Chapter 54: Concepts of Care for Patients With Problems of the
Biliary and Pancreas Ignatavicius: Medical-Surgical Nursing, 10th
System
Editio
1.A client is scheduled for a hepatobiliary iminodiacetic acid (HIDA) scan.
What would the nurse include in client teaching about this diagnostic
test?
a. "You'll have to drink a contrast medium right before the test."
b. "You'll need to do a bowel prep the nursing before the test."
c. "You'll be able to drink liquids up until the test begins."
d. "You'll have a large camera close to you during the test.": d. "You'll
have a large camera close to you during the test."
Rationale: Clients having a HIDA scan are NPO and receive an injectable
nuclear medicine contrast. No bowel preparation is required. A large
camera is close to the client for most of the test which can be a problem
for clients who are claustrophobic.
2.A client has an external percutaneous transhepatic biliary catheter
inserted for a biliary obstruction. What health teaching about catheter care
would the nurse provide for the client?
a. "Cap the catheter drain at night to prevent leakage and skin damage."
b. "Position the drainage bag lower than the catheter insertion site."
c. "Irrigate the catheter with an ounce of saline every night."
d. "Pierce a hole in the top of the drainage bag to get rid of odors.": b.
"Position the drainage bag lower than the catheter insertion site."
Rationale: An external temporary or permanent catheter drains bile by
gravity into a bag that collects bile. Therefore, the drainage bag should
be lower that the catheter insertion site. The catheter should not be
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14
, Chapter 54: Concepts of Care for Patients With Problems of the
Biliary and Pancreas Ignatavicius: Medical-Surgical Nursing, 10th
System
Editio
capped or irrigated, and no holes should be made in the bag to prevent
bile from having contact with the skin
3.After teaching a client who has a history of cholelithiasis, the nurse as-
sesses the client's understanding. Which menu selection indicates that
the client understands the dietary teaching?
a. Lasagna, tossed salad with Italian dressing, and low-fat milk
b. Grilled cheese sandwich, tomato soup, and coffee with cream
c. Cream of potato soup, Caesar salad with chicken, and a diet cola
d. Roasted chicken breast, baked potato with chives, and orange juice:
d. Roasted chicken breast, baked potato with chives, and orange
juice
Rationale: Clients with cholelithiasis should avoid foods high in fat and
cholesterol, such as whole milk, butter, and fried foods. Lasagna, low-fat
milk, grilled cheese, cream, and cream of potato soup all have high
levels of fat. The meal with the least amount of fat is the chicken breast
dinner.
4.A client is admitted with acute pancreatitis. What priority problem would
the nurse expect the client to report?
a. Nausea and vomiting
b. Severe boring abdominal pain
c. Jaundice and itching
d. Elevated temperature: b. Severe boring abdominal pain
Rationale: The client who has acute pancreatitis reports severe boring
abdominal pain that is often rated by clients as a 10+ on a 0-10 pain
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14
Biliary and Pancreas Ignatavicius: Medical-Surgical Nursing, 10th
System
Editio
1.A client is scheduled for a hepatobiliary iminodiacetic acid (HIDA) scan.
What would the nurse include in client teaching about this diagnostic
test?
a. "You'll have to drink a contrast medium right before the test."
b. "You'll need to do a bowel prep the nursing before the test."
c. "You'll be able to drink liquids up until the test begins."
d. "You'll have a large camera close to you during the test.": d. "You'll
have a large camera close to you during the test."
Rationale: Clients having a HIDA scan are NPO and receive an injectable
nuclear medicine contrast. No bowel preparation is required. A large
camera is close to the client for most of the test which can be a problem
for clients who are claustrophobic.
2.A client has an external percutaneous transhepatic biliary catheter
inserted for a biliary obstruction. What health teaching about catheter care
would the nurse provide for the client?
a. "Cap the catheter drain at night to prevent leakage and skin damage."
b. "Position the drainage bag lower than the catheter insertion site."
c. "Irrigate the catheter with an ounce of saline every night."
d. "Pierce a hole in the top of the drainage bag to get rid of odors.": b.
"Position the drainage bag lower than the catheter insertion site."
Rationale: An external temporary or permanent catheter drains bile by
gravity into a bag that collects bile. Therefore, the drainage bag should
be lower that the catheter insertion site. The catheter should not be
1/
14
, Chapter 54: Concepts of Care for Patients With Problems of the
Biliary and Pancreas Ignatavicius: Medical-Surgical Nursing, 10th
System
Editio
capped or irrigated, and no holes should be made in the bag to prevent
bile from having contact with the skin
3.After teaching a client who has a history of cholelithiasis, the nurse as-
sesses the client's understanding. Which menu selection indicates that
the client understands the dietary teaching?
a. Lasagna, tossed salad with Italian dressing, and low-fat milk
b. Grilled cheese sandwich, tomato soup, and coffee with cream
c. Cream of potato soup, Caesar salad with chicken, and a diet cola
d. Roasted chicken breast, baked potato with chives, and orange juice:
d. Roasted chicken breast, baked potato with chives, and orange
juice
Rationale: Clients with cholelithiasis should avoid foods high in fat and
cholesterol, such as whole milk, butter, and fried foods. Lasagna, low-fat
milk, grilled cheese, cream, and cream of potato soup all have high
levels of fat. The meal with the least amount of fat is the chicken breast
dinner.
4.A client is admitted with acute pancreatitis. What priority problem would
the nurse expect the client to report?
a. Nausea and vomiting
b. Severe boring abdominal pain
c. Jaundice and itching
d. Elevated temperature: b. Severe boring abdominal pain
Rationale: The client who has acute pancreatitis reports severe boring
abdominal pain that is often rated by clients as a 10+ on a 0-10 pain
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14
