Which one of the following is a function of the liver?

Appeared in: RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Explanation

The liver is the primary site for the synthesis of most plasma proteins.
These proteins include albumin, which is crucial for maintaining plasma oncotic pressure and preventing fluid from leaking out of blood vessels (edema).
It also synthesizes key clotting factors like fibrinogen and prothrombin, which are essential for blood coagulation.

Option B: The liver does not eliminate carbohydrates; it plays a central role in their metabolism to maintain blood glucose homeostasis.
Option C: The liver produces bile, but the gallbladder is the organ responsible for storing and concentrating it.
Option D: Cholecystokinin (CCK) is a gastrointestinal hormone, not a product of the liver.

Visual 1: Anatomical Diagram - An illustration showing the liver, gallbladder, pancreas, and small intestine. This helps visualize the distinct locations and roles of each organ mentioned in the options.
Visual 2: Flowchart - A flowchart depicting the major metabolic, synthetic, and detoxification pathways of the liver to provide a comprehensive overview of its functions.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Functions of the Liver as background academic context rather than a clinical decision trigger.
In patients with liver disease (e.g., cirrhosis or hepatitis), the liver's ability to synthesize proteins is impaired. Nurses will monitor for low albumin levels (hypoalbuminemia), which can lead to peripheral edema and ascites, and prolonged prothrombin time (PT/INR), indicating an increased risk of bleeding.
Monitoring liver function tests (LFTs), which include albumin and PT/INR, is a critical nursing responsibility in assessing the synthetic function of the liver and guiding patient care.
What if? If a patient has their gallbladder removed (cholecystectomy), the liver still produces bile, but it is no longer stored and concentrated. Instead, it drips continuously into the small intestine, which can affect the digestion of fatty meals.

How to Approach the Question

First, identify the core subject of the question, which is the physiological functions of the liver.
This is a factual recall question. You need to access your knowledge about the liver's roles in the body.
Evaluate each option one by one. For each option, ask yourself: 'Is this a known function of the liver?'
For Option A: Recall that the liver makes proteins like albumin. This is a primary function.
For Option B: Recall the liver's role in glucose metabolism (storage/release), not elimination.
For Option C: Differentiate between production (liver) and concentration/storage (gallbladder) of bile.

Concept Tested & Keywords

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Guyton & Hall Textbook of Medical Physiology 13e — Part 2 p. 976-979

Practise the full RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Attempt every question from this paper in a timed mock, then review the full solution for each one.