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A patient with hepatitis A is in the acute phase. The nurse plans care for the patient based on the knowledge that

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pruritus is a common problem with jaundice in this phase

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A patient with acute hepatitis B is being discharged in 2 days. In the discharge teaching plan the nurse should include instructions to

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use a condom during sexual intercourse

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A patient has been told that she has elevated liver enzymes caused by nonalcoholic fatty liver disease (NAFLD). The nursing teaching plan should include

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recommending a heart-healthy diet

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The patient with advanced cirrhosis asks why his abdomen is so swollen. The nurse's response is based on the knowledge that a. a lack of clotting factors promotes the collection of blood in the abdominal cavity

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portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space

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In planning care for a patient with metastatic liver cancer, the nurse should include interventions that

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focus primarily on symptomatic and comfort measures Rationale: Nursing intervention for a patient with liver cancer focuses on keeping the patient as comfortable as possible. The prognosis for patients with liver cancer is poor. The cancer grows rapidly, and death may occur within 4 to 7 months as a result of hepatic encephalopathy or massive blood loss from gastrointestinal (GI) bleeding.

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Nursing management of the patient with acute pancreatitis includes (select all that apply)

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checking for signs of hypocalcemia giving insulin based on a sliding scale

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A patient with pancreatic cancer is admitted to the hospital for evaluation of possible treatment options. The patient asks the nurse to explain the Whipple procedure that the surgeon has described. The explanation includes the information that a Whipple procedure involves

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removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum

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The nursing management of the patient with cholecystitis associated with cholelithiasis is based on the knowledge that

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laparoscopic cholecystectomy is the treatment of choice in most patients who are symptomatic

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Teaching in relation to home management after a laparoscopic cholecystectomy should include

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reporting any bile-colored drainage or pus from any incision

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NCLEX pre-test question The nurse is caring for a woman recently diagnosed with viral hepatitis A. Which individual should the nurse refer for an immunoglobin (IG) injection?

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A caregiver who lives in the same household with the patient

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NCLEX pre-test question The nurse provides discharge instructions for a 64-year-old woman with ascites and peripheral edema related to cirrhosis. Which statement, if made by the patient, indicates teaching was effective?

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"Herbs and other spices should be used to season my foods instead of salt."

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NCLEX pre-test question The nurse is caring for a 55-year-old man patient with acute pancreatitis resulting from gallstones. Which clinical manifestation would the nurse expect the patient to exhibit?

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Left upper abdominal pain

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NCLEX pre-test question The nurse is caring for a group of patients. Which patient is at highest risk for pancreatic cancer?

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A 72-year-old African American male who has smoked cigarettes for 50 years

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NCLEX pre-test question The nurse instructs a 50-year-old woman about cholestyramine to reduce pruritis caused by gallbladder disease. Which statement by the patient to the nurse indicates she understands the instructions?

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"The medication is a powder and needs to be mixed with milk or juice.

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NCLEX review question A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To what diagnosis does the nurse attribute these findings?

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Alcohol abuse

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NCLEX review question The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will monitor for effectiveness of this medication for this patient by assessing what?

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Decreased ammonia levels

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NCLEX review question The family of a patient newly diagnosed with hepatitis A asks the nurse what they can do to prevent becoming ill themselves. Which response by the nurse is most appropriate?

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"An injection of immunoglobulin will need to be given to prevent or minimize the effects from this exposure."

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NCLEX review question When planning care for a patient with cirrhosis, the nurse will give highest priority to which nursing diagnosis?

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Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume

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NCLEX review question When caring for a patient with liver disease, the nurse recognizes the need to prevent bleeding resulting from altered clotting factors and rupture of varices. Which nursing interventions would be appropriate to achieve this outcome (select all that apply)?

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- Use smallest gauge needle possible when giving injections or drawing blood. - Teach patient to avoid straining at stool, vigorous blowing of nose, and coughing. - Advise patient to use soft-bristle toothbrush and avoid ingestion of irritating food. - Apply gentle pressure for the shortest possible time period after performing venipuncture.

