Liver, Gallbladder, and Pancreas Diseases: Exam Study Guide, Exams of Nursing

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Gallbladder - and Exocrine

Pancreas

Comprehensive Exam Study Guide

Latest Updated 2024/

Gallbladder - and Exocrine

Pancreas

Comprehensive Exam Study Guide

Latest Updated 2024/

Chapter 16 - Diseases of the Liver - Gallbladder - and Exocrine Pancreas

1. Bile salts aid in the absorption of fatty acids through the formation of which substance? a. micelles b. chylomicrons c. acetyl CoA d. prothrombin e. mucoproteins ANSWER: a DIFFICULTY: Bloom's: Understand REFERENCES: Anatomy and Physiology of the Hepatobiliary System
2. Which organ stores bile that is produced in the liver? a. pancreas b. kidney c. spleen d. gallbladder e. stomach ANSWER: d DIFFICULTY: Bloom's: Remember REFERENCES: Anatomy and Physiology of the Hepatobiliary System
3. Delta cells of the pancreas are responsible for secreting: a. glucagon. b. insulin. c. somatostatin. d. amylase. e. cholecystokinin. ANSWER: c DIFFICULTY: Bloom's: Remember REFERENCES: Anatomy and Physiology of the Hepatobiliary System
4. Increased destruction of red blood cells with rapid release of bilirubin into the blood is known as: a. obstructive jaundice. b. bilirubin conjugation. c. post-hepatic jaundice. d. hemolytic jaundice.

Gallbladder - and Exocrine

Pancreas

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e. 3.3-3.5 mg/dL ANSWER: d DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology Common to the Hepatobiliary Tract

6. When ascites is present, which nutrition modification is typically necessary? a. low sodium b. decreased fluid intake c. increased vitamin K d. low fiber e. decreased protein ANSWER: a DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology Common to the Hepatobiliary Tract
7. A syndrome of impaired mental status and abnormal neuromuscular function that results from liver failure is known as: a. hepatic stenosis. b. jaundice. c. hepatic encephalopathy. d. fulminant hepatitis. e. hepatomegaly. ANSWER: c DIFFICULTY: Bloom's: Remember REFERENCES: Pathophysiology Common to the Hepatobiliary Tract
8. A patient with hepatic encephalopathy is being assessed according to the Adapted West Haven Criteria. The patient has marked somnolence, psychomotor agitation, and his speech is difficult to understand. In which stage would this patient be classified? a. 0 b. 1 c. 2 d. 3 e. 4 ANSWER: d DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology Common to the Hepatobiliary Tract

Gallbladder - and Exocrine

Pancreas

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9. Ammonia is absorbed and transported in the intestinal venous blood to the liver, where it is metabolized into what substance? a. amino acids b. urea c. fatty acids d. glucose e. glycogen ANSWER: b DIFFICULTY: Bloom's: Remember

Gallbladder - and Exocrine

Pancreas

Comprehensive Exam Study Guide

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d. generalized rash. e. dilated pupils. ANSWER: b DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver

14. The most common nutrient-drug interactions that occur with antiviral medications are: a. high cholesterol and hypertriglyceridemia. b. dyspepsia, abdominal pain, and diarrhea.

Gallbladder - and Exocrine

Pancreas

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c. hematochezia and iron deficiency anemia. d. muscle cramps, joint pain, and fever. e. headache, dizziness, and confusion. ANSWER: b DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver

15. What treatment is used in the management of both hepatitis B and hepatitis C? a. neomycin b. spironolactone c. prednisone d. interferon e. famotidine ANSWER: d DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver
16. Which is a true statement regarding alcoholism in older adults? a. Approximately 20% of people over 65 abuse alcohol. b. Most adults become addicted to alcohol later in life in response to problems. c. Older adults are even more susceptible to nutrient deficiencies when they abuse alcohol. d. Most primary care providers identify alcohol abuse in older adults because of routine assessments. e. Alcohol abuse among older adults is one of the most commonly identified problems of aging. ANSWER: c DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver
17. What laboratory level is most likely to be elevated in a patient with fatty liver? a. serum albumin b. glucose c. red blood cells d. cortisol e. serum transaminase ANSWER: e DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver

Gallbladder - and Exocrine

Pancreas

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REFERENCES: Pathophysiology of the Liver

19. The cause of fatty liver after alcohol ingestion is: a. greater amounts of glucagon secretion and enhanced gluconeogenesis from amino acids. b. elevated tryptophan levels and the formation of serotonin. c. increased availability of fatty acids in the liver. d. esterification of fatty acids. e. increased production and absorption of ammonia. ANSWER: c DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver
20. Which best describes hepatobiliary scintigraphy? a. A non-invasive test produces cross-section images of parts of the body. b. A gamma camera takes pictures of a radioactive compound as the bile moves through the liver, bile ducts, and gallbladder. c. An endoscope is inserted down the throat, through the stomach, and into the small intestine to view internal structures. d. A non-invasive X-ray produces three-dimensional pictures of parts of the body. e. The patient is injected with a small amount of radioactive material that is absorbed by the gallbladder, which stimulates it to contract. ANSWER: b DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver
21. Cystic fibrosis is an inherited disorder of epithelial transport and is one of the most common lethal inherited disorders of which ethnic group? a. Asians b. African Americans c. Caucasians d. Pacific Islanders e. Native Americans ANSWER: c DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver
22. Alcohol causes increased urinary excretion of which nutrient?

