Chapter 58 EAQ

Which patient statement causes the nurse to suspect that the patient has stage I hepatic encephalopathy? 'I am unable to recognize people.' 'I feel numb when I should feel pain.' 'I am unable to sleep during the night.' 'I am unable to move my hands freely.'

'I am unable to sleep during the night.'

Which instruction is essential for the nurse to include when teaching a patient who is undergoing treatment for hepatitis with ribavirin? Never miss a dose. Avoid going out in the sun. Take the medication on an empty stomach. Take the medication at the same time each day.

Never miss a dose.

What type of cirrhosis is caused by hepatitis C? Biliary Laennec's Cholestatic Postnecrotic

Postnecrotic

The serum level of what enzyme is elevated in patients with obstructive jaundice? Alkaline phosphatase Lactate dehydrogenase Alanine aminotransferase Aspartate aminotransferase

Alkaline phosphatase

Which diet instruction does the nurse give to a patient with active hepatitis? 'Follow a low-protein, low-fat diet.' 'Consume soft, easy-to-chew foods.' 'Eat small meals at frequent intervals.' 'Eat a normal diet with fluid restrictions.'

'Eat small meals at frequent intervals.'

Which drug is used to treat liver cancer and acts by kinase inhibition? Cisplatin Sorafenib Doxorubicin 5-Fluorouracil

Sorafenib

Which statement by a patient with cirrhosis indicates that further instruction is needed about the disease? 'Cirrhosis is a chronic disease that has scarred my liver.' 'The scars on my liver create problems with blood circulation.' 'Because of the scars on my liver, blood clotting and blood pressure are affected.' 'My liver is scarred, but the cells can regenerate themselves and repair the damage.'

'My liver is scarred, but the cells can regenerate themselves and repair the damage.'

The nurse is discussing with a nursing student the care of a patient with cirrhosis. Which statement by the student indicates a correct understanding of how to observe for esophageal bleeding in the patient? 'I should observe for epistaxis.' 'Hematuria may indicate bleeding varices.' 'Any melena should be reported immediately.' 'Prothrombin time should be monitored daily.'

'Any melena should be reported immediately.'

The nurse is teaching a spouse and patient with hepatitis C about preventing the spread of infection. Which instruction does the nurse include in the teaching plan? 'Drink only bottled water.' 'Do not share toothbrushes.' 'Donate blood only once yearly.' 'You should use a separate bathroom.'

'Do not share toothbrushes.'

A patient who has liver disease with ascites refuses the evening dinner tray and reports moderate abdominal pain. The nurse notifies the provider after assessing a low-grade fever and abdominal rigidity. The provider prepares to perform a paracentesis and orders an antibiotic to be given. When does the nurse administer the antibiotic? After a short-term ascites drain has been placed After a sample of fluid is sent to the lab for culture Before the paracentesis to prevent sepsis from the procedure After the culture and sensitivity results are returned from the lab

After a sample of fluid is sent to the lab for culture

A patient with Laennec's cirrhosis has an increased abdominal girth of 12 cm over the measured abdominal girth from a previous admission. Which condition does the nurse suspect in this patient? Ascites Splenomegaly Hepatomegaly Esophageal varices

Ascites

When caring for a patient with portal hypertension, the nurse assesses for which potential complications? Select all that apply. Some correct answers were not selected Fever Ascites Hematuria Hemorrhoids Esophageal varices

Ascites Hemorrhoids Esophageal varices

A patient who has liver disease has undergone a percutaneous needle biopsy. Which is the prioritynursing assessment for the patient after this procedure? Assessing for bleeding Determining pain level Evaluating urine output Monitoring for hepatomegaly

Assessing for bleeding

The nurse asks a patient with liver disease to raise the arms to shoulder level and dorsiflex the hands. A few moments later, the hand begins to flap upward and downward. How does the nurse correctly document this in the medical record? Asterixis Kehr's sign Hyperreflexia Positive Babinski's sign

Asterixis

A patient who has liver disease with ascites asks about any necessary dietary changes. What instruction does the nurse include when teaching this patient? Avoid using table salt. Eat foods high in calcium. Consume a high-protein diet. Take potassium supplements.

