Question 1

Health promotion activities a nurse could recommend to a client in order to prevent pancreatitis include (Select all that apply)

Accepted Answer

A)   avoiding alcohol abuse.
B)   eating a high-protein diet.
C)   getting regular exercise.
D)   losing weight if needed.E) All of the above
F) B) and C)

Question 2

A client with a history of cholelithiasis presents at the hospital with nausea and vomiting, abdominal pain, and jaundice. The nurse would assess the client for

Accepted Answer

A)   common bile duct obstruction.
B)   infarct of the hepatic vein.
C)   perforation of the gallbladder.
D)   spasm of the biliary tree.E) C) and D)
F) None of the above

Question 3

A client with acute pancreatitis has a drop in blood pressure from (142/80)  to (105/65)  mm Hg at 2 hours after admission. The client has not voided and has become short of breath. The nurse would anticipate that the abnormal laboratory value consistent with these manifestations is

Accepted Answer

A)   hypercalcemia.
B)   hyperglycemia.
C)   hypoalbuminemia.
D)   hypokalemia.E) A) and D)
F) None of the above

Question 4

The nurse explains that for a client who is a poor surgical risk, one of the nonsurgical alternatives for gallstone disease is

Accepted Answer

A)   abdominal ultrasound.
B)   laser therapy.
C)   retrograde endoscopy.
D)   T-tube placement.E) A) and B)
F) A) and C) C

Question 5

When a client is admitted to the hospital for treatment of acute cholecystitis, the nurse would anticipate that the immediate medical management will be

Accepted Answer

A)   antibiotic therapy.
B)   provided by a medical nutritionist.
C)   systemic corticosteroid administration.
D)   total parenteral nutrition.E) C) and D)
F) B) and C)

Question 6

The nurse is providing discharge instructions to a client going home with a T tube after an open cholecystectomy. Goals for teaching have been met when the client says

Accepted Answer

A)   "For drainage that is thick with mucus or blood, I can irrigate the T tube."
B)   "I will need to milk the tube every 4 hours and record the drainage."
C)   "The tube can be used to administer stone dissolving medications"
D)   "This tube will stay in for 1-2 weeks and I should watch for diminishing drainage."E) A) and C)
F) All of the above D

Question 7

A client with a T tube following choledochostomy asks the nurse why the tube is being clamped during mealtimes. The most accurate response by the nurse is

Accepted Answer

A)   "It causes less pain during mealtime."
B)   "It helps keep the common bile duct patent."
C)   "It helps with digestion of fats in the meal."
D)   "It will help the tube to come out more quickly."E) A) and B)
F) None of the above

Question 8

The nursing diagnosis that would serve as the primary guide when providing care to a client with cystic fibrosis (CF)  is

Accepted Answer

A)   Constipation
B)   Fluid Volume Excess
C)   Ineffective Airway Clearance
D)   Swallowing, ImpairedE) A) and B)
F) None of the above C

Question 9

The nurse recognizes that the client with gallstones who would be the best candidate for treatment with extracorporeal shock wave lithotripsy (ECSL)  is a client with

Accepted Answer

A)   common bile duct stones.
B)   liver disease.
C)   stones that are 6 cm in diameter.
D)   two gallstones.E) A) and B)
F) A) and C)

Question 10

A nurse is teaching a client and spouse about insulin administration. The spouse becomes quite upset, saying "Why are we having to use insulin at home? The diagnosis is pancreatitis! How did you make him a diabetic?" The best response by the nurse is

Accepted Answer

A)   "I see you are upset. Let me answer your questions before we talk about insulin."
B)   "I'm sorry you're upset. But you both need to understand how to use insulin."
C)   "When so much endocrine tissue is damaged, the client becomes diabetic."
D)   "Would you like the diabetic educator to come talk with you both?"E) A) and D)
F) All of the above

Question 11

In preparing the teaching plan on dietary changes after discharge for a client with chronic pancreatitis, the nurse would know that the statement most indicative of the client's understanding of the information is

Accepted Answer

A)   "I won't be eating any more French fries or drinking hard liquor."
B)   "A chicken breast and a glass of white wine sound like a good dinner."
C)   "I'm anxious to cooperate if it means I can get rid of this pain permanently."
D)   "My diet doesn't sound too bad; lots of people have to watch what they eat."E) All of the above
F) A) and B)

Question 12

Activities the nurse could suggest to a client interested in preventing gallstone formation include which of the following?

Accepted Answer

A)   Drink only bottled water.
B)   Increase the amount of protein eaten each day.
C)   Limit the amount of calcium in the diet.
D)   Maintain a low-fat diet.E) A) and C)
F) B) and C)

Question 13

The nurse planning the care of a client admitted with severe pancreatitis would anticipate the diet order of

Accepted Answer

A)   clear liquids.
B)   enteral feedings.
C)   NPO with TPN.
D)   soft, low fat.E) C) and D)
F) B) and D)

Question 14

A client returned to the nursing unit after cholecystectomy with common bile duct exploration has bile leaking from around the wound. The most appropriate nursing intervention at this time would be to

Accepted Answer

A)   assess the client further, asking about pain.
B)   reassure the client that this is normal and reinforce the dressing.
C)   monitor the client for elevations in blood pressure and pulse.
D)   encourage the client to change position in bed.E) A) and B)
F) A) and C)

Question 15

A nurse is providing discharge instructions for a post-cholecystectomy client. The nurse would view the goals for teaching had been effective when the client states he/she would

Accepted Answer

A)   call the physician if gas occurs.
B)   notify the physician of jaundice or itching.
C)   remain indoors until the dressings are removed.
D)   report dark-colored stools to the clinic.E) None of the above
F) A) and B)

Question 16

The morning after admission, a client being treated for gallstones begins to vomit about every 15 minutes and is complaining of abdominal pain. The most appropriate action by the nurse would be to

Accepted Answer

A)   encourage the client to ambulate.
B)   offer clear fluids.
C)   prepare to insert a nasogastric tube.
D)   turn the client to the right side.E) All of the above
F) C) and D)

Question 17

A client has returned from an open cholecystectomy. The nurse places the highest priority on which intervention?

