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PART 2: NUTRITIONAL-METABOLIC PATTERNS

Chapter 24: Nursing Care of Clients with Gallbladder, Liver, and Pancreatic Disorders

NCLEX® Review

NCLEX® Review

This activity contains 10 questions.

	A client with advanced cirrhosis has been diagnosed with hepatic encephalopathy. The nurse expects to assess for:   hand tremors. weight loss. malaise. stomatitis.

	The nurse reviews the I & O of a client who had a cholecystectomy and choledochotomy who is 24-hours post-op. The output of the T-tube as 445 ml. The nurse should:   call the surgeon immediately and report findings. increase the iv rate to cover the fluid loss over the next 24 hours. recognize that this is normal and do not intervene. turn the client to the left side to increase drainage.

	The initial treatment plan for a client with acute pancreatitis included insertion of an NG tube. The nurse explains to the client that the rationale for this procedure is to:   ensure adequate nutrition via tube feedings. rest the gi tract. provide adequate water intake. administer medications that cannot be given intravenously.

	A client was admitted to the hospital with a diagnosis of acute cholecystitis due to cholelithiasis. The client complains of severe abdominal pain, nausea, and has vomited 3 times. What is the priority nursing diagnosis for this client?   Imbalanced nutrition: less than body requirements related to vomiting Deficient fluid volume related to vomiting Infection related to gallbladder inflammation Acute pain related to biliary spasm

	A client diagnosed with chronic cirrhosis who has ascites and pitting peripheral edema also has hepatic encephalopathy. Which of the following nursing interventions are appropriate to prevent skin breakdown? Select all that apply.   Range of motion every 4 hours Turn and reposition every 2 hours Abdominal and foot massages every 2 hours Alternating air pressure mattress Sit in chair for 30 minutes each shift

	A client with chronic pancreatitis is being discharged from the hospital. Which of the following statements by the client demonstrates that the client understands how to take prescribed pancreatic enzyme replacements?   “I must take capsules three times daily spaced about 8 hours apart.” “I must take the medication when I wake up and before bed.” “I must take the medication with meals and snacks.” “I must take the capsules every 4 hours while awake.”

	The nurse is preparing a staff development program about caring for clients with hepatitis A. Which of the following interventions will the nurse include?   Wear a mask when providing care. Wear gloves when providing direct care. Assign a client with this diagnosis to a private room. Put on a gown prior to entering the client’s room.

	The nurse is preparing discharge instructions for a client with hepatitis B. The discharge plan should include which of the following instructions for the client?   Use a condom during sexual intercourse. Avoid all alcohol consumption for one month. Eat a low protein, high carbohydrate diet. Have all family members vaccinated for hepatitis.

	Which of the following will the nurse include in the care plan for a client hospitalized with viral hepatitis?   Bland diet Administer antibiotics as ordered Increase fluid intake to 3000 ml per day Adequate bed rest

	Spironolacctone (Aldactone) is prescribed for a client with chronic cirrhosis and ascites. The nurse should monitor the client for which of the following medication-related side effects?   Tachycardia Hyperkalemia Constipation Jaundice

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