Deck 59: Coordinating Care for Patients With Hepatic Disorders

Question 1

A young adult waiter has been treated for viral hepatitis at a healthcare clinic. Which patient outcome requires an intervention by the nurse?
1)
1)Body mass index (BMI) changes from 24 to 2
2)Return demonstration of hand washing is correctly performed.
3)Social Services notified the health department of the occurrence.
4)Patient denies abdominal or epigastric pain.

Answer 1

1

Question 2

Which statement by the patient diagnosed with hepatitis indicates the need for further teaching?
1)"After I take a walk, I will rest for about an hour."
2)"The prescribed antiemetic medication will decrease my nausea."
3)"A vaccine would not have helped me because I have hepatitis A."
4)"I will use a nutritional supplement to ensure I get enough calories each day."

Answer 2

3

Question 3

Which statement by the family member of a patient who has a Sengstaken-Blakemore tube placed to treat complications of liver disease indicates understanding of this treatment modality?
1)"The tube removes gastrointestinal fluids."
2)"The tube provides a way to administer medications."
3)"The tube provides compression to stop esophageal bleeding."
4)"The tube will need to be in place for 48 to 72 hours."

Answer 3

3

Question 4

The nurse provides education to a patient who experiences ascites as a result of cirrhosis. Which patient statement indicates a need for additional teaching?
1)"I will take a diuretic to increase water excretion."
2)"I will need to decrease foods that are rich in salt."
3)"I might need to have a procedure to drain the fluid from my stomach."
4)"I might need to have a banding procedure to stop the bleeding in my stomach."

Question 5

The nurse is providing care to a patient diagnosed with cirrhosis and monitors for which clinical manifestation of stage 2 hepatic encephalopathy?
1)Coma
2)Tremors
3)Disorientation
4)Difficulty to awaken

Question 6

The nurse correlates which type of viral hepatitis to the fecal-oral route of transmission?
1)Hepatitis A (HAV)
2)Hepatitis B (HBV)
3)Hepatitis C (HCV)
4)Hepatitis D (HDV)

Question 7

Which information should the nurse include in a teaching session for a patient who is to receive the hepatitis B vaccine?
1)"You will receive three injections over a 6- to 12-month period."
2)"This vaccine provides protection within 2 to 4 weeks of vaccine administration."
3)"You will receive one shot followed by a booster 6 to 12 months later."
4)"This vaccine is recommended for those who engage in risky behavior, such as illegal injected drug users."

Question 8

The nurse correlates which data from the patient's health as a risk factor for the current diagnosis of cirrhosis?
1)Biliary disease
2)Social alcohol use
3)Hepatitis D infection
4)Chronic intravenous drug use

Question 9

Which assessment data collected by the nurse after a liver biopsy requires the nurse to immediately notify the healthcare provider?
1)The patient is drowsy.
2)The patient's blood pressure is 80/50 mm Hg.
3)The patient's heart rate is 100 bpm.
4)The patient's respiratory rate is 16 breaths/minute.

Question 10

The nurse correlates which laboratory result to a diagnosis of liver disease?
1)Decreased aspartate aminotransaminase (AST)
2)Increased albumin
3)Increased ammonia
4)Decreased total bilirubin

Question 11

The nurse is planning education for an adolescent patient recently diagnosed with hepatitis. The patient moved back to the parents' home. Which recommendation to the parents will best prevent them from acquiring hepatitis B (HBV)?
1)Avoiding blood donations
2)Using safe water sources
3)Obtaining postexposure prophylaxis
4)Abstaining from alcohol

Question 12

The nurse teaches the patient diagnosed with hepatitis B about which oral medication used to treat this health problem?
1)Ribavirin
2)Tenofovir
3)Interferon-alpha
4)Pegylated interferon

Question 13

The nurse is providing care to a patient diagnosed with cirrhosis and monitors for which clinical manifestation of stage 3 hepatic encephalopathy?
1)Coma
2)Tremors
3)Disorientation
4)Difficulty to awaken

Question 14

In documenting assessment data on the patient diagnosed with hepatic encephalopathy, the nurse uses which term to describe a sweet fecal smell of the breath?
1)Asterixis
2)Icterus
3)Fetor hepaticus
4)Ketosis

