Chapter 22: Gastrointestinal Disorders and Therapeutic Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Accumulation of ammonia and other toxins normally detoxified by the liver can produce which of the following?

a.	Ketoacidosis
b.	Hepatic encephalopathy
c.	Hemorrhage
d.	Portal hypertension

 

ANS:   B

Hepatic encephalopathy is thought to result from failure of the liver to detoxify various substances in the bloodstream and may be worsened by metabolic and electrolyte imbalances.

 

DIF:    Cognitive Level: Comprehension       REF:    449

OBJ:    Nursing Process: Evaluation   TOP:    Gastrointestinal Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. To decrease portal hypertension, an interventional radiologist can:

a.	insert a vena cava umbrella.
b.	perform a transjugular intrahepatic portosystemic shunt procedure.
c.	insert a hepatic stent.
d.	perform hepatic lobectomy.

 

ANS:   B

A transjugular intrahepatic portosystemic shunt is a shunt created by means of an angiographic interventional procedure to decrease portal hypertension. The shunt procedure is usually performed by a gastroenterologist, vascular surgeon, or interventional radiologist.

 

DIF:    Cognitive Level: Comprehension       REF:    454

OBJ:    Nursing Process: Implementation       TOP:    Gastrointestinal Therapeutic Management

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

3. A patient with hepatic encephalopathy shows euphoria, mild confusion, and normal electroencephalographic (EEG) findings. The nurse charts these observations to confirm the diagnosis of what stage of the condition?

a.	Stage I
b.	Stage II
c.	Stage III
d.	Stage IV

 

ANS:   A

Stage I hepatic encephalopathy is characterized by euphoria or depression, mild confusion, slurred speech, disordered sleep rhythm, slight asterixis, and normal EEG results.

 

DIF:    Cognitive Level: Analysis      REF:    Box 22-8

OBJ:    Nursing Process: Assessment TOP:    Gastrointestinal Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. The patient with stage III hepatic encephalopathy would show which of the following signs and symptoms?

a.	Stupor and hyporeflexia
b.	Hyperexcitability with intermittent drowsiness
c.	Incoherent speech and arousable sleepiness
d.	Response only to noxious stimuli and normal EEG

 

ANS:   C

Stage III hepatic encephalopathy is characterized by marked confusion, incoherent speech, sleepiness but with the ability to be aroused, asterixis, and abnormal EEG results.

 

DIF:    Cognitive Level: Synthesis     REF:    Box 22-8

OBJ:    Nursing Process: Assessment TOP:    Gastrointestinal Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. As the nurse reviews the patient’s laboratory values, the nurse expects to find elevations in which test results to establish a diagnosis of acute liver failure?

a.	Blood glucose and serum potassium levels
b.	Serum bilirubin and alkaline phosphatase levels
c.	Serum albumin level and anion gap
d.	Serum sodium and chloride levels

 

ANS:   B

Findings diagnostic of acute liver failure include elevated serum levels of bilirubin, aspartate aminotransferase, alkaline phosphatase, and ammonia and decreased serum albumin level. Arterial blood gas analysis reveals respiratory alkalosis and/or metabolic acidosis.

 

DIF:    Cognitive Level: Analysis      REF:    449

OBJ:    Nursing Process: Assessment TOP:    Gastrointestinal Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation