Ash Lig
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Quiz to prep for Biliary Disorders lecture.

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Biliary disorders

Question 1 of 30

1

How much bile does the gallbladder usually store?

Select one of the following:

  • 60-100 mL

  • 30-60 mL

  • 20-50 mL

  • 5-10 mL

Explanation

Question 2 of 30

1

Bile leaves the ____ via the ____ duct and enters the _____ via the _____ duct.

Select one of the following:

  • liver; hepatic; gallbladder; cystic

  • gallbladder; cystic; liver; hepatic

  • liver; anterior; gallbladder; cystic

  • liver; common; gallbladder; receiving

Explanation

Question 3 of 30

1

The two main functions of the gallbladder are to (store/produce) bile and to (concentrate/dilute) bile.

Select one of the following:

  • store; concentrate

  • produce; dilute

  • store; dilute

  • produce; concentrate

Explanation

Question 4 of 30

1

Fat enters the ________, which causes intestinal mucosa to secrete _________. This stimulates gallbladder contraction.

Select one of the following:

  • duodenum; cholecystokinin (CCK)

  • duodenum; motilin

  • stomach; cholecystokinin (CCK)

  • stomach; motilin

Explanation

Question 5 of 30

1

Cholinergic braches of the _____ nerve mediate gallbladder contraction.

Select one of the following:

  • Vagus

  • Lumbar

  • Thoracic

  • Phrenic

Explanation

Question 6 of 30

1

How much bile does the liver secrete each day on average?

Select one of the following:

  • 700-1200 mL

  • 100-200 mL

  • 800-1000 mL

  • 1000-1500 mL

Explanation

Question 7 of 30

1

Bile is an _______ substance.

Select one of the following:

  • Alkaline

  • Acidic

Explanation

Question 8 of 30

1

What is the function of bile salts?

Select one of the following:

  • To produce primary bile acids

  • To emulsify and absorb fats

  • To produce secondary bile acids

  • To stimulate contraction of the gallbladder

Explanation

Question 9 of 30

1

Why are gallstones harmful?

Select one of the following:

  • 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

Explanation

Question 10 of 30

1

Cholelithiasis can cause the formation of gallstones.

Select one of the following:

  • True
  • False

Explanation

Question 11 of 30

1

Where might gallstones be found? Select all that apply.

Select one or more of the following:

  • Hepatic duct

  • Gallbladder

  • Cystic duct

  • Common bile duct

Explanation

Question 12 of 30

1

What does it mean if a patient is diagnosed with choledocholithiasis?

Select one of the following:

  • 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

Explanation

Question 13 of 30

1

Which type of gallstone is most common?

Select one of the following:

  • Cholesterol gallstones

  • Black pigmented gallstones

  • Brown pigmented gallstones

  • Mixed stones

Explanation

Question 14 of 30

1

Which of the following can decrease your risk of forming gallstones?

Select one or more of the following:

  • Nuts

  • Unsaturated fat

  • Insoluble fiber

  • Saturated fat

  • Refined carbohydrates

Explanation

Question 15 of 30

1

60-80% of people with cholelithiasis are asymptomatic.

Select one of the following:

  • True
  • False

Explanation

Question 16 of 30

1

From the following list, select the two cardinal manifestations of cholelithiasis.

Select one or more of the following:

  • Epigastric and right upper quadrant pain

  • Intolerance to fatty foods

  • Jaundice

  • Flatulence

  • Nausea and vomiting

  • Heartburn

Explanation

Question 17 of 30

1

Ultrasound detects gallstones in 95% of cases.

Select one of the following:

  • True
  • False

Explanation

Question 18 of 30

1

Which form of diagnostic imaging is most useful in detecting gallstones in the common bile duct?

Select one of the following:

  • Ultrasound

  • Gallbladder nuclear scanning (cholescintigram)

  • Endoscopic retrograde cholangio-pancreatography (ERCP)

  • Magnetic resonance cholangio-pancreatography (MRCP)

Explanation

Question 19 of 30

1

A combination of surgical and non-surgical treatments are recommended for both asymptomatic and symptomatic patients with gallstones.

Select one of the following:

  • True
  • False

Explanation

Question 20 of 30

1

From the following, select all correct contraindications for a laproscopic cholecystectomy.

Select one or more of the following:

  • 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

Explanation

Question 21 of 30

1

Patients with acute cholecystitis often present with nausea and vomiting. What is responsible for this manifestation?

Select one of the following:

  • 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

Explanation

Question 22 of 30

1

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?

Select one of the following:

  • Biliary ultrasound

  • Abdominal xray

  • MRI

  • ERCP

Explanation

Question 23 of 30

1

4-8% of patients with acute cholecystitis are acalculous (no stones). From the following, select all common causes of the acute inflammation.

Select one or more of the following:

  • Severe burns

  • Multiple transfusions

  • Bacterial sepsis

  • Prolonged childbirth (postpartum period)

  • Debilitating systemic diseases (e.g. TB, CVD)

Explanation

Question 24 of 30

1

50% of cases of acute acalculous cholecystitis have no apparent precipitating factors.

Select one of the following:

  • True
  • False

Explanation

Question 25 of 30

1

Chronic cholecystitis is almost always associated with gallstones (95% of cases). Which of the following populations has the highest incidence of this condition?

Select one of the following:

  • Middle-aged and older obese women

  • Older obese men

  • Older men and women with poorly managed diabetes

  • Obese children

Explanation

Question 26 of 30

1

Which of the following statements is INCORRECT regarding gallbladder function?

Select one of the following:

  • 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.

Explanation

Question 27 of 30

1

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?

Select one of the following:

  • 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

Explanation

Question 28 of 30

1

A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:

Select one of the following:

  • yellow sclerae

  • light amber urine

  • circumoral pallor

  • black, tarry stools

Explanation

Question 29 of 30

1

Which of the following descriptions best describes Murphy's sign?

Select one of the following:

  • 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

Explanation

Question 30 of 30

1

Which of the following factors should be the main focus of nursing management for a client hospitalized for cholecystitis?

Select one of the following:

  • Administration of antibiotics

  • Assessment for complications (e.g. infection, n/v, sepsis)

  • Health teaching

  • Preparation for surgery

Explanation

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