2917564
Questão 1
Questão
How much bile does the gallbladder usually store?
Responda
-
60-100 mL
-
30-60 mL
-
20-50 mL
-
5-10 mL
Questão 2
Questão
Bile leaves the ____ via the ____ duct and enters the _____ via the _____ duct.
Responda
-
liver; hepatic; gallbladder; cystic
-
gallbladder; cystic; liver; hepatic
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liver; anterior; gallbladder; cystic
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liver; common; gallbladder; receiving
Questão 3
Questão
The two main functions of the gallbladder are to (store/produce) bile and to (concentrate/dilute) bile.
Responda
-
store; concentrate
-
produce; dilute
-
store; dilute
-
produce; concentrate
Questão 4
Questão
Fat enters the ________, which causes intestinal mucosa to secrete _________. This stimulates gallbladder contraction.
Responda
-
duodenum; cholecystokinin (CCK)
-
duodenum; motilin
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stomach; cholecystokinin (CCK)
-
stomach; motilin
Questão 5
Questão
Cholinergic braches of the _____ nerve mediate gallbladder contraction.
Responda
-
Vagus
-
Lumbar
-
Thoracic
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Phrenic
Questão 6
Questão
How much bile does the liver secrete each day on average?
Responda
-
700-1200 mL
-
100-200 mL
-
800-1000 mL
-
1000-1500 mL
Questão 7
Questão
Bile is an _______ substance.
Responda
-
Alkaline
-
Acidic
Questão 8
Questão
What is the function of bile salts?
Responda
-
To produce primary bile acids
-
To emulsify and absorb fats
-
To produce secondary bile acids
-
To stimulate contraction of the gallbladder
Questão 9
Questão
Why are gallstones harmful?
Responda
-
They release toxins into the gallbladder, which impairs the digestive system
-
They can be ejected from the gallbladder and become lodged in the cystic duct or anywhere in the biliary tree and obstruct the flow of bile
-
They can travel into the stomach and disrupt the acidic environment needed to absorb fat-soluble vitamins
-
They cause an inflammatory response in the gallbladder, which triggers the liver to abruptly stop it's production of bile
Questão 10
Questão
Cholelithiasis can cause the formation of gallstones.
Responda
- True
- False
Questão 11
Questão
Where might gallstones be found? Select all that apply.
Responda
-
Hepatic duct
-
Gallbladder
-
Cystic duct
-
Common bile duct
Questão 12
Questão
What does it mean if a patient is diagnosed with choledocholithiasis?
Responda
-
They have gallstones lodged in the common bile duct
-
They have gallstones lodged in the hepatic duct
-
They have gallstones present in the body of the gallbladder
-
They are in what is known as a "Lithogenic" state, in which conditions favor gallstone formation
Questão 13
Questão
Which type of gallstone is most common?
Responda
-
Cholesterol gallstones
-
Black pigmented gallstones
-
Brown pigmented gallstones
-
Mixed stones
Questão 14
Questão
Which of the following can decrease your risk of forming gallstones?
Responda
-
Nuts
-
Unsaturated fat
-
Insoluble fiber
-
Saturated fat
-
Refined carbohydrates
Questão 15
Questão
60-80% of people with cholelithiasis are asymptomatic.
Responda
- True
- False
Questão 16
Questão
From the following list, select the two cardinal manifestations of cholelithiasis.
Responda
-
Epigastric and right upper quadrant pain
-
Intolerance to fatty foods
-
Jaundice
-
Flatulence
-
Nausea and vomiting
-
Heartburn
Questão 17
Questão
Ultrasound detects gallstones in 95% of cases.
Responda
- True
- False
Questão 18
Questão
Which form of diagnostic imaging is most useful in detecting gallstones in the common bile duct?
Responda
-
Ultrasound
-
Gallbladder nuclear scanning (cholescintigram)
-
Endoscopic retrograde cholangio-pancreatography (ERCP)
-
Magnetic resonance cholangio-pancreatography (MRCP)
Questão 19
Questão
A combination of surgical and non-surgical treatments are recommended for both asymptomatic and symptomatic patients with gallstones.
Responda
- True
- False
Questão 20
Questão
From the following, select all correct contraindications for a laproscopic cholecystectomy.
Responda
-
stones are in the CBD
-
stones are in the gallbladder
-
client's physique does not allow access to the gallbladder
-
stones are primarily pigmented, not cholesterol
Questão 21
Questão
Patients with acute cholecystitis often present with nausea and vomiting. What is responsible for this manifestation?
Responda
-
Impulse transmitted to vomiting center from distention of bile duct
-
Impulse transmitted to vomiting center from distention of the gallbladder
-
Impulse transmitted to vomiting center from inflammation of gallbladder walls
-
Build up of toxins, secondary to necrosis of parenchymal tissue
Questão 22
Questão
A patient presents to the ER with acute pain in the supscapular region that started suddenly. The patient is also complaining of nausea, vomiting, and has a low grade fever. You suspect this patient has acute cholecystitis. Which diagnostic study will likely be done first?
Responda
-
Biliary ultrasound
-
Abdominal xray
-
MRI
-
ERCP
Questão 23
Questão
4-8% of patients with acute cholecystitis are acalculous (no stones). From the following, select all common causes of the acute inflammation.
Responda
-
Severe burns
-
Multiple transfusions
-
Bacterial sepsis
-
Prolonged childbirth (postpartum period)
-
Debilitating systemic diseases (e.g. TB, CVD)
Questão 24
Questão
50% of cases of acute acalculous cholecystitis have no apparent precipitating factors.
Responda
- True
- False
Questão 25
Questão
Chronic cholecystitis is almost always associated with gallstones (95% of cases). Which of the following populations has the highest incidence of this condition?
Responda
-
Middle-aged and older obese women
-
Older obese men
-
Older men and women with poorly managed diabetes
-
Obese children
Questão 26
Questão
Which of the following statements is INCORRECT regarding gallbladder function?
Responda
-
Within 30 minutes of eating, the gallbladder forces bile into the stomach.
-
Cholinergic branches of the vagus nerve mediate gallbladder contraction.
-
Cholecystokinin and motilin provide hormonal regulation of gallbladder contraction.
-
The sphincter of Oddi controls the flow of bile from the gallbladder.
Questão 27
Questão
A patient was admitted to the hospital with a diagnosis of acute cholecystitis due to cholethiasis. The client complains of severe abdominal pain, nausea, and has vomited 3 times. What is the priority nursing diagnosis for this client?
Responda
-
Imbalanced nutrition: less than body requirements related to vomiting
-
Deficient fluid volume related to vomiting
-
Infection related to gallbladder inflammation
-
Acute pain related to biliary spasm
Questão 28
Questão
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:
Responda
-
yellow sclerae
-
light amber urine
-
circumoral pallor
-
black, tarry stools
Questão 29
Questão
Which of the following descriptions best describes Murphy's sign?
Responda
-
Periumbilical eccymosis exists
-
On deep palpation and release, pain is elicited
-
On deep inspiration, pain is elicited and breathing stops
-
Abdominal muscles are tightened in anticipation of palpation
Questão 30
Questão
Which of the following factors should be the main focus of nursing management for a client hospitalized for cholecystitis?
Responda
-
Administration of antibiotics
-
Assessment for complications (e.g. infection, n/v, sepsis)
-
Health teaching
-
Preparation for surgery
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