Accepted Answer

A)   Coughing and deep breathing
B)   Early ambulation
C)   Wearing anti-embolic hose
D)   Use of a nasogastric tubeE) None of the above
F) A) and B)

Question 18

A client is admitted with acute pancreatitis. The orders are for "pancreatic rest." The nurse would implement which of the following? (Select all that apply.)

Accepted Answer

A)   Administering pancreatic enzymes with meals
B)   Bed rest with appropriate positioning
C)   Immediate insertion of an NG tube
D)   Withholding foods and liquidsE) None of the above
F) A) and C)

Question 19

A client who had pancreatic surgery has been started on medication therapy with pancrelipase (Pancrease) . The manifestation that the nurse would report as an indication that the dosage may be insufficient is

Accepted Answer

A)   black, tarry stools.
B)   clay-colored stools.
C)   constipation.
D)   steatorrhea.E) A) and D)
F) All of the above

Question 20

A nurse assessing the first 24 hours of drainage from a T tube inserted during surgery for cholelithiasis would record as normal the T-tube output of

Accepted Answer

A)   less than 50 ml.
B)   100 to 200 ml.
C)   300 to 500 ml.
D)   500-1000 ml.E) All of the above
F) A) and B)

Exam 46: Management of Clients with Exocrine Pancreatic and Biliary Disorders

Health promotion activities a nurse could recommend to a client in order to prevent pancreatitis include (Select all that apply)

Correct AnswerverifiedShow Answer

A client with a history of cholelithiasis presents at the hospital with nausea and vomiting, abdominal pain, and jaundice. The nurse would assess the client for

Correct AnswerverifiedShow Answer

A client with acute pancreatitis has a drop in blood pressure from (142/80) to (105/65) mm Hg at 2 hours after admission. The client has not voided and has become short of breath. The nurse would anticipate that the abnormal laboratory value consistent with these manifestations is

Correct AnswerverifiedShow Answer

The nurse explains that for a client who is a poor surgical risk, one of the nonsurgical alternatives for gallstone disease is

Correct AnswerverifiedC

When a client is admitted to the hospital for treatment of acute cholecystitis, the nurse would anticipate that the immediate medical management will be

Correct AnswerverifiedShow Answer

The nurse is providing discharge instructions to a client going home with a T tube after an open cholecystectomy. Goals for teaching have been met when the client says

Correct AnswerverifiedD

A client with a T tube following choledochostomy asks the nurse why the tube is being clamped during mealtimes. The most accurate response by the nurse is

Correct AnswerverifiedShow Answer

The nursing diagnosis that would serve as the primary guide when providing care to a client with cystic fibrosis (CF) is

Correct AnswerverifiedC

The nurse recognizes that the client with gallstones who would be the best candidate for treatment with extracorporeal shock wave lithotripsy (ECSL) is a client with

Correct AnswerverifiedShow Answer

A nurse is teaching a client and spouse about insulin administration. The spouse becomes quite upset, saying "Why are we having to use insulin at home? The diagnosis is pancreatitis! How did you make him a diabetic?" The best response by the nurse is

Correct AnswerverifiedShow Answer

In preparing the teaching plan on dietary changes after discharge for a client with chronic pancreatitis, the nurse would know that the statement most indicative of the client's understanding of the information is

Correct AnswerverifiedShow Answer

Activities the nurse could suggest to a client interested in preventing gallstone formation include which of the following?

Correct AnswerverifiedShow Answer

The nurse planning the care of a client admitted with severe pancreatitis would anticipate the diet order of

Correct AnswerverifiedShow Answer

A client returned to the nursing unit after cholecystectomy with common bile duct exploration has bile leaking from around the wound. The most appropriate nursing intervention at this time would be to

Correct AnswerverifiedShow Answer

A nurse is providing discharge instructions for a post-cholecystectomy client. The nurse would view the goals for teaching had been effective when the client states he/she would

Correct AnswerverifiedShow Answer

The morning after admission, a client being treated for gallstones begins to vomit about every 15 minutes and is complaining of abdominal pain. The most appropriate action by the nurse would be to

Correct AnswerverifiedShow Answer

A client has returned from an open cholecystectomy. The nurse places the highest priority on which intervention?

Correct AnswerverifiedShow Answer

A client is admitted with acute pancreatitis. The orders are for "pancreatic rest." The nurse would implement which of the following? (Select all that apply.)

Correct AnswerverifiedShow Answer

A client who had pancreatic surgery has been started on medication therapy with pancrelipase (Pancrease) . The manifestation that the nurse would report as an indication that the dosage may be insufficient is

Correct AnswerverifiedShow Answer

A nurse assessing the first 24 hours of drainage from a T tube inserted during surgery for cholelithiasis would record as normal the T-tube output of

Correct AnswerverifiedShow Answer

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