Exam 1 hepatitis lippincott practice questions

A nurse is developing a care plan for a client with hepatic encephalopathy. Which are goals for the care for this client select all that apply 1.Prevent constipation 2.Administer lactulose to reduce blood ammonia levels 3.Monitor coordination while walking 4.Check the pupil reaction 5.Provide food and fluids high in carbohydrates 6.Encourage physical activity

1,2,3,4,5

What diet should be implemented for a client who is in the early stages of cirrhosis? 1.High calorie high carbohydrate 2.High protein, low fat 3.Low-fat, low protein 4.High carbohydrate, low sodium

1. High calorie high carb Is preferred to provide an adequate supply of nutrients in the early stages of cirrhosis, there is no need to restrict fat protein or sodium

When planning care for a client with hepatitis A, the nurse should review laboratory reports for which laboratory values? 1. Prolong prothrombin time 2. Decreased blood glucose level 3. Elevated serum potassium level 4. Decreased serum calcium level

1. The prothrombin time may be prolonged because of decreased absorption of vitamin K and decrease production of prothrombin by the liver

A client recently diagnosed with hepatitis C states : now that you know what's wrong with me, you can just get me those new drugs to take care of it, right? What should the nurse tell the client? 1. There are new antiviral drugs available that may make treatment more effective and help you tolerate it better 2. There are drugs to help with the symptoms but once you have hepatitis C you will never be cured 3.The medicine currently used to treat hepatitis C is very expensive, and your insurance probably will not pay for it 4. If you continue to make the same lifestyle choices, the medicine will not make any difference

1. There are new antiviral drugs available that may make treatment more effective and help you tolerate it better

A client with chronic hepatitis C Is experiencing nausea, anorexia, and fatigue. During the health history, the client states that he is homosexual, drinks 1 to 2 glasses of wine with dinner, is taking St. John's wort for a bit of depression, and takes acetaminophen for frequent headaches. What should the nurse do select all that apply 1. Instruct the client that the wine with meals can be beneficial for cardiovascular health 2. Instruct the client to ask the healthcare provider about taking any other medications as they may interact with medications the client is currently taking 3. Instruct the client to increase the protein in his diet and eat less frequently 4. Advise the client of the need for additional testing for HIV 5. Encourage the client to obtain sufficient rest

2,4,5

The nurse is assessing a client who is in the early stages of cirrhosis of the liver. Which focused assessment is appropriate? 1.Constipation 2. Hyperkalemia 3.Irregular pulse 4. Dysuria

2. Hyperkalemia You're an electron is a potassium sparing diuretic therefore the client should be monitored closely for hyperkalemia other common adverse effects include abdominal cramping, diarrhea, dizziness, headache, rash

The nurse is developing a teaching plan for the client with hepatitis A what should the nurse tell the client to do? 1. Limit caloric intake and reduce weight 2.Increase carbohydrates and protein in the diet 3.Avoid contact with others and sleep in a separate room 4.Intensify routine exercise and increase strength

2. Increase carbohydrate and protein in the diet

Which finding is normal for a client during the icteric phase of hepatitis A? 1. Tarry stool 2. Yellow sclerae 3. Shortness of breath 4. Light frothy tribe

2. yellow sclerae

The nurse is establishing goals for the client with hepatitis A which goal is appropriate? The client will : 1.Demonstrate a decrease in fluid retention related to ascites 2.Verbalize the importance of reporting bleeding gums or bloody stools 3. Limit use of alcohol to 2 to 3 drinks per week 4.Restrict activity to within the home to prevent disease transmission

2.Verbalize the importance of reporting bleeding gums or bloody stools

The nurse develops a teaching plan for the client about how to prevent the transmission of hepatitis A. Which discharge instruction is appropriate for the client 1.Spray the house to eliminate infected insects 2. Tell family members to try to stay away from the client 3.Ask family members to wash their hands frequently 4. Disinfect all clothing and eating utensils

3. Ask family members to wash their hands frequently

The nurse is assessing a client with cirrhosis who has developed Hepatic encephalopathy. The nurse should notify the healthcare provider of a decrease in which serum lab that you that is a potential precipitating factor for hepatic encephalopathy 1.Aldosterone 2.Creatinine 3.Potassium 4.Protein

3. Potassium hypokalemia is a precipitating factor in hepatic encephalopathy

A client plans to travel to a country where hepatitis B is common. What should the nurse advised the client about the most effective way to prevent the disease 1. Drink purified water 2. Avoid crowded and enclosed spaces 3. Complete the vaccination series 4. Observe safe sex practice

