Chapter 44: Nursing Management: Liver, Pancreas, and Biliary Tract Problems

Chapter 44: Nursing Management: Liver, Pancreas, and Biliary Tract Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient contracts hepatitis from contaminated food. During the acute (icteric) phase of
the patient’s illness, the nurse would expect serologic testing to reveal
a. antibody to hepatitis D (anti-HDV).
b. hepatitis B surface antigen (HBsAg).
c. anti-hepatitis A virus immunoglobulin G (anti-HAV IgG).
d. anti-hepatitis A virus immunoglobulin M (anti-HAV IgM).
ANS: D
Hepatitis A is transmitted through the oral-fecal route, and antibody to HAV IgM appears
during the acute phase of hepatitis A. The patient would not have antigen for hepatitis B
or antibody for hepatitis D. Anti-HAV IgG would indicate past infection and lifelong
immunity.
DIF: Cognitive Level: Application REF: 1060-1061 | 1064
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. The nurse determines that administration of hepatitis B vaccine to a patient has been
effective when a specimen of the patient’s blood reveals
a. HBsAg.
b. anti-HBs.
c. anti-HBc IgG.
d. anti-HBc IgM.
ANS: B
The presence of surface antibody to HBV (anti-HBs) is a marker of a positive response to
the vaccine. The other laboratory values indicate current infection with HBV.
DIF: Cognitive Level: Analysis REF: 1061-1062 | 1064
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
3. A patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection.
Which action by the nurse is appropriate?
a. Schedule the patient for HCV genotype testing.
b. Administer immune globulin and the HCV vaccine.
c. Instruct the patient on ribavirin (Rebetol) treatment.
d. Teach that the infection will resolve in a few months.
ANS: A
Test Bank 44-2
Genotyping of HCV has an important role in managing treatment and is done before drug
therapy is initiated. Since most patients with acute HCV infection convert to the chronic
state, the nurse should not teach the patient that the HCV will resolve in a few months.
Immune globulin or vaccine is not available for HCV. Ribavirin is used for chronic HCV
infection.
DIF: Cognitive Level: Application REF: 1063-1064
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. When a patient is diagnosed with acute hepatitis B, the nurse will plan to teach the patient
about
a. ways to increase exercise and activity level.
b. self-administration of α-interferon (Intron A).
c. side effects of nucleoside and nucleotide analogs.
d. measures that will be helpful in improving appetite.
ANS: D
Maintaining adequate nutritional intake is important for regeneration of hepatocytes.
Interferon and antivirals may be used for chronic hepatitis B, but they are not prescribed
for acute hepatitis B infection. Rest is recommended.
DIF: Cognitive Level: Application REF: 1064-1065 | 1069-1070
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. When combination therapy of -interferon and ribavirin (Rebetol) is being used to treat
chronic hepatitis C, the nurse will plan to monitor for
a. leukopenia.
b. hypokalemia.
c. polycythemia.
d. hypoglycemia.
ANS: A
Therapy with ribavirin and -interferon may cause leukopenia. The other problems are
not associated with this drug therapy.
DIF: Cognitive Level: Application REF: 1066 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity