Chapter 31: Care of Patients with Disorders of the Gallbladder, Liver, and Pancreas

Chapter 31: Care of Patients with Disorders of the Gallbladder, Liver, and Pancreas

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient who has had his fifth attack of gallstones is encouraged to have a cholecystectomy to prevent the threat of:

ANS:  C

Repeated gallstone attacks with their attendant gallbladder inflammation can lead to cancer of the gallbladder.

DIF:    Cognitive Level: Comprehension     REF:   694                OBJ:   1 (theory)

TOP:   Cholelithiasis: Cholecystectomy       KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

2. A patient comes to the emergency department with the complaint of severe vomiting and nausea and a temperature elevation to 101° F. The patient complains of stomach pain that radiates to his right scapula. These assessments suggest:

ANS:  A

All the symptoms and signs alert the medical staff to the probability of cholecystitis. Hepatitis causes liver dysfunction, including jaundice. Pancreatitis causes abdominal pain that is usually acute, but this can vary among individuals. The pain is steady and is localized to the epigastrium or left upper quadrant. Gastroenteritis causes nausea, vomiting, and diarrhea.

DIF:    Cognitive Level: Application           REF:   691                OBJ:   2 (theory)

TOP:   Cholecystitis: Signs and Symptoms

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Health Promotion and Maintenance

3. The nurse explains to a patient with cholelithiasis that the purpose of the cholescintigraphy (HIDA scan) is to:

ANS:  C

The HIDA scan can diagnose abnormal contractions of the gallbladder, which occur in the presence of gallstones or a gallbladder that is not functioning properly.

DIF:    Cognitive Level: Comprehension     REF:   692                OBJ:   1 (theory)

TOP:   Cholelithiasis: HIDA Scan               KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

4. The nurse is caring for a patient diagnosed with gallstones. The patient’s medical record indicates the presence of two gallstones less than 1.5 inches. The patient is obese and has a history of insulin-dependent diabetes. The patient asks the nurse why he could not have a lithotripsy. The nurse points out that the criteria for the procedure are rigid and that he failed to meet them because:

ANS:  C

Lithotripsy is not effective on obese persons. The three criteria are as follows: the gallstones must be fewer than three, of no more than 1.5 inches in diameter, and the patient must not be obese.

DIF:    Cognitive Level: Application           REF:   693                OBJ:   1 (theory)

TOP:   Lithotripsy: Criteria                         KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

5. A patient who had a laparoscopic cholecystectomy 4 hours ago complains of fullness in the abdomen and mild discomfort. Because his vital signs are stable, the nurse should:

ANS:  A

Ambulation helps relieve gas. After a laparoscopic procedure, retained CO₂ causes “free air” pain. The stable vital signs indicate no threat of hemorrhage.

DIF:    Cognitive Level: Analysis                REF:   692                OBJ:   2 (theory)

TOP:   Laparoscopic Surgery: “Free Air”    KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Basic Care and Comfort