Avoid using table salt.

The nurse is reviewing the diagnostic test results for a patient with hepatitis. Which elevated test result does the nurse correlate to the presence of jaundice? Bilirubin Blood urea nitrogen (BUN) Alanine aminotransferase (ALT) Aspartate aminotransferase (AST)

Bilirubin

What is the most accurate test to confirm the diagnosis of liver cancer? Cholangiogram Ultrasound scan Abdominal x-ray Computed tomography (CT) guided liver biopsy

Computed tomography (CT) guided liver biopsy

The nurse is caring for a patient with cirrhosis. What factors may lead to hepatic encephalopathy in the patient? Select all that apply. Some correct answers were not selected Constipation Low-protein diet Decreased fluid volume Gastrointestinal bleeding Increased serum potassium

Constipation Decreased fluid volume Gastrointestinal bleeding

When providing dietary teaching to a patient with hepatitis, what practice does the nurse recommend? Restricting fluids to 1500 mL per day Having a larger meal early in the morning Limiting alcoholic beverages to once weekly Consuming increased carbohydrates and moderate protein

Consuming increased carbohydrates and moderate protein

he nurse is assessing a patient who underwent a liver transplantation for the treatment of liver cancer. Which finding indicates normal liver function? Clay-colored stools Increased serum bilirubin levels Dark green drainage in the T-tube Increased international normalized ratio (INR)

Dark green drainage in the T-tube

What treatment utilizes liquid nitrogen to destroy liver tumors? Cryotherapy Radiation therapy Radiofrequency ablation Percutaneous ethanol injection

Cryotherapy

After a liver transplant for the treatment of liver cancer, the nurse observes decreased urine output and increased serum creatinine. What drug may be the cause of this condition? Acyclovir Rifaximin Cyclosporin Metronidazole

Cyclosporin

A patient admitted for treatment of liver disease has a decreased serum total protein. Based on this finding, how may the nurse classify this patient's disease? Acute Severe Chronic Advanced

Chronic

When assessing a patient for possible liver dysfunction, the nurse notices round, pinpoint, red-purple lesions on the patient's skin. What term should the nurse use to document such lesions? Petechiae Ecchymosis Telangiectases Spider angioma

Petechiae

The nurse is teaching a patient with hepatitis about proper diet. Which meal selection demonstrates that the patient has a correct understanding of the teaching? Whole-wheat pasta, vegetable oil, and garlic Baked chicken breast with spinach and lemon Roast duck with orange sauce, and broccoli with cheese Fried fish with baked potato, sour cream, and green beans

Baked chicken breast with spinach and lemon

A patient underwent a liver biopsy for suspected liver cancer. The nurse knows to be vigilant for which complication of this procedure? Bleeding Constipation Hypertension Loss of appetite

Bleeding

A patient is scheduled to undergo placement of a transjugular intrahepatic portal-systemic shunt (TIPS). The nurse explains that this is placed to prevent which complication? Hepatic encephalopathy Bleeding esophageal varices Spontaneous bacterial peritonitis Malnutrition and vitamin deficiency

Bleeding esophageal varices

What is a risk factor for liver cancer? Cirrhosis Fatty liver Hepatomegaly Portal vein thrombosis

Cirrhosis

In caring for a patient who has undergone paracentesis, which changes in the patient's status should be promptly reported to the provider? Decreased blood pressure, increased heart rate Tachypnea, diaphoresis, increased blood pressure Increased blood pressure, increased respiratory rate Increased respiratory rate, increased apical pulse, pallor

Decreased blood pressure, increased heart rate

Following paracentesis, during which 2500 mL of fluid was removed, which assessment finding is mostimportant to communicate to the health care provider? The patient's platelet count is 135,000. The patient's albumin level is 2.8 mg/dL. The patient's heart rate is 122 beats/min. The dressing has a 2-cm area of serous drainage.

The patient's heart rate is 122 beats/min.

Which vitamin may be especially important for a patient who is alcoholic with liver disease? Folate Niacin Thiamine Vitamin D

Thiamine

The primary health care provider prescribes cyclosporin A to a patient who underwent a liver transplant for the treatment of primary liver cancer. What is the rationale behind this intervention? To prevent infection To prevent acute renal failure To prevent hepatic thrombosis To prevent acute graft rejection

To prevent acute graft rejection

When caring for a patient with hepatic encephalopathy, which patient condition would cause the nurse to question the use of neomycin? Kidney failure Fetor hepaticus Refractory ascites Paracentesis scheduled in 2 hours

Kidney failure

A patient who is being treated for hepatic encephalopathy reports intestinal bloating and cramping. On assessment, the nurse finds that the patient is experiencing alcohol withdrawal. The nurse reviews the patient's medication profile and identifies that which medication will likely be discontinued? Lactulose Rifaximin Alprazolam Metronidazole

Lactulose

The nurse teaches a patient with hepatic encephalopathy that certain food should be consumed in moderation while the patient's serum ammonia level is elevated. Which food does the nurse instruct the patient to limit? Pasta Rice Lean meats Vegetables

Lean meats

The registered nurse is teaching a student nurse about liver cancer. What statement made by the student nurse needs correcting? 'Risk factors include hepatitis B and hepatitis C.' 'Alcoholic liver disease increases the risk of liver cancer.' 'Treatment involves surgical resection and liver transplantation.' 'Patients with liver cancer will have a decrease in serum alpha fetoprotein.'

'Patients with liver cancer will have a decrease in serum alpha fetoprotein.'

The registered nurse is teaching a group of student nurses about assessment findings of each stage of portal systemic encephalopathy. Which statement made by a student nurse indicates a need for further teaching? 'The patient in stage IV will have seizures.' 'The patient in stage I will have slurred speech.' 'The patient in stage III will have hyperreflexia.' 'The patient in stage II will have muscle twitching.'

'The patient in stage II will have muscle twitching.'

A patient with long-standing alcoholic liver disease has a decrease in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) from previously assessed levels. What does the nurse tell the patient about these results? 'These results indicate improvement.' 'These decreases may indicate liver deterioration.' 'These results indicate depletion of AST and ALT enzymes.' 'These decreases usually occur when osteoporosis is present.'

'These decreases may indicate liver deterioration.'

A patient diagnosed with hepatitis A asks the nurse how this disease may have been contracted. Which answer by the nurse is correct? 'You may have consumed foods contaminated with the virus.' 'If you received a blood transfusion, you may have been exposed.' 'You may have been exposed if you had unprotected sexual intercourse.' 'The virus is airborne, so you may have contracted it from an infected person.'

'You may have consumed foods contaminated with the virus.'

The nurse is counseling an asymptomatic patient who is worried about possible hepatitis C exposure several years ago. What does the nurse tell this patient about the risk of this disease? 'Unless you have signs of liver disease, you are no longer infected.' 'You have probably cleared the virus since you have not had symptoms.' 'You may be a carrier, but will never have serious symptoms of the disease.' 'You may have serious long-term damage even without symptoms.'

'You may have serious long-term damage even without symptoms.'

A patient has undergone liver transplantation for the treatment of liver cancer. Which findings may indicate impaired function of the transplanted liver? Select all that apply. Some correct answers were not selected Petechiae Ecchymosis Encephalopathy Decreased jaundice Dark green bile in the T-tube

Petechiae Ecchymosis Encephalopathy

The nurse is instructing a patient with liver cancer about how to drain excess ascitic fluid using the PleurX drainage system. The nurse will know the teaching is successful if the patient identifies which number as the maximum amount to be drained in a session? 2000 mL 2500 mL 3000 mL 3500 mL

2000 mL

The nurse is completing an abdominal assessment of a patient who has suspected liver cancer. What should the nurse expect to feel when palpating the right upper quadrant of the abdomen? Tenderness Soft and smooth liver Enlarged and nodular liver Firm with irregular surface liver

Enlarged and nodular liver

A liver is retrieved from a donor for liver transplantation for a patient with liver cancer. What would be the maximum duration within which the liver has to be transplanted to the cancer patient? 2 hours 5 hours 8 hours 18 hours

8 hours

A patient with liver disease has portal hypertension. Which clinical finding prompts the nurse to notify the provider immediately? Liver distention Blood-tinged emesis Urine output of 200 mL/hr Blood pressure of 145/95 mm Hg

Blood-tinged emesis

Which is an important institutional measure that a hospital should take to prevent the transmission of hepatitis B (HBV) to health care workers? Provide immunoglobulin injections within 14 days of exposure to the virus. Develop a hospital-wide needleless system for delivery of medications. Provide information about HBV transmission to at-risk employees. Reinforce Standard Precautions procedures among all hospital employees.

Develop a hospital-wide needleless system for delivery of medications.

A patient with cirrhosis reports having difficulty getting to sleep and staying asleep. Which action by the nurse is correct? Tell the patient that this indicates irreversible encephalopathy. Reassure the patient that this is a transient disease side effect. Contact the provider to discuss ordering a sedating medication. Discuss this early sign of serious complications with the provider.

Discuss this early sign of serious complications with the provider.

When caring for a patient with Laennec's cirrhosis and portal hypertension, which point is most important for the nurse to emphasize to the patient and family? Do not consume any alcohol. Avoid saturated fats in the diet. Adhere to anticoagulant therapy. Reduce the amount of sodium in the diet.

Do not consume any alcohol.

When teaching a patient with viral hepatitis, which instructions does the nurse include in the plan of care? Select all that apply. Some correct answers were not selected Do not consume any alcohol. Consume a high-protein diet. Avoid carbonated beverages. Do not drive a car for 1 to 2 weeks. Monitor blood pressure and pulse daily. Avoid medications containing acetaminophen.

Do not consume any alcohol. Avoid medications containing acetaminophen.

What laboratory finding signifies an immune response to liver disease? Elevated serum globulin Elevated serum ammonia Decreased serum albumin Decreased serum total protein

Elevated serum globulin

Which activity by the nurse will best relieve symptoms associated with ascites? Administering oxygen Elevating the head of the bed Administering intravenous fluids Monitoring serum albumin levels

Elevating the head of the bed

Which is a risk factor for the development of hepatitis C? Consuming shellfish Traveling internationally Chronic alcohol consumption Employment in the health care field

Employment in the health care field

A patient who contracted hepatitis C several years ago via intravenous drug use appears angry and withdrawn and refuses to participate in self-care activities and exercise. Which initial action should the nurse take? Encourage the patient to discuss feelings of guilt or remorse. Reassure the patient that feelings of malaise will improve over time. Request a psychological consultation and involvement of a social worker. Enlist the assistance of a family member to encourage increased activity.

Encourage the patient to discuss feelings of guilt or remorse.

A nurse is reviewing the medical records of patients diagnosed with liver disease. Which patient condition can be resolved with liver transplantation? Select all that apply. Some correct answers were not selected Metastatic liver cancer End-stage liver disease Autoimmune liver disease Recurrent bacterial peritonitis A patient with active infection of hepatitis C virus

End-stage liver disease Autoimmune liver disease

Which intervention is important for the nurse to include in the plan of care for a patient who is to undergo paracentesis later today? Measure and record drainage. Obtain informed consent for the procedure. Have the patient void before the procedure is performed. Monitor aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase.

Have the patient void before the procedure is performed.

