HEPATIC AND BILIARY NCLEX
QUESTIONS 2026 COMPLETE REVIEW
WITH VERIFIED ANSWERS| GRADED A+
| GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,A client with pancreatitis is admitted to the medical B) Reserving an antecubital site for a peripherally inserted central catheter (PICC)
intensive care unit. Which nursing intervention is most
appropriate? Pancreatitis treatment typically involves resting the GI tract by maintaining
A) Providing the client with plenty of P.O. fluids nothing-by-mouth status. The nurse should reserve the antecubital site for a PICC,
B) Reserving an antecubital site for a peripherally which enables the client to receive long-term total parenteral nutrition. Clients in
inserted central catheter (PICC) the acute stages of pancreatitis also require large volumes of I.V. fluids to
C) Limiting I.V. fluid intake according to the physician's compensate for fluid loss.
order
D) Providing generous servings at mealtime
A client has an elevated serum ammonia concentration D) Hepatic encephalopathy
and is exhibiting changes in mental status. The nurse
should suspect which condition? Hepatic encephalopathy is a central nervous system dysfunction resulting from
A) Portal hypertension liver disease. It is frequently associated with an elevated ammonia concentration
B) Asterixis that produces changes in mental status, altered level of consciousness, and coma.
C) Cirrhosis Portal hypertension is an elevated pressure in the portal circulation resulting from
D) Hepatic encephalopathy obstruction of venous flow into and through the liver. Asterixis is an involuntary
flapping movement of the hands associated with metabolic liver dysfunction.
Which enzyme aids in the digestion of fats? C) Lipase
A) Amylase
B) Secretin Lipase is a pancreatic enzyme that aids in the digestion of fats. Amylase aids in the
C) Lipase digestion of carbohydrates. Secretin is responsible for stimulating secretion of
D) Trypsin pancreatic juice. Trypsin aids in the digestion of protein.
When performing a physical examination on a client with C) Measure abdominal girth according to a set routine.
cirrhosis, a nurse notices that the client's abdomen is
enlarged. Which of the following interventions should the If the abdomen appears enlarged, the nurse measures it according to a set
nurse consider? routine. The nurse reports any change in mental status or signs of gastrointestinal
A) Provide the client with nonprescription laxatives. bleeding immediately. It is not essential for the client to take laxatives unless
B) Ask the client about food intake. prescribed. The client's food intake does not affect the size of the abdomen in
C) Measure abdominal girth according to a set routine. case of cirrhosis.
D) Report the condition to the physician immediately.
A client being treated for pancreatitis faces the risk of A) Reposition the client every 2 hours.
atelectasis. Which of the following interventions would be
important to implement to minimize this risk? Repositioning the client every 2 hours minimizes the risk of atelectasis in a client
A) Reposition the client every 2 hours. who is being treated for pancreatitis. The client should be instructed to cough
B) Withhold oral feedings for the client. every 2 hours to reduce atelectasis. Monitoring the pulse oximetry helps show
C) Monitor pulse oximetry every hour. changes in respiratory status and promote early intervention, but it would do little
D) Instruct the client to avoid coughing. to minimize the risk of atelectasis. Withholding oral feedings limits the reflux of
bile and duodenal contents into the pancreatic duct.
, A client is given a diagnosis of hepatic cirrhosis. The client A) Enlarged liver size
asks the nurse what findings led to this determination. C) Hemorrhoids
Which of the following clinical manifestations would the E) Ascites
nurse correctly identify? Select all that apply.
A) Enlarged liver size Early in the course of cirrhosis, the liver tends to be large, and the cells are
B) Excess storage of vitamin C loaded with fat. The liver is firm and has a sharp edge that is noticeable on
C) Hemorrhoids palpation. Portal obstruction and ascites, late manifestations of cirrhosis, are
D) Accelerated behaviors and mental processes caused partly by chronic failure of liver function and partly by obstruction of the
E) Ascites portal circulation. The obstruction to blood flow through the liver caused by
fibrotic changes also results in the formation of collateral blood vessels in the GI
system and shunting of blood from the portal vessels into blood vessels with
lower pressures. These distended blood vessels form varices or hemorrhoids,
depending on their location. Because of inadequate formation, use, and storage
of certain vitamins (notably vitamins A, C, and K), signs of deficiency are common,
particularly hemorrhagic phenomena associated with vitamin K deficiency.
Additional clinical manifestations include deterioration of mental and cognitive
function with impending hepatic encephalopathy and hepatic coma, as previously
described.
