CHAPTER 44: Nursing Management: Liver, Pancreas,
and Biliary Tract Problems
EVOLVE NCLEX Review Questions - 9th Edition
1
Q
1. A patient with hepatitis A is in the acute phase. The nurse plans
care for the patient based on the knowledge that
a. pruritus is a common problem with jaundice in this phase.
b. the patient is most likely to transmit the disease during this phase.
c. gastrointestinal symptoms are not as severe in hepatitis A as they
are in hepatitis B.
d. extrahepatic manifestations of glomerulonephritis and polyarteritis
are common in this phase.
A
a. pruritus is a common problem with jaundice in this phase.
2
Q
2. A patient with acute hepatitis B is being discharged in 2 days. In
the discharge teaching plan the nurse should include instructions to
a. avoid alcohol for the first 3 weeks.
b. use a condom during sexual intercourse.
c. have family members get an injection of immunoglobulin.
d. follow a low-protein, moderate-carbohydrate, moderate-fat diet.
,A
b. use a condom during sexual intercourse.
3
Q
3. A patient has been told that she has elevated liver enzymes
caused by nonalcoholic fatty liver disease (NAFLD). The nursing
teaching plan should include
a. having genetic testing done.
b. recommending a heart-healthy diet.
c. the necessity to reduce weight rapidly.
d. avoiding alcohol until liver enzymes return to normal.
A
b. recommending a heart-healthy diet.
4
Q
4. The patient with advanced cirrhosis asks why his abdomen is so
swollen. The nurse’s response is based on the knowledge that
a. a lack of clotting factors promotes the collection of blood in the
abdominal cavity.
b. portal hypertension and hypoalbuminemia cause a fluid shift into
the peritoneal space.
,c. decreased peristalsis in the GI tract contributes to gas formation
and distention of the bowel.
d. bile salts in the blood irritate the peritoneal membranes, causing
edema and pocketing of fluid.
A
b. portal hypertension and hypoalbuminemia cause a fluid shift into
the peritoneal space.
5
Q
5. In planning care for a patient with metastatic liver cancer, the nurse
should include interventions that
a. focus primarily on symptomatic and comfort measures.
b. reassure the patient that chemotherapy offers a good prognosis.
c. promote the patient’s confidence that surgical excision of the tumor
will be successful.
d. provide information necessary for the patient to make decisions
regarding liver transplantation.
A
a. focus primarily on symptomatic and comfort measures.
6
Q
6. Nursing management of the patient with acute pancreatitis includes
(select all that apply)
, a. checking for signs of hypocalcemia.
b. providing a diet low in carbohydrates.
c. giving insulin based on a sliding scale.
d. observing stools for signs of steatorrhea.
e. monitoring for infection, particularly respiratory tract infection.
A
a. checking for signs of hypocalcemia.
e. monitoring for infection, particularly respiratory tract infection.
7
Q
7. A patient with pancreatic cancer is admitted to the hospital for
evaluation of possible treatment options. The patient asks the nurse to
explain the Whipple procedure that the surgeon has described. The
explanation includes the information that a Whipple procedure
involves
a. creating a bypass around the obstruction caused by the tumor by
joining the gallbladder to the jejunum.
b. resection of the entire pancreas and the distal portion of the
stomach, with anastomosis of the common bile duct and the stomach
into the duodenum.
c. removal of part of the pancreas, part of the stomach, the
duodenum, and the gallbladder, with joining of the pancreatic duct, the
common bile duct, and the stomach into the jejunum.
d. radical removal of the pancreas, the duodenum, and the spleen,
and Biliary Tract Problems
EVOLVE NCLEX Review Questions - 9th Edition
1
Q
1. A patient with hepatitis A is in the acute phase. The nurse plans
care for the patient based on the knowledge that
a. pruritus is a common problem with jaundice in this phase.
b. the patient is most likely to transmit the disease during this phase.
c. gastrointestinal symptoms are not as severe in hepatitis A as they
are in hepatitis B.
d. extrahepatic manifestations of glomerulonephritis and polyarteritis
are common in this phase.
A
a. pruritus is a common problem with jaundice in this phase.
2
Q
2. A patient with acute hepatitis B is being discharged in 2 days. In
the discharge teaching plan the nurse should include instructions to
a. avoid alcohol for the first 3 weeks.
b. use a condom during sexual intercourse.
c. have family members get an injection of immunoglobulin.
d. follow a low-protein, moderate-carbohydrate, moderate-fat diet.
,A
b. use a condom during sexual intercourse.
3
Q
3. A patient has been told that she has elevated liver enzymes
caused by nonalcoholic fatty liver disease (NAFLD). The nursing
teaching plan should include
a. having genetic testing done.
b. recommending a heart-healthy diet.
c. the necessity to reduce weight rapidly.
d. avoiding alcohol until liver enzymes return to normal.
A
b. recommending a heart-healthy diet.
4
Q
4. The patient with advanced cirrhosis asks why his abdomen is so
swollen. The nurse’s response is based on the knowledge that
a. a lack of clotting factors promotes the collection of blood in the
abdominal cavity.
b. portal hypertension and hypoalbuminemia cause a fluid shift into
the peritoneal space.
,c. decreased peristalsis in the GI tract contributes to gas formation
and distention of the bowel.
d. bile salts in the blood irritate the peritoneal membranes, causing
edema and pocketing of fluid.
A
b. portal hypertension and hypoalbuminemia cause a fluid shift into
the peritoneal space.
5
Q
5. In planning care for a patient with metastatic liver cancer, the nurse
should include interventions that
a. focus primarily on symptomatic and comfort measures.
b. reassure the patient that chemotherapy offers a good prognosis.
c. promote the patient’s confidence that surgical excision of the tumor
will be successful.
d. provide information necessary for the patient to make decisions
regarding liver transplantation.
A
a. focus primarily on symptomatic and comfort measures.
6
Q
6. Nursing management of the patient with acute pancreatitis includes
(select all that apply)
, a. checking for signs of hypocalcemia.
b. providing a diet low in carbohydrates.
c. giving insulin based on a sliding scale.
d. observing stools for signs of steatorrhea.
e. monitoring for infection, particularly respiratory tract infection.
A
a. checking for signs of hypocalcemia.
e. monitoring for infection, particularly respiratory tract infection.
7
Q
7. A patient with pancreatic cancer is admitted to the hospital for
evaluation of possible treatment options. The patient asks the nurse to
explain the Whipple procedure that the surgeon has described. The
explanation includes the information that a Whipple procedure
involves
a. creating a bypass around the obstruction caused by the tumor by
joining the gallbladder to the jejunum.
b. resection of the entire pancreas and the distal portion of the
stomach, with anastomosis of the common bile duct and the stomach
into the duodenum.
c. removal of part of the pancreas, part of the stomach, the
duodenum, and the gallbladder, with joining of the pancreatic duct, the
common bile duct, and the stomach into the jejunum.
d. radical removal of the pancreas, the duodenum, and the spleen,
