Lewis - Med-Surg - Ch. 43: Liver, Pancreas,
and Biliary Tract Problems UPDATED
ACTUAL Questions and CORRECT
Answers
A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has
a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To what diagnosis does the nurse
attribute these findings?
A. Malnutrition
B. Osteomyelitis
C. Alcohol abuse
D. Diabetes mellitus - CORRECT ANSWER - C
The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will
monitor for effectiveness of this medication for this patient by assessing what?
A. Relief of constipation
B. Relief of abdominal pain
C. Decreased liver enzymes
D. Decreased ammonia levels - CORRECT ANSWER - D
The family of a patient newly diagnosed with hepatitis A asks the nurse what they can do to prevent
becoming ill themselves. Which response by the nurse is most appropriate?
A. "The hepatitis vaccine will provide immunity from this exposure and future exposures."
B. "I am afraid there is nothing you can do since the patient was infectious before admission."
C. "You will need to be tested first to make sure you don't have the virus before we can treat you."
D. "An injection of immunoglobulin will need to be given to prevent or minimize the effects from this
exposure." - CORRECT ANSWER - D
When planning care for a patient with cirrhosis, the nurse will give highest priority to which nursing
diagnosis?
A. Impaired skin integrity related to edema, ascites, and pruritus
,B. Imbalanced nutrition: less than body requirements related to anorexia
C. Excess fluid volume related to portal hypertension and hyperaldosteronism
D. Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume - CORRECT
ANSWER - D
When caring for a patient with liver disease, the nurse recognizes the need to prevent bleeding resulting
from altered clotting factors and rupture of varices. Which nursing interventions would be appropriate to
achieve this outcome (select all that apply)?
A. Use smallest gauge needle possible when giving injections or drawing blood.
B. Teach patient to avoid straining at stool, vigorous blowing of nose, and coughing.
C. Advise patient to use soft-bristle toothbrush and avoid ingestion of irritating food.
D. Apply gentle pressure for the shortest possible time period after performing venipuncture. -
CORRECT ANSWER - A, B, C
A patient with type 2 diabetes and cirrhosis asks the nurse if it would be okay to take silymarin (milk
thistle) to help minimize liver damage. The nurse responds based on what knowledge?
A. Milk thistle may affect liver enzymes and thus alter drug metabolism.
B. Milk thistle is generally safe in recommended doses for up to 10 years.
C. There is unclear scientific evidence for the use of milk thistle in treating cirrhosis.
D. Milk thistle may elevate the serum glucose levels and is thus contraindicated in diabetes. - CORRECT
ANSWER - A
When caring for a patient with a biliary obstruction, the nurse will anticipate administering which vitamin
supplements (select all that apply)?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
E. Vitamin B - CORRECT ANSWER - A, B, C, D
A patient who has hepatitis B surface antigen (HBsAg) in the serum is being discharged with pain
medication after knee surgery. Which medication order should the nurse question because it is most likely
to cause hepatic complications?
, A. Tramadol (Ultram)
B. Hydromorphone (Dilaudid)
C. Oxycodone with aspirin (Percodan)
D. Hydrocodone with acetaminophen (Vicodin) - CORRECT ANSWER - D
The condition of a patient who has cirrhosis of the liver has deteriorated. Which diagnostic study would
help determine if the patient has developed liver cancer?
A. Serum α-fetoprotein level
B. Ventilation/perfusion scan
C. Hepatic structure ultrasound
D. Abdominal girth measurement - CORRECT ANSWER - C
The patient with right upper quadrant abdominal pain has an abdominal ultrasound that reveals
cholelithiasis. What should the nurse expect to do for this patient?
A. Prevent all oral intake.
B. Control abdominal pain.
C. Provide enteral feedings.
D. Avoid dietary cholesterol. - CORRECT ANSWER - B
A patient with cholelithiasis needs to have the gallbladder removed. Which patient assessment is a
contraindication for a cholecystectomy?
A. Low-grade fever of 100° F and dehydration
B. Abscess in the right upper quadrant of the abdomen
C. Activated partial thromboplastin time (aPTT) of 54 seconds - CORRECT ANSWER - C
When teaching the patient with acute hepatitis C (HCV), the patient demonstrates understanding when the
patient makes which statement?
