Ch 46 Liver
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Health Sciences
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50 questions
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1.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
The nurse clarifies that which event happens to unconjugated bilirubin, which is made up of broken-down red cells?
It is stored in the gallbladder to make bile.
Water-insoluble bilirubin must be converted by the liver.
A by-product is excreted directly into the bowel for excretion.
Red blood cells are necessary for digestion of fats.
Answer explanation
Unconjugated bilirubin is a water-insoluble product that must be converted in the liver to conjugated bilirubin (water soluble) so that it may be excreted through the bowel.
2.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
The patient with cirrhosis has an albumin of 2.8 g/dL. The nurse is aware that normal is 3.5 to 5 g/dL. Based on these findings, which would the nurse expect the patient to exhibit?
Jaundice
Edema
Copious urine output
Pallor
Answer explanation
Low serum albumin levels result also from excessive loss of albumin into urine or into third-space volumes, causing ascites or edema.
3.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Which is an essential nursing measure to prevent injury to the patient who is to receive a paracentesis?
Have patient sign a permit.
Pad side rails.
Check for allergy to contrast media or to shellfish.
Have patient void immediately before procedure.
Answer explanation
To prevent the puncturing of the bladder, the patient must void immediately before the procedure. A permit is required but it is not a safety precaution for the patient. There is no contrast media used in a paracentesis.
4.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Which should the nurse expect of a patient with a malabsorption of vitamin K?
Anemia
Excess platelet production
Increased coagulation time
Elevated for infection due to diminished white blood cell count
Answer explanation
Prothrombin times are increased because malabsorption of vitamin K or inability to produce the clotting factors VII, IX, and X cause the patient to have bleeding tendencies.
5.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A patient was scheduled for a laparoscopic cholecystectomy, but complications developed and the patient underwent an open cholecystectomy with a T tube inserted into the common bile duct. Which is the purpose of the T tube?
To decompress the duct and relieve pain caused by stimulation of the sphincter of Oddi.
To improve diaphragmatic expansion and prevention of atelectasis.
To shorten postoperative recovery and hasten the healing process.
To keep the duct open and allow drainage of the bile until edema resolves.
Answer explanation
If the stones are in the common bile duct and edema is present, a biliary drainage tube, or T tube, will be inserted to keep the duct open and allow drainage of the bile until the edema resolves.
6.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
The nurse caring for a patient who has had an open cholecystectomy with a T Tube will take which action?
open the T tube to the air so that it will drain freely.
position and secure the drainage bag at mid-chest level.
place the collection bag so the tube is not kinked.
irrigate the T tube with normal saline to ensure the free flow of bile.
Answer explanation
The T tube is placed below the level of the common bile duct to prevent the reflux of bile. The bag must be positioned so the tube is not kinked, or bile cannot drain from the liver. Normally T tubes are not irrigated.
7.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Which nursing intervention should will be completed immediately after the health care provider has performed a needle liver biopsy?
Assisting to ambulate for the bathroom
Keeping the patient on the right side for a minimum of 2 hours
Taking vital signs every 4 hours
Keeping the patient on the left side for a minimum of 4 hours
Answer explanation
Keep the patient lying on the right side with a rolled towel against the puncture site for minimum of 2 hours to splint the puncture site. It compresses the liver capsule against the chest wall to decrease the risk of hemorrhage or bile leak. Vital signs are taken every 15 minutes for 30 minutes, then every 30 minutes for 2 hours.
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