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Management Of Clients With Exocrine Pancreatic And Biliary Disorders

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Question 1
Free
Multiple Choice

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

Choose correct answer/s
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.

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Question 2
Free
Multiple Choice

The nurse recognizes that the individual at highest risk for development of gallstones is

Choose correct answer/s
A

a 20-year-old black man with sickle cell disease.

B

a 35-year-old white woman being treated for breast cancer.

C

a 49-year-old white man with a sedentary lifestyle.

D

a 60-year-old white woman being treated for obesity.

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Question 3
Free
Multiple Choice

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

Choose correct answer/s
A

common bile duct obstruction.

B

infarct of the hepatic vein.

C

perforation of the gallbladder.

D

spasm of the biliary tree.

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Question 4
Free
Multiple Choice

In evaluating a client for the presence of gallbladder disease, the nurse would recognize that the client's statement most suggestive of this problem is

Choose correct answer/s
A

"I am having difficulty swallowing."

B

"I get a sharp, stabbing pain every time I take a deep breath or cough."

C

"I have a terrible pain in my stomach; it is so bad I can feel it in my shoulder."

D

"I have a very strong craving for fatty foods like bacon and eggs fried in butter."

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Question 5
Free
Multiple Choice

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

Choose correct answer/s
A

abdominal ultrasound.

B

laser therapy.

C

retrograde endoscopy.

D

T-tube placement.

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Question 6
Multiple Choice

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

Choose correct answer/s
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.
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Question 7
Multiple Choice

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

Choose correct answer/s
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.
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Question 8
Multiple Choice

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

Choose correct answer/s
A
Coughing and deep breathing
B
Early ambulation
C
Wearing anti-embolic hose
D
Use of a nasogastric tube
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Question 9
Multiple Choice

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

Choose correct answer/s
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.
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Question 10
Multiple Choice

A client has been diagnosed with cancer of the gallbladder. Which statement by the client would lead the nurse to feel concern for this client's coping?

Choose correct answer/s
A
"After my chemotherapy is over, I think I will retire and do a lot of traveling.
B
"I'm going to see a lawyer and update my will and advance directives."
C
"It's hard deciding if I should have chemo or radiation because both have bad results."
D
"My doctors say there is no agreement on the best treatment."
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Question 11
Multiple Choice

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

Choose correct answer/s
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."
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Question 12
Multiple Choice

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

Choose correct answer/s
A
antibiotic therapy.
B
provided by a medical nutritionist.
C
systemic corticosteroid administration.
D
total parenteral nutrition.
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Question 13
Multiple Choice

A client with acute pancreatitis has developed a Cullen's sign. Which nursing diagnosis takes priority for this client?

Choose correct answer/s
A
Acute Pain
B
Altered Nutrition
C
Imbalanced Fluid Volume
D
Ineffective Breathing Patterns
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Question 14
Multiple Choice

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

Choose correct answer/s
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?"
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Question 15
Multiple Choice

To attempt to alleviate the pain of a client with acute pancreatitis, the nurse would place the client in the

Choose correct answer/s
A
prone position with a pillow under the abdomen.
B
semi-Fowler position with a small pillow under the knees.
C
side-lying position with a pillow splinting the abdomen.
D
supine position with a cold pack to the abdomen.
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Question 16
Multiple Choice

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

Choose correct answer/s
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."
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Question 17
Multiple Choice

The nurse would explain that Whipple's operation involves

Choose correct answer/s
A
excavation of a pancreatic abscess and implantation of an external drain.
B
removal of the head of the pancreas and portions of the stomach and duodenum.
C
surgical removal of a pancreatic pseudocyst and implantation of an external drain.
D
surgical removal of the tail of the pancreas and portions of the colon.
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Question 18
Multiple Choice

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

Choose correct answer/s
A
Constipation
B
Fluid Volume Excess
C
Ineffective Airway Clearance
D
Swallowing, Impaired
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Question 19
Multiple Choice

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

Choose correct answer/s
A
common bile duct stones.
B
liver disease.
C
stones that are 6 cm in diameter.
D
two gallstones.
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Question 20
Multiple Choice

A client had an endoscopic retrograde papillotomy for stone removal and has returned to the nursing unit. The client is asking for ice chips. What assessment takes priority? The nurse should assess the client's

Choose correct answer/s
A
bowel sounds.
B
gag reflex.
C
sedation level.
D
vital signs.
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