Chapter 40 Assessment and Management of Patients With Biliary Disorders

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Chapter 40  Assessment and Management of Patients With Biliary Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. The nurse is assessing a typical patient with cholecystitis. The patient complains of localized pain. Where would the nurse also ask the patient if the pain has radiated to?
A) Left upper arm
B) Lower abdomen

C) Neck or jaw D) Right shoulder

Ans: D
Chapter: 40
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication and Documentation Objective: 1
Page and Header: 1173, Cholelithiasis

Feedback: The patient may have biliary colic with excruciating upper right abdominal pain that radiates to the back or right shoulder. Pain from cholecystitis does not radiate to the left upper arm, the lower abdomen, the neck, or the jaw.

2. A 55-year-old male with acute pancreatitis is being admitted. What is the critical care nurse aware of concerning the common description of acute pancreatitis?
A) Toxic substances inflame the pancreas.
B) The patient abuses alcohol.

C) Viruses digest the pancreas.
D) Pancreatic enzymes digest the pancreas.

Ans: D
Chapter: 40
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 3
Page and Header: 1181, Disorders of the Pancreas

Feedback: Although the mechanisms causing pancreatitis are unknown, pancreatitis is commonly described as the autodigestion of the pancreas. Less commonly, toxic substances, alcohol, and viruses are implicated as the cause of pancreatitis.

3. You are assessing a patient newly admitted with chronic pancreatitis. What would you anticipate potential dysfunction of?
A) Pancreatic islet cells
B) Peristalsis

C) Decrease in biliary stenosis D) Large bowel absorption

Ans: A
Chapter: 40
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3
Page and Header: 1189, Chronic Pancreatitis

Feedback: For the patient with chronic pancreatitis, nonsurgical management of diabetes mellitus resulting from dysfunction of the pancreatic islet cells is treated with diet, insulin, or oral antidiabetic agents. You would not anticipate potential dysfunction of peristalsis or large bowel absorption. There would be an increase in biliary stenosis rather than a decrease.

4. Your patient has a gallstone blocking the bile duct. When you assess the patient’s laboratory studies what would you expect to find?
A) Increased bilirubin level in the blood
B) Decreased cholesterol level

C) Increased BUN level
D) Decreased serum alkaline phosphatase level

Ans: A
Chapter: 40
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 1170, Anatomic and Physiologic Overview

Feedback: If the flow of blood is impeded, bilirubin, a pigment derived from the breakdown of red blood cells, does not enter the intestines. As a result bilirubin, levels in the blood increase.

5. The nurse in the walk-in clinic cares for a wide range of individuals. The nurse knows that the patient at increased risk for an acute pancreatitis attack is which of the following?
A) A 45-year-old woman with a high-fat diet
B) An 18-year-old man who is a weekend binge drinker

C) A 39-year-old man with chronic alcoholism
D) A 51-year-old woman who smokes one pack of cigarettes per day

Ans: C
Chapter: 40
Client Needs: D-3
Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Nursing Process Objective: 4
Page and Header: 1189, Chronic Pancreatitis

Feedback: The median age of patients diagnosed with chronic pancreatitis is 37 to 40 years. Frequently, at that age, patients already report a long history of alcohol abuse. Excessive and prolonged consumption of alcohol accounts for approximately 70% to 80% of all cases of chronic pancreatitis. Therefore options A, B, and D are incorrect.

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