A. "I will use care when kissing my wife to prevent giving it to her."
B. "I will need to take adofevir (Hepsera) to prevent chronic HCV."
C. "Now that I have had HCV, I will have immunity and not get it again."
and Biliary Tract Problems UPDATED
ACTUAL Questions and CORRECT
Answers
A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has
a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To what diagnosis does the nurse
attribute these findings?
A. Malnutrition
B. Osteomyelitis
C. Alcohol abuse
D. Diabetes mellitus - CORRECT ANSWER - C
The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will
monitor for effectiveness of this medication for this patient by assessing what?
A. Relief of constipation
B. Relief of abdominal pain
C. Decreased liver enzymes
D. Decreased ammonia levels - CORRECT ANSWER - D
The family of a patient newly diagnosed with hepatitis A asks the nurse what they can do to prevent
becoming ill themselves. Which response by the nurse is most appropriate?
A. "The hepatitis vaccine will provide immunity from this exposure and future exposures."
B. "I am afraid there is nothing you can do since the patient was infectious before admission."
C. "You will need to be tested first to make sure you don't have the virus before we can treat you."
D. "An injection of immunoglobulin will need to be given to prevent or minimize the effects from this
exposure." - CORRECT ANSWER - D
When planning care for a patient with cirrhosis, the nurse will give highest priority to which nursing
diagnosis?
A. Impaired skin integrity related to edema, ascites, and pruritus
,B. Imbalanced nutrition: less than body requirements related to anorexia
C. Excess fluid volume related to portal hypertension and hyperaldosteronism
D. Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume - CORRECT
ANSWER - D
When caring for a patient with liver disease, the nurse recognizes the need to prevent bleeding resulting
from altered clotting factors and rupture of varices. Which nursing interventions would be appropriate to
achieve this outcome (select all that apply)?
A. Use smallest gauge needle possible when giving injections or drawing blood.
B. Teach patient to avoid straining at stool, vigorous blowing of nose, and coughing.
C. Advise patient to use soft-bristle toothbrush and avoid ingestion of irritating food.
D. Apply gentle pressure for the shortest possible time period after performing venipuncture. -
CORRECT ANSWER - A, B, C
A patient with type 2 diabetes and cirrhosis asks the nurse if it would be okay to take silymarin (milk
thistle) to help minimize liver damage. The nurse responds based on what knowledge?
A. Milk thistle may affect liver enzymes and thus alter drug metabolism.
B. Milk thistle is generally safe in recommended doses for up to 10 years.
C. There is unclear scientific evidence for the use of milk thistle in treating cirrhosis.
D. Milk thistle may elevate the serum glucose levels and is thus contraindicated in diabetes. - CORRECT
ANSWER - A
When caring for a patient with a biliary obstruction, the nurse will anticipate administering which vitamin
supplements (select all that apply)?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
E. Vitamin B - CORRECT ANSWER - A, B, C, D
A patient who has hepatitis B surface antigen (HBsAg) in the serum is being discharged with pain
medication after knee surgery. Which medication order should the nurse question because it is most likely
to cause hepatic complications?
, A. Tramadol (Ultram)
B. Hydromorphone (Dilaudid)
C. Oxycodone with aspirin (Percodan)
D. Hydrocodone with acetaminophen (Vicodin) - CORRECT ANSWER - D
The condition of a patient who has cirrhosis of the liver has deteriorated. Which diagnostic study would
help determine if the patient has developed liver cancer?
A. Serum α-fetoprotein level
B. Ventilation/perfusion scan
C. Hepatic structure ultrasound
D. Abdominal girth measurement - CORRECT ANSWER - C
The patient with right upper quadrant abdominal pain has an abdominal ultrasound that reveals
cholelithiasis. What should the nurse expect to do for this patient?
A. Prevent all oral intake.
B. Control abdominal pain.
C. Provide enteral feedings.
D. Avoid dietary cholesterol. - CORRECT ANSWER - B
A patient with cholelithiasis needs to have the gallbladder removed. Which patient assessment is a
contraindication for a cholecystectomy?
A. Low-grade fever of 100° F and dehydration
B. Abscess in the right upper quadrant of the abdomen
C. Activated partial thromboplastin time (aPTT) of 54 seconds - CORRECT ANSWER - C
When teaching the patient with acute hepatitis C (HCV), the patient demonstrates understanding when the
patient makes which statement?
A. "I will use care when kissing my wife to prevent giving it to her."
B. "I will need to take adofevir (Hepsera) to prevent chronic HCV."
C. "Now that I have had HCV, I will have immunity and not get it again."
