Chapter_30-_Disorders_of_Hepatobiliary_and_Exocrine_Pancreatic_Function My Nursing Test Banks

 

1.

Abnormally high accumulation of bilirubin in the blood causes:

A)

jaundice.

B)

cholestasis.

C)

xanthomas.

D)

biliary cirrhosis.

2.

The mechanisms of liver damage in viral hepatitis include:

A)

direct cellular injury.

B)

fatty liver changes.

C)

disrupted bile flow.

D)

bile duct inflammation.

3.

Alcoholic liver disease manifests in three stages. The intermediate stage, alcoholic hepatitis, is characterized by liver cell:

A)

necrosis.

B)

nodules.

C)

atrophy.

D)

hypertrophy.

4.

A major factor in the development of hepatic encephalopathy is:

A)

hypersplenism.

B)

high sodium level.

C)

neurotoxin accumulation.

D)

steroid hormone deficiency.

5.

Kupffer cells function as ______ to remove harmful substances or cells from the portal blood as it moves through the venous sinusoids.

A)

filters

B)

channels

C)

phagocytes

D)

cytotoxic cells

6.

Both prehepatic and posthepatic causes of portal hypertension include the formation of:

A)

fibrous nodules.

B)

venous thrombosis.

C)

collateral circulation.

D)

portosystemic shunts.

7.

The late manifestations of cirrhosis are related to liver failure and:

A)

hepatomegaly.

B)

diffuse liver fibrosis.

C)

portal hypertension.

D)

hepatorenal syndrome.

8.

Factors that contribute to the formation of gallstones, or acute cholelithiasis, include:

A)

chronic pancreatitis.

B)

rapid elimination of bile.

C)

gallbladder inflammation.

D)

excessive alcohol intake.

9.

The patient has right upper quadrant pain caused by acute choledocholithiasis. If the common bile duct becomes obstructed, manifestations will also include:

A)

ascites.

B)

vomiting.

C)

bilirubinuria.

D)

hemorrhage.

10.

Acute pancreatitis involves activated pancreatic enzymes that escape into surrounding tissues to cause _______.

A)

fatty deposits

B)

autodigestion

C)

bowel obstruction

D)

abscess formation

11.

Individuals with liver disease often experience the effects of excess serum ammonia as a result of impairment of the livers ability to process ammonia. How does the liver process ammonia in healthy individuals?

A)

By converting it into bilirubin which is then excreted intestinally

B)

By processing ammonia into nitrogen and hydrogen ions for excretion

C)

By processing it into urea and releasing it into the circulation

D)

By combining it with oxygen to create ammonium oxide

12.

A patients longstanding diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this patient most likely experience?

A)

Prehepatic

B)

Intrahepatic

C)

Posthepatic

D)

Infectious

13.

A decrease in the serum level of which of the following substances is suggestive of liver injury?

A)

g-Glutamyltransferase (GGT)

B)

Albumin

C)

Alanine aminotransferase (ALT)

D)

Alkaline phosphatase

14.

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the patients statements suggests that he understands his new diagnosis?

A)

I guess Im an example of why you should always use condoms.

B)

Im embarrassed that Ill be a carrier of hepatitis from now on.

C)

Im still trying to deal with the fact that this will forever change my life.

D)

I dont know why I didnt bother to get vaccinated against this.

15.

A 16-year-old girl has been admitted to the emergency department after ingesting 20 g of acetaminophen (Tylenol) in a suicide attempt. The care team would recognize that this patient faces a severe risk of:

A)

acute fulminant hepatitis.

B)

hepatitis D virus infection.

C)

secondary biliary cirrhosis.

D)

portal hypertension.

16.

Which of the following factors accounts for the poor prognosis that typically accompanies a diagnosis of primary hepatocellular cancer?

A)

Surgical options do not exist because removal of all or part of the liver is a threat to health.

B)

Liver cancer typically metastasizes at a much earlier stage than other cancers.

C)

Liver tumors are poorly differentiated due to the low density of hepatic tissue.

D)

The nonspecific symptomatology of liver cancer means that diagnosis often happens at a late stage.

17.

Which of the following factors is most strongly associated with the pathogenesis of gallstones?

A)

Excess serum ammonia and urea levels

B)

Portal hypertension

C)

Abnormalities or stasis of bile

D)

High cholesterol diet

18.

Which of the following individuals most likely faces the highest risk of developing chronic pancreatitis?

A)

A woman who has six to eight drinks each evening

B)

A man who has become profoundly ill during a tropical vacation

C)

A woman who takes two Tylenol tablets five to six times a day

D)

An obese man who has a high-fat diet and has a sedentary lifestyle

19.

The nurse who is providing care for a patient with pancreatic cancer should prioritize which of the following assessments?

A)

Assessment for ascites and close monitoring of fluid balance

B)

Respiratory assessment and monitoring of arterial blood gases

C)

Vigilant monitoring of blood glucose levels

D)

Assessment for deep vein thrombosis

20.

Which of the following signs and symptoms is most suggestive of acute cholecystitis?

A)

Upper right quadrant or epigastric pain

B)

Fever and sudden abdominal distention

C)

Appearance of undigested fat in feces

D)

Nausea resulting in greenish vomitus

Answer Key

1.

A

2.

A

3.

A

4.

C

5.

C

6.

B

7.

C

8.

C

9.

C

10.

B

11.

C

12.

A

13.

B

14.

D

15.

A

16.

A

17.

C

18.

A

19.

D

20.

A

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