A preoperative client scheduled to have an open C) decompression
cholecystectomy says to the nurse, "The doctor said that
after surgery, I will have a tube in my nose that goes into Negative pressure exerted through a tube inserted in the stomach removes
my stomach. Why do I need that?" What most common secretions and gaseous substances from the stomach, preventing abdominal
reason for a client having a nasogastric tube in place distention, nausea, and vomiting. Instillations in a nasogastric tube after surgery
after abdominal surgery should the nurse include in a are done when necessary to promote patency; this is not the most common
response? purpose of a nasogastric tube after surgery. Gavage is contraindicated after
A) lavage abdominal surgery until peristalsis returns. Lavage after surgery may be done to
B) gavage promote hemostasis in the presence of gastric bleeding, but this is not the most
C) decompression common purpose of a nasogastric tube after surgery.
D) instillation
A client comes to the ED with severe abdominal pain, D) Serum amylase
nausea, and vomiting. The physician plans to rule out
acute pancreatitis. The nurse would expect the diagnosis Serum amylase and lipase concentrations are used to make the diagnosis of acute
to be confirmed by an elevated result on which pancreatitis. Serum amylase and lipase concentrations are elevated within 24
laboratory test? hours of the onset of symptoms. Serum amylase usually returns to normal within
A) Serum bilirubin 48 to 72 hours, but the serum lipase concentration may remain elevated for a
B) Serum calcium longer period, often days longer than amylase. Urinary amylase concentrations
C) Serum potassium also become elevated and remain elevated longer than serum amylase
D) Serum amylase concentrations.
The nurse is planning care for a client following an B) Assisting the client to turn, cough, and deep breathe every 2 hours
incisional cholecystectomy for cholelithiasis. Which
intervention is the highest nursing priority for this client? Assessment should focus on the client's respiratory status. If a traditional surgical
A) Teaching the client to choose low-fat foods from the approach is planned, the high abdominal incision required during surgery may
menu interfere with full respiratory excursion. The other nursing actions are also
B) Assisting the client to turn, cough, and deep breathe important, but are not as high a priority as ensuring adequate ventilation.
every 2 hours
C) Assisting the client to ambulate the evening of the
operative day
D) Performing range-of-motion (ROM) leg exercises
hourly while the client is awake
QUESTIONS 2026 COMPLETE REVIEW
WITH VERIFIED ANSWERS| GRADED A+
| GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,A client with pancreatitis is admitted to the medical B) Reserving an antecubital site for a peripherally inserted central catheter (PICC)
intensive care unit. Which nursing intervention is most
appropriate? Pancreatitis treatment typically involves resting the GI tract by maintaining
A) Providing the client with plenty of P.O. fluids nothing-by-mouth status. The nurse should reserve the antecubital site for a PICC,
B) Reserving an antecubital site for a peripherally which enables the client to receive long-term total parenteral nutrition. Clients in
inserted central catheter (PICC) the acute stages of pancreatitis also require large volumes of I.V. fluids to
C) Limiting I.V. fluid intake according to the physician's compensate for fluid loss.
order
D) Providing generous servings at mealtime
A client has an elevated serum ammonia concentration D) Hepatic encephalopathy
and is exhibiting changes in mental status. The nurse
should suspect which condition? Hepatic encephalopathy is a central nervous system dysfunction resulting from
A) Portal hypertension liver disease. It is frequently associated with an elevated ammonia concentration
B) Asterixis that produces changes in mental status, altered level of consciousness, and coma.
C) Cirrhosis Portal hypertension is an elevated pressure in the portal circulation resulting from
D) Hepatic encephalopathy obstruction of venous flow into and through the liver. Asterixis is an involuntary
flapping movement of the hands associated with metabolic liver dysfunction.
Which enzyme aids in the digestion of fats? C) Lipase
A) Amylase
B) Secretin Lipase is a pancreatic enzyme that aids in the digestion of fats. Amylase aids in the
C) Lipase digestion of carbohydrates. Secretin is responsible for stimulating secretion of
D) Trypsin pancreatic juice. Trypsin aids in the digestion of protein.
When performing a physical examination on a client with C) Measure abdominal girth according to a set routine.
cirrhosis, a nurse notices that the client's abdomen is
enlarged. Which of the following interventions should the If the abdomen appears enlarged, the nurse measures it according to a set
nurse consider? routine. The nurse reports any change in mental status or signs of gastrointestinal
A) Provide the client with nonprescription laxatives. bleeding immediately. It is not essential for the client to take laxatives unless
B) Ask the client about food intake. prescribed. The client's food intake does not affect the size of the abdomen in
C) Measure abdominal girth according to a set routine. case of cirrhosis.
