Deck 31: Infection, Inflammation, and Cirrhosis of the Liver

Question 1

The nurse is reviewing the pathophysiology of nonalcoholic fatty liver disease (NAFLD) with staff nurses. Which statement made by an attending nurse indicates understanding?
1)"NAFLD is linked to metabolic syndrome."
2)"Exposure to vinyl chloride can cause NAFLD."
3)"Increased level of adiponectin is associated with NAFLD."
4)"NAFLD is caused by accumulation of fat in the adipose tissue."

Answer 1

1

Question 2

The client with alcoholic liver disease is experiencing bruising, nosebleed, and hematemesis. Which treatment option does the nurse suspect to be effective in this client?
1)Diuretics
2)Vitamin K
3)Band ligation
4)Phototherapy

Answer 2

2

Question 3

While assessing a client with liver cirrhosis, the nurse examines the client for indication of encephalopathy. Which manifestation indicates the development of encephalopathy?
1)Spider angiomata
2)Abdominal ascites
3)Coagulopathy
4)Asterixis

Answer 3

4

Question 4

Which virus helper function is needed for the replication of hepatitis D virus?
1)Hepatitis A virus (HAV)
2)Hepatitis B virus (HBV)
3)Hepatitis C virus (HCV)
4)Hepatitis E virus (HEV)

Question 5

For which reason does the nurse identify the change of urine color in a client with liver disease?
1)Failure of bilirubin to reach the intestine
2)Accumulation of bilirubin in the bloodstream
3)Accumulation of bile salts in the bloodstream
4)Infiltration of the liver with fat

Question 6

While reviewing the medical file of a client with cirrhosis, the nurse finds that the client has steatorrhea. Which reason does the nurse identify for this condition in the client?
1)Hyperbilirubinemia
2)Activation of stellate cells
3)Diminished synthesis of bile
4)Nitrogenous waste accumulation in the blood

Question 7

After assessing a client with biliary cirrhosis, the nurse identifies the presence of xanthelasmas. Which laboratory test supports the nurse's assessment finding?
1)Endoscopy
2)Lipid levels
3)Bilirubin levels
4)Prothrombin time

Question 8

The nurse is reviewing portal hypertension with a group of staff nurses. Which statement by an attending nurse indicates the need for further review?
1)"Caput medusa is a sign of portal hypertension."
2)"Portal hypertension can cause hematemesis."
3)"Ascites is associated with portal hypertension."
4)"Portal hypertension causes coagulation abnormalities."

Question 9

The nurse suspects hepatic encephalopathy in a client with severe liver dysfunction. Which symptom supports the nurse's suspicion?
1)Stupor
2)Ascites
3)Hematemesis
4)Spider angiomata

Question 10

The laboratory reports of a client diagnosed with alcoholism show hepatic encephalopathy and portal hypertension. Which nursing interventions will be beneficial for the client? Select all that apply.
1)Provide a low-sodium diet
2)Provide a low-calorie diet
3)Provide a high-protein diet
4)Administer calcium compounds
5)Encourage the use of thiamine supplements

Question 11

The health-care provider suggests the hepatitis C virus (HCV) genotyping test to a client with liver disease. Which is the most likely rationale for this testing?
1)To predict prognosis
2)To determine the severity of the disease
3)To predict the likelihood of response and the duration of treatment
4)To detect the presence of antibodies against two or more antigens

Question 12

While assessing a client who has liver dysfunction, the nurse finds the client has shifting abdominal dullness. Which condition does the nurse suspect in the client?
1)Ascites
2)Splenomegaly
3)Spider angiomata
4)Esophageal varices

Question 13

The nurse finds ursodiol in a client's prescription. Which condition does the nurse suspect in the client?
1)Gilbert's syndrome
2)Alcoholic liver disease
3)Crigler-Najjar syndrome
4)Primary biliary cirrhosis

Question 14

The laboratory reports of a client with alcoholic liver disease reveal low hemoglobin levels. For which reasons does the nurse recognize this condition? Select all that apply.
1)Hypersplenism
2)Hemochromatosis
3)Hypoalbuminemia
4)Folic acid deficiency
5)Decreased levels of thrombopoietin

Question 15

The nurse in an intensive care unit (ICU) is providing care for a client diagnosed with encephalopathy due to severe liver disease. Which nonpharmacological treatment is most important for the nurse to initiate?
1)Frequently reorient the client to person, time, and place
2)Monitor routinely for an increase in jaundice
3)Pad side rails and protect from physical injury
4)Encourage frequent, nutritional dietary intake

Question 16

A client reports fatigue and arthralgia to the nurse. On physical assessment, the nurse finds that the client has hyperpigmentation of the skin. Which laboratory test does the nurse suggest for safe and effective care of the client?
1)Bilirubin levels
2)Serum ferritin levels
3)Ceruloplasmin levels
4)Immunoglobulins level

Question 17

The nurse is caring for multiple clients in an acute care setting. Which client does the nurse identify as being at risk for nonalcoholic fatty liver disease (NAFLD)?
1)The client being treated for hepatitis B
2)The client with exposure to isoniazid
3)The client who is a strict vegetarian
4)The client with cell-mediated immunity

Question 18

The nurse is providing care for a client with renal disease and notices a slight yellowish color of the skin. The client reports recent symptoms of the flu. Which contributing factor does the nurse identify as increasing the client's possibility of hepatitis B?
1)Renal disease is treated with hemodialysis
2)Ethnic background identified as Caucasian
3)Recent travel to Central and Southeast Asia
4)Ingestion of raw or undercooked shellfish

Question 19

The nurse is counseling a client about high doses of NSAIDs taken to "keep aches and pains away." The nurse shares that the liver is at risk for damage. The client asks, "What does the liver do, anyway?" Which is the best answer by the nurse?
1)"The liver plays multiple important roles in digestion."
2)"Damage to the liver can cause serious illnesses."
3)"The liver can be damaged by overuse of medications."
4)"A seriously diseased liver may require a liver transplant."

Question 20

The nurse is providing care for a client with suspected gallbladder disease. Assessment by the nurse reveals jaundice, dark-colored urine, and upper right quadrant abdominal pain. Based on the assessment findings, which is the most likely cause of the client's condition?
1)A gallstone lodged in the cystic duct
2)A gallstone lodged in the common bile duct
3)Multiple gallstones located in the gallbladder
4)Gallstones in the liver from a ruptured gallbladder

Question 21

The nurse is caring for a client with glucuronyl transferase enzyme deficiency. The laboratory reports show elevated serum bilirubin levels. Which treatment does the nurse suspect to be effective in the client? Select all that apply.
1)Phenobarbital
2)Phototherapy
3)Paracentesis
4)Deferoxamine
5)Penicillamine

Question 22

Which findings can the nurse observe in the laboratory reports of a client after 4 weeks of hepatitis A infection? Select all that apply.
1)A rise in liver enzymes
2)Appearance of immunoglobulin M (IgM) antibodies
3)Appearance of immunoglobulin G (IgG) antibodies
4)Appearance of hepatitis A virus (HAV) in the stool
5)Presence of antimitochondrial antibodies (AMAs)

Question 23

Arrange the processes occurring in four developmental stages of primary biliary cirrhosis in their correct order. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Destruction of the liver cells, fibrotic tissue taking over hepatic cells, and loss of intralobular bile ducts
2) Progression of inflammation
3) Development of micronodular or macronodular cirrhosis
4) Inflammation of the portal triads and destruction of small and medium bile ducts