Chapter 6: Care of the Patient with a Gallbladder, Liver, Biliary Tract, or Exocrine Pancreatic Disorder

Adult Health Care 7th edition By Cooper

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Chapter 6: 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. The nurse clarifies that unconjugated bilirubin, which is made up of broken-down red cells, is:
a. stored in the gallbladder  to make bile.
b. water insoluble bilirubin that must be converted by the liver.
c. a by-product which is excreted directly into the bowel for excretion.
d. necessary for digestion of fats.

 

 

ANS:  B

Unconjugated bilirubin is a water-insoluble product that must be converted in the liver to conjugated bilirubin (water soluble) so that it may be excreted through the bowel.

 

DIF:    Cognitive Level: Analysis                REF:   Page 233        OBJ:   1

TOP:   Bilirubin         KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

  1. The patient with cirrhosis has an albumin of 2.8 g/dL. The nurse is aware that normal is 3.5 g/dL to 5 g/dL. Based on these findings, what would the nurse expect the patient to exhibit?
a. Jaundice
b. Edema
c. Copious urine output
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 234        OBJ:   1

TOP:   Cirrhosis        KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity

 

  1. What is an essential nursing measure to prevent injury to the patient who is to receive a paracentesis?
a. Have patient sign a permit
b. Pad side rails
c. Check for allergy to contrast media or to shellfish
d. Have patient void immediately before procedure

 

 

ANS:  D

To prevent the puncturing of the bladder, the patient must void immediately before the procedure. A permit is required but it is not a safety precaution for the patient. There is no contrast media used in a paracentesis.

 

DIF:    Cognitive Level: Application           REF:   Page 242        OBJ:   2

TOP:   Paracentesis   KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

  1. What should the nurse expect of a patient with a malabsorption of vitamin K?
a. Lowered hemoglobin
b. Elevated hematocrit
c. Increased prothrombin time
d. Diminished white blood cell count

 

 

ANS:  C

Prothrombin times are increased because malabsorption of vitamin K or inability to produce the clotting factors VII, IX, and X cause the patient to have bleeding tendencies.

 

DIF:    Cognitive Level: Analysis                REF:   Page 240        OBJ:   3

TOP:   Cirrhosis        KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity

 

  1. 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. What is the purpose of the T-tube?
a. To decompress the duct and relieve pain caused by stimulation of the sphincter of Oddi.
b. To improve diaphragmatic expansion and prevention of atelectasis.
c. To shorten postoperative recovery and hasten the healing process.
d. To 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 254, Figure 6-7

OBJ:   8                    TOP:   Cholecystectomy

KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

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