Question 15

The nurse is providing information about hepatitis to a high school health occupations class. The students all volunteer examples of how hepatitis is transmitted. Which statement by one of the students indicates the need for further teaching about hepatitis transmission?
1)"Body piercing or tattoo"
2)"Food or beverages"
3)"Alcohol or drug use"
4)"Mosquito or tick bite"

Question 16

Which statement by a new nurse assigned to the infectious disease clinic regarding the incubation period of hepatitis indicates the need for further teaching?
1)"Hepatitis A has an incubation period of 15 to 50 days."
2)"Hepatitis B has an incubation period of 30 to 60 days."
3)"Hepatitis C has an incubation period of 2 to 25 weeks."
4)"Hepatitis D has an incubation period of 2 to 8 weeks."

Question 17

In administering lactulose to the patient with hepatic encephalopathy, the nurse correlates effectiveness of this medication to which mechanism of action?
1)Increases absorption of protein
2)Decreases production of ammonia
3)Destroys bacteria in the gastrointestinal tract
4)Decreases protein breakdown

Question 18

The nurse is providing care to a patient diagnosed with cirrhosis, and monitors for which clinical manifestations of stage 4 hepatic encephalopathy?
1)Coma
2)Tremors
3)Disorientation
4)Difficulty to awaken

Question 19

The nurse is providing care to a patient diagnosed with cirrhosis, and monitors for which clinical manifestation of stage 1 hepatic encephalopathy?
1)Coma
2)Tremors
3)Disorientation
4)Difficulty to awaken

Question 20

Which information should the nurse provide to a patient who will be receiving the hepatitis A vaccine?
1)"The vaccine is considered effective for 15 years or longer."
2)"You will receive a series of three shots over 6 to 12 months."
3)"You will receive one shot with a booster 6 to 12 months later."
4)"The vaccine is recommended for everyone, including newborns."

Question 21

In providing an educational session regarding hepatitis, the nurse includes information about which types of viral hepatitis that can be prevented with a vaccination? Select all that apply.
1)Hepatitis A
2)Hepatitis B
3)Hepatitis C
4)Hepatitis D
5)Hepatitis E

Question 22

The nurse recognizes which complication of liver trauma as the leading cause of death?
1)Infection
2)Hemorrhage
3)Rhabdomyolysis
4)Liver failure

Question 23

Which assessment data indicate to the nurse that the patient may be experiencing an increased ammonia level, a complication of cirrhosis?
1)Peripheral edema
2)Yellow skin
3)Clay-colored stool
4)Personality changes

Question 24

Which assessment data indicate to the nurse that the patient may be experiencing decreased clotting factors as a complication of cirrhosis?
1)Epistaxis
2)Yellow skin
3)Clay-colored stool
4)Peripheral edema

Question 25

In reviewing the treatment plan for the patient diagnosed with ascites, which prescription does the nurse question?
1)Furosemide
2)Spironolactone
3)Placement of a shunt
4)A 3 g/day sodium diet

Question 26

The nurse monitors for which clinical manifestation assessed in the patient diagnosed with liver cancer?
1)Weight gain
2)Shortness of breath
3)Periumbilical bruising
4)Pain in the left upper quadrant

Question 27

Which statement by the family member of a patient diagnosed with liver cancer indicates the need for further teaching?
1)"A massage will help her relax."
2)"She needs to drink plenty of fluids to keep her kidneys working."
3)"Narcotic-coated lollipops will help her with the pain."
4)"Support stockings will decrease the swelling in her legs."

Question 28

The nurse correlates the metabolic alkalosis in the patient diagnosed with hepatic encephalopathy to which potential causes? Select all that apply.
1)Diarrhea
2)Hyperventilation
3)Diuretic therapy
4)Hypoalbuminemia
5)Vomiting

Question 29

The nurse correlates which factors as associated with an increased risk of developing liver cancer? Select all that apply.
1)African American race
2)Caucasian race
3)Alcohol abuse
4)Obesity
5)Diabetes mellitus

Question 30

The nurse correlates which diagnostic results to the patient diagnosed with advanced cirrhosis? Select all that apply.
1)Serum albumin 3.0 mg/dL
2)Serum magnesium 1.2 mg/dL
3)Serum creatinine 1.0 mg/dL
4)Serum potassium 5.8 mEq/L
5)Serum sodium 130 mEq/L