Chapter 43: Liver, Pancreas, and Biliary Tract Problems

MULTIPLE CHOICE

1. Question: A 24-year-old female contracts hepatitis from contaminated food. During the acute (icteric) phase of the patients illness, the nurse would expect serologic testing to reveal
2. Question: Administration of hepatitis B vaccine to a healthy 18-year-old patient has been effective when a specimen of the patients blood reveals
3. Question: 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?
4. Question: The nurse will plan to teach the patient diagnosed with acute hepatitis B about
5. Question: The nurse administering a-interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C will plan to monitor for
6. Question: Which information given by a 70-year-old patient during a health history indicates to the nurse that the patient should be screened for hepatitis C?
7. Question: A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies but serologic testing is negative for viral causes of hepatitis. Which question by the nurse is most appropriate?
8. Question: Which data will the nurse monitor in relation to the 4+ pitting edema assessed in a patient with cirrhosis?
9. Question: Which topic is most important to include in patient teaching for a 41-year-old patient diagnosed with early alcoholic cirrhosis?
10. Question: 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?
11. Question: Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic encephalopathy?
12. Question: Which finding indicates to the nurse that lactulose (Cephulac) is effective for a 72-year-old man who has advanced cirrhosis?
13. Question: 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?
14. Question: To detect possible complications in a patient with severe cirrhosis who has bleeding esophageal varices, it is most important for the nurse to monitor
15. Question: A 38-year-old patient with cirrhosis has ascites and 4+ edema of the feet and legs. Which nursing action will be included in the plan of care?
16. Question: Which finding indicates to the nurse that a patients transjugular intrahepatic portosystemic shunt (TIPS) placed 3 months ago has been effective?
17. Question: To prepare a 56-year-old male patient with ascites for paracentesis, the nurse
18. Question: 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?
19. Question: 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?
20. Question: Which assessment finding would the nurse need to report most quickly to the health care provider regarding a patient with acute pancreatitis?
21. Question: The nurse will ask a 64-year-old patient being admitted with acute pancreatitis specifically about a history of
22. Question: The nurse will teach a patient with chronic pancreatitis to take the prescribed pancrelipase (Viokase)
23. Question: The nurse recognizes that teaching a 44-year-old woman following a laparoscopic cholecystectomy has been effective when the patient states which of the following?
24. Question: 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?
25. Question: 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?
26. Question: Which response by the nurse best explains the purpose of ranitidine (Zantac) for a patient admitted with bleeding esophageal varices?
27. Question: When taking the blood pressure (BP) on the right arm of a patient with severe acute pancreatitis, the nurse notices carpal spasms of the patients right hand. Which action should the nurse take next?
28. Question: A 67-year-old male patient with acute pancreatitis has a nasogastric (NG) tube to suction and is NPO. Which information obtained by the nurse indicates that these therapies have been effective?
29. Question: Which assessment finding is of most concern for a 46-year-old woman with acute pancreatitis?
30. Question: Which action will be included in the care for a patient who has recently been diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD)?
31. Question: 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?
32. Question: During change-of-shift report, the nurse learns about the following four patients. Which patient requires assessment first?
33. Question: Which goal has the highest priority in the plan of care for a 26-year-old homeless patient admitted with viral hepatitis who has severe anorexia and fatigue?
34. Question: Which action should the nurse in the emergency department take first for a new patient who is vomiting blood?
35. Question: The nurse is planning care for a 48-year-old woman with acute severe pancreatitis. The highest priority patient outcome is
36. Question: The nurse is caring for a 36-year-old patient with pancreatic cancer. Which nursing action is the highest priority?
37. Question: Which assessment information will be most important for the nurse to report to the health care provider about a patient with acute cholecystitis?
38. Question: A 51-year-old woman had an incisional cholecystectomy 6 hours ago. The nurse will place the highest priority on assisting the patient to
39. Question: For a patient with cirrhosis, which of the following nursing actions can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP)?
40. Question: Which action will the nurse include in the plan of care for a patient who has been diagnosed with chronic hepatitis B?
41. Question: A patient born in 1955 had hepatitis A infection 1 year ago. According to Centers for Disease Control and Prevention (CDC) guidelines, which action should the nurse include in care when the patient is seen for a routine annual physical exam?
42. Question: A 23-year-old has been admitted with acute liver failure. Which assessment data are most important for the nurse to communicate to the health care provider?
43. Question: A 36-year-old female patient is receiving treatment for chronic hepatitis C with pegylated interferon (PEG- Intron, Pegasys), ribavirin (Rebetol), and telaprevir (Incivek). Which finding is most important to communicate to the health care provider?
44. Question: 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?
45. Question: In reviewing the medical record shown in the accompanying figure for a patient admitted with acute pancreatitis, the nurse sees that the patient has a positive Cullens sign. Indicate the area where the nurse will assess for this change.