3.Complete the vaccine series

The nurse is caring for a client recently diagnosed with hepatitis C. In reviewing the clients history, what information will be most helpful as the nurse develops a teaching plan? The client : 1. Has a history of exercise induced asthma 2. Is a scientist and is frequently exposed to multiple chemicals 3. Travel to Central America recently and eat uncooked vegetables 4. Has a known history of sexually transmitted disease

4. Has a known history of sexually transmitted disease

The nurse is assessing a client with hepatitis A and notices that the AST and ALT lab values have increased. Which statement by the client indicates the need for further instruction by the nurse 1.I require increased periods of rest 2. I follow a low fat, high carbohydrate diet 3. I eat dry toast to relieve my nausea 4. I take acetaminophen for arthritis pain

4. I take acetaminophen for arthritis pain

A client who is recovering from hepatitis A has fatigue and malaise. The client asks the nurse, when will my strength return? Which response by the nurse is most appropriate 1.Your fatigue should be gone by now. We will evaluate you for a secondary infection 2. Your fatigue is an adverse effect of your drug therapy. It will disappear when your Treatment regimen is complete 3. It is important for you to increase your activity level. That will help decrease your fatigue 4. It is normal for you to feel fatigued. The fatigue should go away in the next 2 to 4 months

4. It is normal for you to feel fatigued the fatigue should go away in the next 2 to 4 months

A client has advanced services of the liver the client spouse asked the nurse why his abdomen is swollen, making it difficult for him to fasten his pants. How should the nurse respond to provide the most accurate explanation of the disease process 1.He must've been eating too many foods with salt in them, salt pulls water with it 2.The swelling in his ankles must have moved up closer to his heart so the fluid circulates better 3. He must've forgotten to take his daily water pill 4. Blood is not able to flow readily through the liver now, and the liver cannot make protein to keep fluid inside the blood vessels

4. Portal hypertension and hypoalbuminemia As a result of cirrhosis cause a fluid shift into the peritoneal space causing ascites

A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has asterixis what should the nurse do next? 1.Assess for gastrointestinal bleeding 2.Withhold the lactulose 3. Increase protein in the diet. 4. Monitor serum BiliRubin levels

1. Assess for G.I. bleed

The nurse is teaching an adult recreational drug user about measures to avoid acquiring hepatitis A. What information should the nurse include in the instruction select all that apply 1. Observing proper handwashing technique 2. Following safety syringe disposal procedure 3.Obtaining a vaccination 4. Wearing a mask when in crowds 5. Using precaution when eating fresh fruits and vegetables

1.2.3.5

The nurse is developing a teaching plan with a client with viral hepatitis. What information should the nurse include in the plan? 1. Obtain adequate bedrest 2. Increase fluid intake 3. Take antibiotic as prescribed 4. Drink it ounces of an electrolyte solution every day

1.Obtain adequate bed rest

interferon alpha-2b Has been prescribed to treat a client with chronic hepatitis B. The nurse should assess the client for which common adverse effect? 1. Retinopathy 2.Constipation 3.Flu like symptoms 4.Hypoglycemia

3.Flu like symptoms

The client with hepatitis A is experiencing fatigue, weakness, general feeling of malaise. The client tires rapidly during morning care. What is the most appropriate goal for this client? 1. Increase mobility 2. Learn new self-care skills 3. Adapt to new levels of energy 4. Gradually increase activity tolerance

4.Gradually increase activity tolerance

The nurse is preparing a community education program about preventing hepatitis B infection. Which information should be incorporated into the teaching plan? 1. Hepatitis B is relatively uncommon among college students 2. Frequent ingestion of alcohol can predispose an individual to the development of hepatitis B 3.Good personal hygiene habits are most effective at preventing the spread of hepatitis B 4.The use of a condom is advised for sexual intercourse

4.The use of a condom is advised for sexual intercourse

A client had a liver biopsy one hour ago. What should the nurse do first? 1.Auscultate lung sounds 2. Check for fever 3. Obtain a CBC 4.Apply packing to the biopsy site

1. Auscultate lung sounds because the biopsy needle insertion site is close to the lung therefore, the risk of lung puncture and pneumothorax is possible

The nurse is assessing a client for ascites. Where does the nurse place the hands to percuss for the presence of fluid ?

The nurse places the client in supine position and percusses each flank for shifting dullness if fluid is present dullness is noted