Which factors may lead to the development of hepatic encephalopathy in a patient with cirrhosis? Select all that apply. Some correct answers were not selected Diarrhea Hypokalemia Hypertension High-protein diet Hypermagnesemia Gastrointestinal bleeding

Hypokalemia High-protein diet Gastrointestinal bleeding

What are the causes of acute renal failure in a patient after undergoing a liver transplant secondary to liver cancer? Select all that apply. Some correct answers were not selected Hypotension Hyperthermia Hypervolemia Acute liver failure Use of cyclosporin

Hypotension Acute liver failure Use of cyclosporin

Which assessment finding is consistent with a diagnosis of viral hepatitis? Icteric skin Dark-brown stool Light-colored urine Left upper quadrant tenderness

Icteric skin

When caring for a patient with Laennec's cirrhosis, which of these does the nurse expect to find on assessment? Select all that apply. Some correct answers were not selected Icterus of skin Currant jelly stool Swollen abdomen Elevated magnesium Elevated amylase level Prolonged partial thromboplastin time (PTT)

Icterus of skin Swollen abdomen Prolonged partial thromboplastin time (PTT)

A patient tests positive for immunoglobulin G (IgG) hepatitis A virus (HAV) antibodies. For which condition is this result indicative? Ongoing liver inflammation caused by HAV Active HAV infection with acute liver changes Immunity to HAV after previous HAV infection Possible hepatic cirrhosis as a result of HAV infection

Immunity to HAV after previous HAV infection

The nurse is caring for a patient with cirrhosis and profound ascites. Which assessment finding causes the nurse to notify the provider? Anasarca Marked jaundice Multiple ecchymoses Inaudible breath sounds

Inaudible breath sounds

A nurse is educating the spouse of a patient with cirrhosis about the patient's diet. Which nutritional recommendation for the patient will the nurse make? Eat large meals Include a multivitamin Prepare high-sodium foods Drink only small amounts of alcohol

Include a multivitamin

A patient is suspected of having liver cancer and the nurse is reviewing the laboratory results. Which laboratory result, if present in the patient's chart, would the nurse recognize as a confirmation of this diagnosis? Increased bilirubin levels Increased alpha-fetoprotein Decreased alkaline phosphatase Increased alanine aminotransferase

Increased alpha-fetoprotein

The nurse is reviewing the medical history of a patient with severe liver disease. Which physiological changes does the nurse expect to be present? Select all that apply. Some correct answers were not selected Increased urinary flow Increased creatinine levels Increased osmolarity of urine Increased blood urea nitrogen Increased urine sodium excretion

Increased creatinine levels Increased osmolarity of urine Increased blood urea nitrogen

A patient who underwent a liver transplant for the treatment of liver cancer is prescribed cyclosporin. The patient reports a sore throat and fever. The nurse suspects which complication? Infection Dehydration Kidney injury Transplant rejection

Infection

What condition may occur if a patient who underwent liver transplantation for the treatment of liver cancer is prescribed cyclosporin A? Infection Hypotension Hypothermia Hepatic thrombosis

Infection

A patient with viral hepatitis has clay-colored stools and dark urine. These findings are typically characteristic of which complication of hepatitis? Hepatic carcinoma Cirrhosis of the liver Obstructive jaundice Intrahepatic obstruction

Intrahepatic obstruction

Which statement about hepatitis A is accurate? It is transmitted by the fecal-oral route. It is more common in affluent countries. It is resistant to the action of chlorine (bleach). It is more severe in children and young adults.

It is transmitted by the fecal-oral route.

When assessing a patient with hepatitis B, the nurse anticipates which assessment findings? Select all that apply. Some correct answers were not selected Itching Brown stool Tea-colored urine Recent influenza infection Right upper quadrant tenderness

Itching Tea-colored urine Right upper quadrant tenderness

Which symptoms would the nurse observe in a patient suspected of liver cancer? Select all that apply. Some correct answers were not selected Jaundice Weight gain Abdominal distension Right lower quadrant pain Nodular liver on palpation

Jaundice Abdominal distension Nodular liver on palpation

The nurse is caring for a patient who has primary liver cancer. The patient is asking the nurse about treatments. What treatment offers the best chance at long-term survival? Liver transplant Chemoembolization Internal radiation therapy Palliative and hospice treatment

Liver transplant

Which nursing intervention will help prevent bile leakage and abscess formation following liver transplantation? Preventing hypotension Administering antibiotic prophylaxis Administering immunosuppressant medications Maintaining the T-tube in a dependent position

Maintaining the T-tube in a dependent position

What teaching does the home health nurse give the family of a patient with hepatitis C to prevent the spread of the infection? Drink only bottled water and avoid ice. The patient must not consume alcohol. Avoid sharing the bathroom with the patient. Members of the household must not share toothbrushes.