Gallbladder - and Exocrine

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a. folate b. vitamin B c. magnesium d. chloride e. sodium ANSWER: a DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver

Gallbladder - and Exocrine

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ANSWER: d DIFFICULTY: Bloom's: Apply REFERENCES: Pathophysiology of the Liver

27. The most common cause of cirrhosis in the United States is: a. alcohol abuse. b. hepatitis B. c. non-alcoholic fatty liver disease. d. hepatitis C.

Gallbladder - and Exocrine

Pancreas

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e. biliary colic. ANSWER: d DIFFICULTY: Bloom's: Remember REFERENCES: Pathophysiology of the Liver

28. There are three types of gallstones: cholesterol, pigment, and: a. bile. b. mixed. c. ammonia. d. inflammatory. e. phospholipid. ANSWER: b DIFFICULTY: Bloom's: Remember REFERENCES: Pathophysiology of the Biliary System
29. Which intervention is appropriate for a patient with an acute attack of cholangitis? a. A low-fat diet b. Decreased fluid intake c. Supplementation with vitamin B d. Enteral nutrition e. Increased carbohydrate intake ANSWER: a DIFFICULTY: Bloom's: Apply REFERENCES: Pathophysiology of the Biliary System
30. The most common cause of chronic pancreatitis in children is: a. phenylketonuria. b. sickle cell anemia. c. necrotizing enterocolitis. d. cystic fibrosis. e. hypothyroidism. ANSWER: d DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Exocrine Pancreas
    31. Symptoms associated with acute pancreatitis include:

Gallbladder - and Exocrine

Pancreas

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32. Which condition is commonly associated with chronic pancreatitis? a. celiac disease b. anorexia c. diabetes d. renal failure e. atrial fibrillation ANSWER: c DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Exocrine Pancreas
33. When steatorrhea associated with pancreatitis occurs, what intervention should follow?

a. Administration of pancreatic digestive enzymes b. Early initiation (within 48 hours) of enteral nutrition c. A low-carbohydrate nutrition prescription with modest protein d. Calcium supplements along with a multivitamin e. Fluid and sodium restriction ANSWER: a DIFFICULTY: Bloom's: Apply REFERENCES: Pathophysiology of the Exocrine Pancreas

JB is a 53 yo male who was recently divorced. He has experienced periods of depression and decreased appetite. Family reports history of heavy drinking habits and 15# weight lost. He was previously diagnosed with cirrhosis and portal hypertension and paracentesis and TIPS procedures were performed. Mr. JB’s condition seems to have worsened; he c/o stomach pains, nausea, and vomiting at times. His abdomen is sore to touch and feels swollen. Mr. JB has developed ascites and pedal edema; his urinary output has decreased and he continues to lose weight. Mr. JB also c/o pain when swallowing food. Because of JB’s persistent symptoms, he’s been admitted to the hospital. A referral to the SLP for a MBS was also ordered and resulted in dysphagia, pureed diet recommended. By day 2 Mr. JB still c/o of nausea and no po intake has been reported. The MD prescribed dietary consult: RD to assess patient and recommend alternate means of nutrition support, currently NPO. Ht: 5’11’’ Wt: 145 # UBW: 163# Dx: End-stage liver cirrhosis, dysphagia PMH: alcoholic cirrhosis, portal hypertension

Labs: Na: 134 Cl: 101 BUN: 4 Alb: 2.3 TG: 305 Transferrin: 101 NH4: 53 Glu: 139 AST: 45 ALT 48 Alk Phos: 40 Bilirubin: 2. K: 5.

Diet: NPO

CO2: 25 Cr: 1.8 H/H: 11/

Gallbladder - and Exocrine

Pancreas

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Meds: Neomycin, Aldactone, Lasix, Reglan

34. Following the paracentesis, the nutritionist might recommend what component to the nutrition prescription? a. vitamin B b. protein c. hypertonic fluid d. vitamin D e. potassium ANSWER: b DIFFICULTY: Bloom's: Apply

Gallbladder - and Exocrine

Pancreas

Comprehensive Exam Study Guide

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38. Because of JB’s history of alcohol abuse, he is most likely at risk of which nutrient deficiency? a. potassium b. vitamin A c. sodium d. vitamin B e. vitamin E ANSWER: d DIFFICULTY: Bloom's: Understand

Gallbladder - and Exocrine

Pancreas

Comprehensive Exam Study Guide

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REFERENCES: Pathophysiology of the Liver PREFACE NAME: case

39. The liver receives blood from two sources: the hepatic portal vein and the hepatic artery. a. True b. False ANSWER: True DIFFICULTY: Bloom's: Remember REFERENCES: Anatomy and Physiology of the Hepatobiliary System
40. Bile (or gall) is a bitter yellow, blue, and green fluid secreted by the liver and stored in the pancreas. a. True b. False ANSWER: False DIFFICULTY: Bloom's: Understand REFERENCES: Anatomy and Physiology of the Hepatobiliary System
41. Autodigestion of the pancreas is prevented by storing the digestive enzymes in their inactive forms, as zymogens. a. True b. False ANSWER: True DIFFICULTY: Bloom's: Understand REFERENCES: Anatomy and Physiology of the Hepatobiliary System
42. Medical treatment for hepatoencephalopathy is primarily directed at reducing the amount of circulating ammonia. a. True b. False ANSWER: True DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology Common to the Hepatobiliary Tract
43. Red blood cells, alkaline phosphatase, and serum glucose are generally elevated with hepatitis. a. True b. False ANSWER: False DIFFICULTY: Bloom's: Understand REFERENCES: Pathophysiology of the Liver