C HAPTER 20: G ASTROINTESTINAL C LINICAL
A SSESSMENT AND D IAGNOSTIC P ROCEDURES
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. The nurse is caring for a patient with acute liver failure. What
laboratory value would the nurse expect to decrease in this situation?
a. Albumin
b. Total bilirubin
c. Alkaline phosphatase
d. Aspartate aminotransferase
ANS: A
In a patient with hepatocellular injury (which occurs with acute liver
failure), total bilirubin, alkaline phosphatase, aspartate
aminotransferase, and alanine aminotransferase values all show
elevation, but albumin values drop as a result of the catabolism.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Diagnosis TOP: Gastrointestinal
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
2. A patient is undergoing a hepatobiliar y scan to assess the progression of
cirrhosis of the liver. The nurse would anticipate which result?
, a. Nonvisualization
b. Little or no uptake
c. Increased uptake
d. Normal uptake
ANS: B
In a hepatobiliary scan, the liver cells take up 80% to 90% of the
radiotracer, which is then secreted into the bile and transported
throughout the biliary system, allowing visualization of the biliary
tract, gallbladder, and duodenum. Pooling of the iminodiacetic agent
around the liver indicates poor uptake and hepatocellular dysf unction.
PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Assessment TOP: Gastrointestinal Clinical
Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
3. Preprocedural teaching of a patient undergoing a liver scan should
include which instruction?
a. Drink at least 500 mL of fluids before the procedure.
b. Remain flat in bed for 12 hours after the procedure.
c. Stay flat and still during the procedure.
d. Sedation will be provided during the proc edure.
ANS: C
The onl y instruction the patient needs is to stay flat and still during the
procedure. No special interventions are required before or after the
procedure.
, PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementatio n TOP: Gastrointestinal
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
4. The practitioner has ordered a magnetic resonance imaging (MRI) of the
liver. What would the nurse do to prepare the p atient for the
examination?
a. Explain the patient must lie still during the procedure.
b. Explain the patient may experience deep pressure sensation.
c. Inform the patient that he or she will have to drink contrast.
d. Inform the patient that the procedure will be pe rformed at the
bedside.
ANS: A
The MR I procedure is lengthy and requires that the patient be
transported to the scanner. The patient must lie motionless in a tight,
enclosed space (if a closed MR I scanner is used), and sedation may be
necessary. The pati ent should not experience any sensations during the
procedure. The patient will not have to drink contrast during the
procedure.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Gastrointestinal
Clinical Assessment and Diagnostic Procedures MSC:
NCLEX: Physiological Integrit y: Reduction of Risk Potential
A SSESSMENT AND D IAGNOSTIC P ROCEDURES
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. The nurse is caring for a patient with acute liver failure. What
laboratory value would the nurse expect to decrease in this situation?
a. Albumin
b. Total bilirubin
c. Alkaline phosphatase
d. Aspartate aminotransferase
ANS: A
In a patient with hepatocellular injury (which occurs with acute liver
failure), total bilirubin, alkaline phosphatase, aspartate
aminotransferase, and alanine aminotransferase values all show
elevation, but albumin values drop as a result of the catabolism.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Diagnosis TOP: Gastrointestinal
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
2. A patient is undergoing a hepatobiliar y scan to assess the progression of
cirrhosis of the liver. The nurse would anticipate which result?
, a. Nonvisualization
b. Little or no uptake
c. Increased uptake
d. Normal uptake
ANS: B
In a hepatobiliary scan, the liver cells take up 80% to 90% of the
radiotracer, which is then secreted into the bile and transported
throughout the biliary system, allowing visualization of the biliary
tract, gallbladder, and duodenum. Pooling of the iminodiacetic agent
around the liver indicates poor uptake and hepatocellular dysf unction.
PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Assessment TOP: Gastrointestinal Clinical
Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
3. Preprocedural teaching of a patient undergoing a liver scan should
include which instruction?
a. Drink at least 500 mL of fluids before the procedure.
b. Remain flat in bed for 12 hours after the procedure.
c. Stay flat and still during the procedure.
d. Sedation will be provided during the proc edure.
ANS: C
The onl y instruction the patient needs is to stay flat and still during the
procedure. No special interventions are required before or after the
procedure.
, PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementatio n TOP: Gastrointestinal
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
4. The practitioner has ordered a magnetic resonance imaging (MRI) of the
liver. What would the nurse do to prepare the p atient for the
examination?
a. Explain the patient must lie still during the procedure.
b. Explain the patient may experience deep pressure sensation.
c. Inform the patient that he or she will have to drink contrast.
d. Inform the patient that the procedure will be pe rformed at the
bedside.
ANS: A
The MR I procedure is lengthy and requires that the patient be
transported to the scanner. The patient must lie motionless in a tight,
enclosed space (if a closed MR I scanner is used), and sedation may be
necessary. The pati ent should not experience any sensations during the
procedure. The patient will not have to drink contrast during the
procedure.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Gastrointestinal
Clinical Assessment and Diagnostic Procedures MSC:
NCLEX: Physiological Integrit y: Reduction of Risk Potential