Members of the household must not share toothbrushes.

When providing community education, the nurse emphasizes that which group should receive immunization for hepatitis B? Men who prefer sex with men Patients who work with shellfish Patients traveling to a third-world country Patients with elevations of aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

Men who prefer sex with men

When providing discharge teaching to a patient with cirrhosis, it is essential for the nurse to emphasize avoidance of which of these? Nonabsorbable antibiotics Potassium-sparing diuretics Vitamin K-containing products Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs)

An unconscious patient brought to the emergency department has a history of Laennec's cirrhosis and esophageal varices. What is the priority assessment for this patient? Assessing the size of the spleen Evaluating the abdomen for ascites Determining the presence of jaundice Noting the presence of bloody emesis or stool

Noting the presence of bloody emesis or stool

A patient with a history of esophageal varices has just been admitted to the emergency department after vomiting a large quantity of blood. Which action should the nurse take first? Ask about abdominal pain. Obtain pulse and blood pressure. Listen for bowel sounds in all quadrants. Obtain the charts from the previous admission.

Obtain pulse and blood pressure.

A patient who was previously treated for hepatitis B virus (HBV) is tested for the presence of the hepatitis B surface antigen (HBsAg) in the blood. The test is positive. What does this result indicate? Patient is infectious Recurrence of infection Long-term liver damage Permanent immunity to HBV

Patient is infectious

The nursing team consists of an RN, an LPN/LVN, and a nursing assistant. Which patient should be assigned to the RN? Patient who is taking lactulose and has diarrhea Patient with hepatitis C who requires a dressing change Obtunded patient with alcoholic encephalopathy who needs a blood draw Patient with end-stage cirrhosis who needs teaching about a low-sodium diet

Patient with end-stage cirrhosis who needs teaching about a low-sodium diet

The RN has just received the change-of-shift report for the medical unit. Which patient should the RN see first? Patient with ascites who had a paracentesis 2 hours ago and is reporting a headache Patient with hepatic cirrhosis and jaundice who has hemoglobin of 10.9 g/dL and thrombocytopenia Patient with portal-systemic encephalopathy (PSE) who has become increasingly difficult to arouse Patient with hepatitis A who has elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST)

Patient with portal-systemic encephalopathy (PSE) who has become increasingly difficult to arouse

The nurse is caring for patients in the outpatient clinic. Which of these phone calls should the nurse return first? Patient with hepatitis A reporting severe and ongoing itching Patient with cirrhosis who has had a 3-pound weight gain over 2 days Patient with esophageal varices and mild right upper quadrant pain Patient with severe ascites who has a temperature of 101.4° F (38° C)

Patient with severe ascites who has a temperature of 101.4° F (38° C)

The community health nurse is exploring the cause of an outbreak of hepatitis A. Which individual does the nurse suspect may be the source? Individual who recently got a tattoo Patients who were infected after eating at the same restaurant Spouse of an intravenous drug abuser who developed hepatitis Patient who had a blood transfusion during cardiac surgery in 1985

Patients who were infected after eating at the same restaurant

Which individual has the greatest risk for developing hepatitis A? Health care worker Intravenous drug user Patient receiving hemodialysis Person who consumes raw oysters

Person who consumes raw oysters

The RN is caring for a patient with end-stage liver disease that has resulted in ascites. Which action does the RN delegate to unlicensed assistive personnel (UAP)? Placing the patient in a semi-Fowler's position Assessing skin integrity and abdominal distention Drawing blood from a central venous line for electrolyte studies Evaluating laboratory study results for the presence of hypokalemia

Placing the patient in a semi-Fowler's position

The nurse is administering spironolactone to a patient with portal hypertension and portal systemic encephalopathy. Which additional medication order does the nurse question? Lactulose Neomycin Propranolol Potassium chloride

