NCLEX Practice Questions: Liver, Biliary and Pancreatic Disorders
1. For a client in hepatic coma, which outcome would be the most appropriate?
A. The client is oriented to time, place, and person.
B. The client exhibits no ecchymotic areas.
C. The client increases oral intake to 2,000 calories/day.
D. The client exhibits increased serum albumin level.
1. Answer: A. The client is oriented to time, place, and person.
Hepatic coma is the most advanced stage of hepatic encephalopathy. As hepatic coma resolves,
improvement in the client's level of consciousness occurs. The client should be able to express
orientation to time, place, and person. Ecchymotic areas are related to decreased synthesis of clotting
factors. Although oral intake may be related to level of consciousness, it is more closely related to
anorexia. The serum albumin level reflects hepatic synthetic ability, not level of consciousness.
2. Jordin is a client with jaundice who is experiencing pruritus. Which nursing intervention would be
included in the care plan for the client?
A. Administering vitamin K subcutaneously
B. Applying pressure when giving I.M. injections
C. Decreasing the client's dietary protein intake
D. Keeping the client's fingernails short and smooth
2. Answer: D. Keeping the client's fingernails short and smooth
The client with pruritus experiences itching, which may lead to skin breakdown and possibly infection
from scratching. Keeping his fingernails short and smooth helps prevent skin breakdown and infection
from scratching. Applying pressure when giving I.M. injections and administering vitamin K
subcutaneously are important if the client develops bleeding problems. Decreasing the client's dietary
intake is appropriate if the client's ammonia levels are increased.
3. Marie, a 51-year-old woman, is diagnosed with cholecystitis. Which diet, when selected by the client,
indicates that the nurse's teaching has been successful?
A. 4-6 small meals of low-carbohydrate foods daily
B. High-fat, high-carbohydrate meals
C. Low-fat, high-carbohydrate meals
, D. High-fat, low protein meals
3. Answer: C. Low-fat, high-carbohydrate meals
For the client with cholecystitis, fat intake should be reduced. The calories from fat should be
substituted with carbohydrates. Reducing carbohydrate intake would be contraindicated. Any diet high
in fat may lead to another attack of cholecystitis.
4. The hospital administrator had undergone percutaneous transhepatic cholangiography. which
assessment finding indicates complication after the operation?
A. Fever and chills
B. Hypertension
C. Bradycardia
D. Nausea and diarrhea
4. Answer: A. Fever and chills
Septicemia is a common complication after a percutaneous transhepatic cholangiography. Evidence of
fever and chills, possibly indicative of septicemia, is important. Hypotension, not hypertension, is
associated with septicemia. Tachycardia, not bradycardia, is most likely to occur. Nausea and diarrhea
may occur but are not classic signs of sepsis.
5. When planning home care for a client with hepatitis A, which preventive measure should be
emphasized to protect the client's family?
A. Keeping the client in complete isolation
B. Using good sanitation with dishes and shared bathrooms
C. Avoiding contact with blood-soiled clothing or dressing
D. Forbidding the sharing of needles or syringes
5. Answer: B. Using good sanitation with dishes and shared bathrooms
Hepatitis A is transmitted through the fecal oral route or from contaminated water or food. Measures to
protect the family include good handwashing, personal hygiene and sanitation, and use of standard
precautions. Complete isolation is not required. Avoiding contact with blood-soiled clothing or dressings
or avoiding the sharing of needles or syringes are precautions needed to prevent transmission of
hepatitis B.
6. For Jayvin who is taking antacids, which instruction would be included in the teaching plan?
A. "Take the antacids with 8 oz of water."
1. For a client in hepatic coma, which outcome would be the most appropriate?
A. The client is oriented to time, place, and person.
B. The client exhibits no ecchymotic areas.
C. The client increases oral intake to 2,000 calories/day.
D. The client exhibits increased serum albumin level.
1. Answer: A. The client is oriented to time, place, and person.
Hepatic coma is the most advanced stage of hepatic encephalopathy. As hepatic coma resolves,
improvement in the client's level of consciousness occurs. The client should be able to express
orientation to time, place, and person. Ecchymotic areas are related to decreased synthesis of clotting
factors. Although oral intake may be related to level of consciousness, it is more closely related to
anorexia. The serum albumin level reflects hepatic synthetic ability, not level of consciousness.
2. Jordin is a client with jaundice who is experiencing pruritus. Which nursing intervention would be
included in the care plan for the client?
A. Administering vitamin K subcutaneously
B. Applying pressure when giving I.M. injections
C. Decreasing the client's dietary protein intake
D. Keeping the client's fingernails short and smooth
2. Answer: D. Keeping the client's fingernails short and smooth
The client with pruritus experiences itching, which may lead to skin breakdown and possibly infection
from scratching. Keeping his fingernails short and smooth helps prevent skin breakdown and infection
from scratching. Applying pressure when giving I.M. injections and administering vitamin K
subcutaneously are important if the client develops bleeding problems. Decreasing the client's dietary
intake is appropriate if the client's ammonia levels are increased.
3. Marie, a 51-year-old woman, is diagnosed with cholecystitis. Which diet, when selected by the client,
indicates that the nurse's teaching has been successful?
A. 4-6 small meals of low-carbohydrate foods daily
B. High-fat, high-carbohydrate meals
C. Low-fat, high-carbohydrate meals
, D. High-fat, low protein meals
3. Answer: C. Low-fat, high-carbohydrate meals
For the client with cholecystitis, fat intake should be reduced. The calories from fat should be
substituted with carbohydrates. Reducing carbohydrate intake would be contraindicated. Any diet high
in fat may lead to another attack of cholecystitis.
4. The hospital administrator had undergone percutaneous transhepatic cholangiography. which
assessment finding indicates complication after the operation?
A. Fever and chills
B. Hypertension
C. Bradycardia
D. Nausea and diarrhea
4. Answer: A. Fever and chills
Septicemia is a common complication after a percutaneous transhepatic cholangiography. Evidence of
fever and chills, possibly indicative of septicemia, is important. Hypotension, not hypertension, is
associated with septicemia. Tachycardia, not bradycardia, is most likely to occur. Nausea and diarrhea
may occur but are not classic signs of sepsis.
5. When planning home care for a client with hepatitis A, which preventive measure should be
emphasized to protect the client's family?
A. Keeping the client in complete isolation
B. Using good sanitation with dishes and shared bathrooms
C. Avoiding contact with blood-soiled clothing or dressing
D. Forbidding the sharing of needles or syringes
5. Answer: B. Using good sanitation with dishes and shared bathrooms
Hepatitis A is transmitted through the fecal oral route or from contaminated water or food. Measures to
protect the family include good handwashing, personal hygiene and sanitation, and use of standard
precautions. Complete isolation is not required. Avoiding contact with blood-soiled clothing or dressings
or avoiding the sharing of needles or syringes are precautions needed to prevent transmission of
hepatitis B.
6. For Jayvin who is taking antacids, which instruction would be included in the teaching plan?
A. "Take the antacids with 8 oz of water."
