Deck 44: Liver Failure

Question 1

When planning care for a patient with liver disease, the nurse keeps in mind that the leading cause of chronic liver disease is:

A) alcoholism.
B) hepatitis C.
C) environmental toxins.
D) hepatotoxic drugs.

Answer 1

alcoholism.

Question 2

When assessing the liver of a patient, in which quadrant should the nurse percuss?

A) Upper left quadrant
B) Upper right quadrant
C) Lower right quadrant
D) Lower left quadrant

Answer 2

Upper right quadrant

Question 3

When planning care for a patient with esophageal varices, which action would be a priority for the nurse?

A) Discussing the importance of Alcoholics Anonymous meetings
B) Assessing for signs and symptoms of hemorrhage
C) Teaching the patient signs of bleeding to report
D) Encouraging rest periods to reduce fatigue

Answer 3

Assessing for signs and symptoms of hemorrhage

Question 4

To prevent complications in the patient with ascites, who is receiving daily furosemide and spironolactone, the nurse should implement which intervention?

A) Restrict sodium.
B) Restrict fluids.
C) Monitor weights.
D) Monitor electrolyte and creatinine levels.

Question 5

Which intravenous solution should the nurse prepare to infuse in the patient with ascites who has had 5.5 liters of fluid removed during paracentesis?

A) 25% albumin
B) 10% dextrose
C) 0.45% normal saline
D) Lactated Ringer's

Question 6

The nurse would expect to assess which finding in the patient with type I hepatorenal syndrome?

A) Previous diagnosis of renal disease
B) Recent ingestion of a nephrotoxic drug
C) Ascites
D) Serum creatinine level of 1.5 mg/dL

Question 7

Which finding should the nurse expect when assessing a patient with severe portopulmonary syndrome?

A) An S4 heart sound (fourth heart sound)
B) A murmur of mitral regurgitation
C) An accentuated S2 (second heart sound)
D) A murmur of pulmonic stenosis

Question 8

The nurse would expect a patient with a diagnosis of portopulmonary syndrome to exhibit:

A) mean pulmonary artery pressure greater than or equal to 25 mmHg.
B) pulmonary vascular resistance less than 240 dyne/s/cm^-5.
C) pulmonary capillary wedge pressure 25 mmHg or more.
D) transpulmonary gradient less than 12 mmHg.

Question 9

The nurse suspects an elevated bilirubin level in a patient who exhibits which findings?

A) Pale itchy skin
B) Icterus with green-colored stools
C) Yellow skin and pruritus
D) Xanthomas and pale urine

Question 10

The nurse is assessing a patient suspected of having hepatitis A. To elicit information about the likely mode of transmission, which question would be most appropriate for the nurse to ask?

A) "Have you had a blood transfusion?"
B) "Do you share needles?"
C) "Are you sexually active?"
D) "Have you recently eaten shellfish?"

Question 11

Which statement by a patient indicates to the nurse that more teaching is needed about the phases of HBV infection?

A) "Chronic infection is the immune tolerant phase."
B) "In the immune active phase I will be HBsAg positive."
C) "I will be HBcAb positive in all phases."
D) "I will develop HBeAb in the inactive phase."

Question 12

Which of the following concepts should the nurse keep in mind when preparing a plan of care for a patient with hepatitis C virus (HCV) infection?

A) The initial infection is always highly symptomatic.
B) Most HCV infections become chronic.
C) Antibodies to HCV are protective.
D) There is only one genotype of HCV infection in the United States.

Question 13

Which concept should the nurse keep in mind when planning care for a patient with hepatitis D (HDV)?

A) The patient also has hepatitis C.
B) The HDV virus is cleared when the HBV virus is cleared.
C) Coinfection with HAV and HBV reduces the risk of cirrhosis.
D) Coinfection with HCV and HDV lowers HCV vital titers.

Question 14

Which of the following should the nurse include when preparing a community program on hepatitis E?

A) Adolescents are at lowest risk for HEV.
B) Mortality is high for pregnant women with HEV.
C) HEV is transmitted through the parenteral route.
D) The incubation for HEV is 8 to 12 weeks.

Question 15

Which patient statement is typical of data collected on patients during the prodromal stage of hepatitis?

A) "I am tired, have a low grade fever, and just don't feel right."
B) "I have gained 5 pounds over the last two weeks."
C) "My stools are clay-colored."
D) "I have left-sided abdominal pain and nausea."

Question 16

What finding would the nurse expect to assess in a patient in the prodromal phase of hepatitis?

A) Decreased PT
B) Decreased liver transaminases
C) Elevated serum bilirubin
D) Decreased INR

Question 17

Which finding indicates to the nurse that a patient with hepatitis B has a resolved infection?

A) Presence of HBsAG
B) Presence of HBcAg IgM
C) Presence of HBsAG for more than 6 months
D) Loss of HBsAG and development of HBsAb

Question 18

Which physical finding should the nurse expect to assess in a patient with alcoholic liver disease?

A) Dyslipidemia
B) Insulin resistance
C) Palmar erythema
D) Hyperglycemia

Question 19

When taking a health history from a patient with acute liver failure, the nurse most likely expects to find:

A) recent use of high doses of acetaminophen.
B) infection with hepatitis B.
C) high consumption of alcoholic beverages.
D) exposure to toxins.

Question 20

Which nursing intervention should be included in the care plan for a patient with acute liver failure with encephalopathy?

A) Have the patient lie flat in bed.
B) Perform frequent neurological checks.
C) Initiate a fluid restriction.
D) Administer lactulose.