Potassium chloride

Which problem for a patient with cirrhosis takes priority? Potential for injury related to hemorrhage Discomfort related to the progression of the disease process Insufficient knowledge related to the prognosis of the disease process Inadequate nutrition related to an inability to tolerate usual dietary intake

Potential for injury related to hemorrhage

The nurse administers lactulose to a patient with cirrhosis for which purpose? Reduces portal pressure Decreases gastrointestinal bleeding Promotes gastrointestinal excretion of ammonia Provides enzymes necessary to digest dairy productions

Promotes gastrointestinal excretion of ammonia

A patient with severe cirrhosis of the liver has a urine output of 400 mL for the past 2 days despite adequate intravenous fluid administration. What is the priority nursing action for this patient? Encourage the patient to increase oral fluid intake. Perform a bladder scan to assess for urinary retention. Contact the provider to discuss obtaining a urine culture. Request an order for blood urea nitrogen (BUN) and serum creatinine levels.

Request an order for blood urea nitrogen (BUN) and serum creatinine levels.

A health care worker believes that he or she may have been exposed to hepatitis A. Which intervention is the highest priority to prevent the health care worked from developing the disease? Requesting vaccination for hepatitis A Using a needleless system in daily work Getting the three-part hepatitis B vaccine Requesting an injection of immunoglobulin

Requesting an injection of immunoglobulin

How does the home care nurse best modify the patient's home environment to manage side effects of lactulose? Provides small frequent meals for the patient Requests a bedside commode for the patient Suggests taking daily potassium supplements Elevates the head of the bed in high Fowler's position

Requests a bedside commode for the patient

What is a feature of hepatic abscess? Mortality rates of hepatic abscesses are low. Right upper abdominal pain is a common manifestation. Symptoms of amebic hepatic abscess are usually sudden. Multiple hepatic abscesses are often found simultaneously.

Right upper abdominal pain is a common manifestation.

A patient is suspected of having liver cancer. What region of the abdomen would have pain on palpation? Right iliac region Hypogastric region Right lumbar region Right upper quadrant region

Right upper quadrant region

A patient with cirrhosis has a weight gain of 2 kg. The nurse notes distention of the abdomen, a heart rate of 92 beats/min, and a blood pressure of 88/58 mm Hg. For which condition is this patient at risk? Shock Jaundice Fluid overload Biliary obstruction

Shock

Which precaution is most appropriate for the nurse to implement with a patient with hepatitis A? Enteric precautions Droplet precautions Protective isolation Standard Precautions

Standard Precautions

A patient underwent a liver transplantation surgery and receives cyclosporine. The nurse monitors the patient for which primary indicator of an acute graft rejection? Tachycardia Hyperventilation Clay-colored stools Foul-smelling urine

Tachycardia

The nurse is caring for a patient who has liver trauma as a result of a motor vehicle crash. What sign/symptom, if present in the patient, would prompt the nurse to suspect internal hemorrhage and hypovolemic shock? Tachypnea Bradycardia Hot, dry skin Hypertension

Tachypnea

A patient with hepatic encephalopathy may require which dietary or pharmacologic therapy to help decrease serum ammonia levels? Nonabsorbable antibiotics given for long-term therapy Trial of lactulose to increase the excretion of ammonia Diet high in carbohydrates and protein with moderate fats Diet low in protein and moderate in fats and carbohydrates

Trial of lactulose to increase the excretion of ammonia

The nurse is caring for a patient with suspected liver cancer. Which diagnostic test would confirm the diagnosis? Serum bilirubin Ultrasound-guided liver biopsy Alkaline phosphatase Contrast-enhanced computed tomography

Ultrasound-guided liver biopsy

A patient with cirrhosis is preparing for discharge home. What instruction does the nurse include when teaching this patient about dietary supplements? An iron supplement should be taken daily. Use only supplements prescribed by the provider. Additional fat-soluble vitamins are usually necessary. Niacin is an important vitamin when treating cirrhosis.

Use only supplements prescribed by the provider.