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NCLEX review question A patient with type 2 diabetes and cirrhosis asks the nurse if it would be okay to take silymarin (milk thistle) to help minimize liver damage. The nurse responds based on what knowledge?

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Milk thistle may affect liver enzymes and thus alter drug metabolism

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NCLEX review question When caring for a patient with a biliary obstruction, the nurse will anticipate administering which vitamin supplements (select all that apply)?

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Vitamin A Vitamin D Vitamin E Vitamin K

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NCLEX review question A patient who has hepatitis B surface antigen (HBsAg) in the serum is being discharged with pain medication after knee surgery. Which medication order should the nurse question because it is most likely to cause hepatic complications?

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Hydrocodone with acetaminophen (Vicodin)

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NCLEX review question The condition of a patient who has cirrhosis of the liver has deteriorated. Which diagnostic study would help determine if the patient has developed liver cancer?

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Hepatic structure ultrasound

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NCLEX review question The patient with right upper quadrant abdominal pain has an abdominal ultrasound that reveals cholelithiasis. What should the nurse expect to do for this patient?

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Control abdominal pain

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NCLEX review question A patient with cholelithiasis needs to have the gallbladder removed. Which patient assessment is a contraindication for a cholecystectomy?

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Activated partial thromboplastin time (aPTT) of 54 seconds

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NCLEX review question When teaching the patient with acute hepatitis C (HCV), the patient demonstrates understanding when the patient makes which statement?

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"I will need to be checked for chronic HCV and other liver problems."

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NCLEX review question The patient with cirrhosis has an increased abdominal girth from ascites. The nurse should know that this fluid gathers in the abdomen for which reasons (select all that apply)?

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- There is decreased colloid oncotic pressure from the liver's inability to synthesize albumin. - Hyperaldosteronism related to damaged hepatocytes increases sodium and fluid retention. - Portal hypertension pushes proteins from the blood vessels, causing leaking into the peritoneal cavity.

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NCLEX review question The patient with cirrhosis is being taught self-care. Which statement indicates the patient needs more teaching?

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"If I notice a fast heart rate or irregular beats, this is normal for cirrhosis."

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NCLEX review question The patient with a history of lung cancer and hepatitis C has developed liver failure and is considering liver transplantation. After the comprehensive evaluation, the nurse knows that which factor discovered may be a contraindication for liver transplantation?

answer

The chest x-ray showed another lung cancer lesion.

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NCLEX review question The patient with sudden pain in the left upper quadrant radiating to the back and vomiting was diagnosed with acute pancreatitis. What intervention(s) should the nurse expect to include in the patient's plan of care?

answer

Insert an NG and maintain NPO status to allow pancreas to rest

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NCLEX review question The patient with suspected pancreatic cancer is having many diagnostic studies done. Which one can be used to establish the diagnosis of pancreatic adenocarcinoma and for monitoring the response to treatment?

answer

Cancer-associated antigen 19-9

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NCLEX review question When providing discharge teaching for the patient after a laparoscopic cholecystectomy, what information should the nurse include?

answer

A lower-fat diet may be better tolerated for several weeks

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What is the #1 cause of pancreatitis?

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Gallbladder disease (alcohol abuse is #2)

question

The nurse explains to a patient with an episode of acute pancreatitis that the most effective means of relieving pain by suppressing pancreatic secretions is the use of:

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NPO status

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The surgical treatment of choice for the patient with symptomatic gallbladder disease is a

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Laparoscopic cholecystectomy

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Postoperatively, a patient with an incisional cholecystectomy has a nursing diagnosis of ineffective breathing pattern related to splinted respirations secondary to a high abdominal incision. Which action should the nurse take first?

answer

Administer the prescribed analgesic

AMS exam 2 – Evolve Chapter 44: Liver, Pancreas, and Biliary Tract Problems – Flashcards

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