Chapter 51 Hepatic, Biliary Tract, and Pancreatic Dysfunction: Nursing Management MULTIPLE CHOICE 1.A child care worker complains of flu-like symptoms. On further assessment, hepatitis is suspected. T he nurse realizes that this individual is at risk for which type of hepatitis? 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis D ANS: 1 Hepatitis A virus (HAV) is spread through the fecal-oral route. Child care workers are at greater risk because of potentially poor hygiene practices. Child care workers are not at the same risk for contracting hepatitis B, C, or D. 2.An older male is diagnosed with cirrhosis of the liver. The nurse knows that the most likely cause of this problem is: 1. being in the military. 2. traveling to a foreign country. 3. drinking excessive alcohol. 4. eating bad food. ANS: 3 The destruction to the liver from alcohol often progresses from fatty liver to alcoholic hepatitis and culminates in alcoholic cirrhosis. Alcoholic cirrhosis accounts for a great number of individuals diagnosed with this disease. Cirrhosis is not associated with being in the military, traveling to a foreign country, or eating bad food. 3.When the liver is seriously damaged, ammonia levels can rise in the body. One of the treatments for this is: 1. administering intravenous (IV) neomycin. 2. giving vitamin K. 3. giving lactulose. 4. starting the patient on insulin. ANS: 3 Lactulose is a laxative that works by pulling water into the stool. It also helps pull ammonia from the blood into the colon for expulsion. IV antibiotics do not reduce serum ammonia levels. Vitamin K controls bleeding, but it does not reduce ammonia levels. Insulin is not used to reduce ammonia levels. 4.A client is scheduled for a liver biopsy. The nurse realizes that the most important sign to assess for is: 1. infection. 2. bleeding. 3. pain. 4. nausea and vomiting. ANS: 2 After a liver biopsy, the client is monitored for bleeding or hemorrhage. Infection and pain are of concern, but they are not the most important signs to be monitored. Nausea and vomiting are not typically associated with a liver biopsy. 5.The nurse realizes that the organ which is a major site for metastases, harboring and growing cancerous cells that originated in some other part of the body, is the: 1. spleen. 2. gallbladder. 3. liver. 4. stomach. ANS: 3 In most developed countries, this secondary type of liver cancer is more common than cancer that originates in the liver itself. The spleen, gallbladder, and stomach are not major sites for metastases. 6.A school age child is placed on a waiting list for a liver transplant. The nurse knows that the most common reason for children to need this type of transplant is because of: (TO BE CONTINUED……………)