouth for severe arthritis pain.How many tablets should the nurse instruct that the patient can safely take in one 24 hour period?

Accepted Answer

A)   2
B)   3
C)   4
D)   5

Question 6

The nurse is caring for a patient with chronic liver failure.Which medication order should the nurse question?

Accepted Answer

A)   Lactulose
B)   Neomycin
C)   Multivitamins
D)   Acetaminophen

Question 7

The nurse is caring for a patient diagnosed with chronic hepatitisB.Which medications should the nurse anticipate being prescribed for this patient? (Select all that apply.)

Accepted Answer

A)   Interferon alpha-2a
B)   Ribavirin (Rebetol) 
C)   Adefovir (Hepsera) 
D)   Lamivudine (Epivir) 
E)   Peginterferon alpha-2b

Question 8

The nurse is providing a patient with cholelithiasis the medication ursodiol (Actigall).What should the nurse instruct the patient about this medication?

Accepted Answer

A)   This medication is used prior to having surgery.
B)   This medication works best with a high-fat diet.
C)   This medication may take a few months to work.
D)   This medication makes sure the stones never return.

Question 9

The nurse is collecting data for a patient with acute pancreatitis.Which laboratory test result should the nurse expect?

Accepted Answer

A)   Decreased serum lipase
B)   Elevated serum amylase
C)   Elevated serum albumin
D)   Decreased serum ammonia

Question 10

The nurse is collecting data for a patient with acute liver failure.Which laboratory test findings should the nurse recognize as supporting this diagnosis? (Select all that apply.)

Accepted Answer

A)   Elevated platelet count
B)   Elevated prothrombin time
C)   Elevated serum bilirubin level
D)   Elevated serum potassium level
E)   Elevated alanine aminotransferase level (ALT) F)  Elevated aspartate aminotransferase level (AST)

Question 11

The nurse is caring for a patient with chronic liver failure.Which laboratory value should the nurse expect as a late sign of liver failure?

Accepted Answer

A)   Low serum albumin
B)   Low serum bilirubin
C)   Low serum ammonia
D)   Low serum aspartate aminotransferase (AST)

Question 12

The nurse is caring for a patient after surgery to drain a pancreatic abscess.Which action should the nurse take to monitor for complications?

Accepted Answer

A)   Document output.
B)   Monitor blood glucose.
C)   Monitor for hyperproteinemia.
D)   Review serum potassium levels.

Question 13

The nurse is contributing to the teaching plan for a patient recovering from a cholecystectomy.Which dietary modification should the nurse recommend for the first few weeks after surgery?

Accepted Answer

A)   Decrease intake of fresh fruits and vegetables to minimize pressure on the small intestine.
B)   Consume at least four servings of meat, cheese, and peanut butter daily to boost protein intake and aid healing.
C)   Distribute fat intake in small portions throughout the day to prevent excessive fat in the intestine at any one time.
D)   Take pancreatic enzymes with meals to replace enzymes that would normally have been secreted before the cholecystectomy.

Question 14

The nurse is caring for a patient with hepatic encephalopathy.Which prescribed medication should the nurse question before providing to this patient?

Accepted Answer

A)   Vitamin K
B)   Neomycin sulfate
C)   Diazepam (Valium) 
D)   Lactulose (Cephulac)

Question 15

A patient is prescribed to receive 20 mg of metoclopramide (Reglan)intramuscularly (IM).The medication available is 5 mg/ mL.How many mL of the medication should the nurse provide to the patient?

Accepted Answer

The answer of A patient is prescribed to receive 20...

Question 16

A patient with liver failure and esophageal varices is prescribed to receive vasopressin.What should the nurse realize is the purpose for this medication?

Accepted Answer

A)   To promote portal circulation
B)   To reduce ammonia buildup and encephalopathy
C)   To constrict vessels causing bleeding in esophageal varices
D)   To maintain blood pressure in a patient with hypotension related to bleeding varices

Question 17

A patient recovering from hepatitis is concerned about liver damage from the infection.What should the nurse instruct the patient to do to prevent long-term liver damage? (Select all that apply.)

Accepted Answer

A)   Get adequate rest.
B)   Ingest nutritious foods.
C)   Abstain from all alcohol.
D)   Restrict physical activity.
E)   Limit the intake of dairy products.

Question 18

The nurse is providing education to a patient recovering from a recent cholecystectomy.What should the nurse include in the teaching? (Select all that apply.)

Accepted Answer

A)   "Fat should be less than 20% of total diet."
B)   "Raw fruits and vegetables should be avoided."
C)   "It is important to increase the protein intake in your diet."
D)   "If you are overweight, it is suggested that you lose weight."
E)   "There are no dietary restrictions once you leave the hospital."F)  "Fat is introduced slowly and adjusted according to individual tolerance."

Question 19

A patient with possible viral hepatitis reports recent intake of raw shellfish.Which type of hepatitis should the nurse consider the patient is experiencing?

Accepted Answer

A)   Hepatitis A virus
B)   Hepatitis B virus
C)   Hepatitis C virus
D)   Hepatitis D virus

Question 20

A patient recovering from a cholecystectomy earlier in the day is reluctant to deep breathe and cough.What intervention should the nurse use to assist the patient to cough and breathe?

Accepted Answer

A)   Remind the patient to deep breathe and cough every hour.
B)   Teach the patient to use relaxation and distraction techniques.
C)   Medicate the patient for pain, and assist to splint the abdomen.
D)   Reinforce the importance of the deep breathing and coughing activities.

Exam 35: Nursing Care of Patients With Liver, Pancreatic, and Gallbladder Disorders