Chapter 06: Care of the Patient with a Gallbladder, Liver, Biliary Tract, or

Exocrine Pancreatic Disorder

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which abnormal lab value would be found in a patient with a pathological condition of the liver?

a.	Hemoglobin
b.	Alkaline phosphatase
c.	pH 5.0
d.	Ca– 125

 

 

ANS:   B

Liver enzyme tests are AST, ALT, LDH, alkaline phosphatase, and gamma GT.

 

DIF:    Cognitive Level: Analysis                  REF:    Pages 232, 244

OBJ:    2                      TOP:    Diagnostic procedures

KEY:   Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

2. The patient has cirrhosis of the liver and an albumin/globulin ratio of 0.9 g/dL. The normal ratio is 1.2 to 2.2 g/dL. In collecting objective data for her, the nurse would probably note which outstanding clinical sign?

a.	Jaundice
b.	Edema
c.	Pruritus
d.	Pallor

 

 

ANS:   B

Low serum albumin levels result also from excessive loss of albumin into urine or into third-space volumes, causing ascites or edema.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 232         OBJ:    3

TOP:    Cirrhosis          KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

3. An essential nursing measure to prevent peritonitis after a paracentesis is

a.	thoroughly cleansing the skin of the abdominal wall.
b.	examining ascites for bacteria.
c.	providing oral or intravenous fluids.
d.	maintaining sterile technique during the procedure.

 

 

ANS:   C

An incision is made in the skin, and a hollow trocar cannula, or catheter, is passed through the incision and into the cavity. Thoroughly cleansing the skin of the abdominal wall is done prior to the procedure.

 

DIF:    Cognitive Level: Application             REF:    Page 238         OBJ:    3

TOP:    Paracentesis    KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

4. Because vitamin K is malabsorbed in the presence of cirrhosis, which laboratory value would be elevated?

a.	Hemoglobin
b.	Hematocrit
c.	Prothrombin time
d.	White blood cell count

 

 

ANS:   C

The cirrhotic liver cannot absorb vitamin K or produce the clotting factors VII, IX, and X. This causes the patient with cirrhosis to have bleeding tendencies. Prothrombin time measures clotting time.

 

DIF:    Cognitive Level: Analysis                  REF:    Pages 237, 241

OBJ:    3                      TOP:    Cirrhosis         KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

5. A patient was scheduled for a laparoscopic cholecystectomy, but complications developed and he underwent an open cholecystectomy with a T-tube inserted into the common bile duct. The purpose of the T-tube is to

a.	decompress the duct and relieve pain caused by stimulation the sphincter of Oddi.
b.	improve diaphragmatic expansion and prevention of atelectasis.
c.	shorten postoperative recovery and hasten the healing process.
d.	keep the duct open and allow drainage of the bile until edema resolves.

 

 

ANS:   D

If the stones are in the common bile duct and edema is present, a biliary drainage tube, or T-tube, will be inserted to keep the duct open and allow drainage of the bile until the edema resolves.

 

DIF:    Cognitive Level: Comprehension      REF:    Page 250, Figure 6-8

OBJ:    3                      TOP:    Cholecystectomy

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity