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?

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?

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

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?

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

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