D) Report the condition to the physician immediately.
A client being treated for pancreatitis faces the risk of A) Reposition the client every 2 hours.
atelectasis. Which of the following interventions would be
important to implement to minimize this risk? Repositioning the client every 2 hours minimizes the risk of atelectasis in a client
A) Reposition the client every 2 hours. who is being treated for pancreatitis. The client should be instructed to cough
B) Withhold oral feedings for the client. every 2 hours to reduce atelectasis. Monitoring the pulse oximetry helps show
C) Monitor pulse oximetry every hour. changes in respiratory status and promote early intervention, but it would do little
D) Instruct the client to avoid coughing. to minimize the risk of atelectasis. Withholding oral feedings limits the reflux of
bile and duodenal contents into the pancreatic duct.
, A client is given a diagnosis of hepatic cirrhosis. The client A) Enlarged liver size
asks the nurse what findings led to this determination. C) Hemorrhoids
Which of the following clinical manifestations would the E) Ascites
nurse correctly identify? Select all that apply.
A) Enlarged liver size Early in the course of cirrhosis, the liver tends to be large, and the cells are
B) Excess storage of vitamin C loaded with fat. The liver is firm and has a sharp edge that is noticeable on
C) Hemorrhoids palpation. Portal obstruction and ascites, late manifestations of cirrhosis, are
D) Accelerated behaviors and mental processes caused partly by chronic failure of liver function and partly by obstruction of the
E) Ascites portal circulation. The obstruction to blood flow through the liver caused by
fibrotic changes also results in the formation of collateral blood vessels in the GI
system and shunting of blood from the portal vessels into blood vessels with
lower pressures. These distended blood vessels form varices or hemorrhoids,
depending on their location. Because of inadequate formation, use, and storage
of certain vitamins (notably vitamins A, C, and K), signs of deficiency are common,
particularly hemorrhagic phenomena associated with vitamin K deficiency.
Additional clinical manifestations include deterioration of mental and cognitive
function with impending hepatic encephalopathy and hepatic coma, as previously
described.
A preoperative client scheduled to have an open C) decompression
cholecystectomy says to the nurse, "The doctor said that
after surgery, I will have a tube in my nose that goes into Negative pressure exerted through a tube inserted in the stomach removes
my stomach. Why do I need that?" What most common secretions and gaseous substances from the stomach, preventing abdominal
reason for a client having a nasogastric tube in place distention, nausea, and vomiting. Instillations in a nasogastric tube after surgery
after abdominal surgery should the nurse include in a are done when necessary to promote patency; this is not the most common
response? purpose of a nasogastric tube after surgery. Gavage is contraindicated after
A) lavage abdominal surgery until peristalsis returns. Lavage after surgery may be done to
B) gavage promote hemostasis in the presence of gastric bleeding, but this is not the most
C) decompression common purpose of a nasogastric tube after surgery.
D) instillation
A client comes to the ED with severe abdominal pain, D) Serum amylase
nausea, and vomiting. The physician plans to rule out
acute pancreatitis. The nurse would expect the diagnosis Serum amylase and lipase concentrations are used to make the diagnosis of acute
to be confirmed by an elevated result on which pancreatitis. Serum amylase and lipase concentrations are elevated within 24
laboratory test? hours of the onset of symptoms. Serum amylase usually returns to normal within
A) Serum bilirubin 48 to 72 hours, but the serum lipase concentration may remain elevated for a
B) Serum calcium longer period, often days longer than amylase. Urinary amylase concentrations
C) Serum potassium also become elevated and remain elevated longer than serum amylase
D) Serum amylase concentrations.
The nurse is planning care for a client following an B) Assisting the client to turn, cough, and deep breathe every 2 hours
incisional cholecystectomy for cholelithiasis. Which
intervention is the highest nursing priority for this client? Assessment should focus on the client's respiratory status. If a traditional surgical
A) Teaching the client to choose low-fat foods from the approach is planned, the high abdominal incision required during surgery may
menu interfere with full respiratory excursion. The other nursing actions are also
B) Assisting the client to turn, cough, and deep breathe important, but are not as high a priority as ensuring adequate ventilation.
every 2 hours
C) Assisting the client to ambulate the evening of the
operative day
D) Performing range-of-motion (ROM) leg exercises
hourly while the client is awake
