4068_Ch35_779-808 15/11/14 1:47 PM Page 807
Chapter 35 Nursing Care of Patients With Liver, Pancreatic, and Gallbladder Disorders
REVIEW QUESTIONS
1. The nurse is planning care for a patient with cirrhosis.
For which condition would the nurse place the patient
on bleeding precautions?
1. Encephalopathy
2. Low vitamin K
3. Elevated liver enzymes
4. Hepatorenal syndrome
2. The nurse is caring for a patient with cirrhosis. The
nurse would cautiously use sedatives for the patient
due to which of the following?
1. The liver’s ability to synthesize protein is altered.
2. Sedatives may increase the risk of jaundice.
3. Sedatives are potentially toxic to the cirrhosis
patient.
4. Sedatives promote the conversion of ammonia to
ammonium ion.
3. The nurse is collecting data for a patient with suspected
acute hepatitis A infection. Which clinical manifesta-
tions would the nurse expect the patient to report?
1. Brown urine and anorexia
2. Malaise, lighter colored stools, and pruritus
3. Headache, nausea, and flulike symptoms
4. Abdominal pain and jaundice
4. The nurse is caring for a patient with chronic pancre-
atitis. While reviewing laboratory data to contribute
to the plan of care, the nurse would expect an eleva-
tion in which laboratory value?
1. Serum bilirubin
2. Serum calcium
3. Serum albumin
4. Serum amylase
5. A patient with acute pancreatitis is started on early
aggressive IV hydration. Which laboratory result
indicates the need to consult the dietitian for initial
nutritional support?
1. Potassium 4.2 mEq/L
2. Sodium 130 mEq/L
3. Fasting glucose 82 mg/dL
4. Serum albumin 2.9 g/dL
6. The nurse is planning care for a newly admitted
patient with acute pancreatitis. Which patient
outcome should receive the highest priority in
the plan of care?
1. Patient expresses satisfaction with pain control.
2. Patient verbalizes understanding of medications at
discharge.
3. Patient increases activity tolerance.
4. Patient maintains normal bowel function.
807
7. The nurse is collecting data for a patient who
develops jaundice and dark, amber-colored urine.
The nurse recognizes that which of the following is
most likely the cause of these manifestations?
1. Encephalopathy
2. Pancreatitis
3. Bile duct obstruction
4. Cholecystitis
8. The nurse reinforces teaching for a patient after a
cholecystectomy who is on a low-fat diet. The nurse
will know that the patient understands the diet if
which menu items are selected?
1. Roast chicken, rice, gelatin dessert
2. Cream of chicken soup, milk, gelatin dessert
3. Meat loaf, mashed potatoes with small amount of
gravy, green beans
4. Turkey and cheese sandwich on whole-grain bread,
apple, milk
9. The nurse is caring for a patient who had an open
cholecystectomy 24 hours ago. Which actions should
the nurse take to assist the patient to maintain an
effective breathing pattern? Select all that apply.
1. Place in a supine position.
2. Provide analgesics for pain relief.
3. Encourage coughing and deep breathing.
4. Monitor bowel sounds.
5. Assist with splinting during coughing.
6. Maintain bed rest for 48 hours after surgery.
10. The nurse is to administer promethazine 12.5 mg
intramuscularly and has 50 mg/mL on hand. How
many milliliters should be drawn up? Fill in the
blank.
Answer: ______________ mL
Answers can be found in Appendix C.