Chapter 54: Concepts of Care for Patients
with Problems of the Biliary System and
Pancreas
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse cares for a client with end-stage pancreatic cancer. The client asks, “Why is
this happening to me?” How would the nurse respond?
a. “I don’t know. I wish I had an answer for you, but I don’t.”
b. “It’s important to keep a positive attitude for your family right now.”
c. “Scientists have not determined why cancer develops in certain people.”
d. “I think that this is a trial so you can become a better person because of it.”
ANS: A
The client is not asking the nurse to actually explain why the cancer has occurred. The
client may be expressing his or her feelings of confusion, frustration, distress, and
grief related to this diagnosis. Reminding the client to keep a positive attitude for his
or her family does not address the client’s emotions or current concerns. The nurse
would validate that there is no easy or straightforward answer as to why the client has
cancer. Telling a client that cancer is a trial is untrue and may negatively impact the
client–nurse relationship.
DIF: Applying TOP: Integrated Process: Caring KEY: Pancreatic
cancer, Coping MSC: Client Needs Category: Psychosocial Integrity
, 2. A client had an open traditional Whipple procedure this morning. For what priority
complication would the nurse assess?
a. Urinary tract infection
b. Chronic kidney disease
c. Heart failure
d. Fluid and electrolyte imbalances
ANS: D
Due to the length and complexity of this type of surgery, the client is at risk for fluid
and electrolyte imbalances. The nurse would assess for signs and symptoms of these
imbalances so they can be managed early to prevent potentially life-threatening
complications.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
MSC: Client Needs Category: Physiological Integrity: Physiological
Adaptation
3. A nurse assesses a client who has cholecystitis. Which sign or symptom indicates that
this condition is chronic rather than acute?
a. Temperature of 100.1° F (37.8° C)
b. Positive Murphy sign
c. Clay-colored stools
d. Upper abdominal pain after eating
ANS: C
Jaundice, clay-colored stools, and dark urine are more commonly seen with chronic
cholecystitis. The other symptoms are seen in clients with either chronic or acute
cholecystitis.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: Cholecystitis, Assessment MSC: Client Needs Category:
Physiological Integrity: Physiological Adaptation
with Problems of the Biliary System and
Pancreas
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse cares for a client with end-stage pancreatic cancer. The client asks, “Why is
this happening to me?” How would the nurse respond?
a. “I don’t know. I wish I had an answer for you, but I don’t.”
b. “It’s important to keep a positive attitude for your family right now.”
c. “Scientists have not determined why cancer develops in certain people.”
d. “I think that this is a trial so you can become a better person because of it.”
ANS: A
The client is not asking the nurse to actually explain why the cancer has occurred. The
client may be expressing his or her feelings of confusion, frustration, distress, and
grief related to this diagnosis. Reminding the client to keep a positive attitude for his
or her family does not address the client’s emotions or current concerns. The nurse
would validate that there is no easy or straightforward answer as to why the client has
cancer. Telling a client that cancer is a trial is untrue and may negatively impact the
client–nurse relationship.
DIF: Applying TOP: Integrated Process: Caring KEY: Pancreatic
cancer, Coping MSC: Client Needs Category: Psychosocial Integrity
, 2. A client had an open traditional Whipple procedure this morning. For what priority
complication would the nurse assess?
a. Urinary tract infection
b. Chronic kidney disease
c. Heart failure
d. Fluid and electrolyte imbalances
ANS: D
Due to the length and complexity of this type of surgery, the client is at risk for fluid
and electrolyte imbalances. The nurse would assess for signs and symptoms of these
imbalances so they can be managed early to prevent potentially life-threatening
complications.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
MSC: Client Needs Category: Physiological Integrity: Physiological
Adaptation
3. A nurse assesses a client who has cholecystitis. Which sign or symptom indicates that
this condition is chronic rather than acute?
a. Temperature of 100.1° F (37.8° C)
b. Positive Murphy sign
c. Clay-colored stools
d. Upper abdominal pain after eating
ANS: C
Jaundice, clay-colored stools, and dark urine are more commonly seen with chronic
cholecystitis. The other symptoms are seen in clients with either chronic or acute
cholecystitis.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: Cholecystitis, Assessment MSC: Client Needs Category:
Physiological Integrity: Physiological Adaptation
