Hepatic Disorders PrepU

In actively bleeding patients with esophageal varices, the initial drug of therapy is usually: 1) Sandostatin 2) Corgard 3) Pitressin 4) Inderal

1) Sandostatin

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? 1) Vasopressin 2) Spironolactone 3) Nitroglycerin 4) Cimetidine

1) Vasopressin

A client has a blockage of the passage of bile from a stone in the common bile duct. What type of jaundice does the nurse suspect this client has? 1) Hemolytic jaundice 2) Cirrhosis of the liver 3) Hepatocellular jaundice 4) Obstructive jaundice

4) Obstructive jaundice

Which is the most common cause of esophageal varices? 1) Ascites 2) Portal hypertension 3) Asterixis 4) Jaundice

2) Portal hypertension

The nurse is administering Cephulac (lactulose) to decrease the ammonia level in a patient who has hepatic encephalopathy. What should the nurse carefully monitor for that may indicate a medication overdose? 1) Vomiting 2) Asterixis 3) Watery diarrhea 4) Ringing in the ears

3) Watery diarrhea

A nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice? 1) Elevated urobilinogen in the urine 2) Reduced hematocrit 3) Straw-colored urine 4) Clay-colored stools

4) Clay-colored stools

The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent? 1) Spironolactone 2) Kanamycin 3)Cholestyramine 4) Lactulose

4) Lactulose

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia? 1) Acetazolamide (Diamox) 2) Furosemide (Lasix) 3) Bumetanide (Bumex) 4) Spironolactone (Aldactone)

4) Spironolactone (Aldactone)

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide? 1) Reduce fluid accumulation and venous pressure. 2) Promote optimal neurologic function. 3) Cure the cirrhosis. 4) Treat the esophageal varices.

1) Reduce fluid accumulation and venous pressure.

The nurse is caring for a patient with ascites due to cirrhosis of the liver. What position does the nurse understand will activate the renin-angiotensin aldosterone and sympathetic nervous system and decrease responsiveness to diuretic therapy? 1)Upright 2)Supine 3)Left-lateral Sims' 4)Prone

1)Upright

A mother brings her teenage son to the clinic, where tests show that he has hepatitis A virus (HAV). They ask the nurse how this could have happened. Which of the following explanations would the nurse correctly identify as possible causes? Select all that apply. 1) Ingestion of undercooked beef 2) Sexual activity 3) Infection at school 4) Consumption of sewage-contaminated water or shellfish 5) Suboptimal sanitary habits

2) Sexual activity 3) Infection at school 4) Consumption of sewage-contaminated water or shellfish 5) Suboptimal sanitary habits

While conducting a physical examination of a client, which of the following skin findings would alert the nurse to the liklihood of liver problems? Select all that apply. 1) Aphthous stomatitis 2)Jaundice 3)Cyanosis of the lips 4)Ecchymoses 5)Petechiae

2)Jaundice 4)Ecchymoses 5)Petechiae

A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing? 1) Vitamin A deficiency 2) Vitamin K deficiency 3) Riboflavin deficiency 4) Folic acid deficiency

2) Vitamin K deficiency

After being in remission from Hodgkin's disease for 18 months, a client develops a fever of unknown origin. A healthcare provider orders a liver biopsy to rule out advancing Hodgkin's disease and infection. Twenty-four hours after the biopsy, the client has a fever, complains of severe abdominal pain, and seems increasingly confused. What should the nurse suspect? 1) An allergic reaction to the contrast media used during the liver biopsy 2) Peritonitis from bleeding in the liver caused by the liver biopsy 3) Perforation of the colon caused by the liver biopsy 4) Normal postprocedural pain, with a change in the level of consciousness resulting from the pre-existing fever

2) Peritonitis from bleeding in the liver caused by the liver biopsy

A nurse educator is providing an in-service to a group of nurses working on a medical floor that specializes in liver disorders. What is an important education topic regarding ingestion of medications? 1) need for increased drug dosages 2) metabolism of medications 3) medications becoming ineffective in clients with liver disease 4) need for more frequently divided doses

2) metabolism of medications

A client with liver cirrhosis develops ascites. Which medication will the nurse prepare teaching for this client? 1) Ammonium chloride 2) Acetazolamide 3) Spironolactone 4) Furosemide

3) Spironolactone

A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect? 1) Serum potassium level of 3.5 mEq/L 2) Blood pH of 7.25 3) Serum sodium level of 135 mEq/L 4) Loss of 2.2 lb (1 kg) in 24 hours

4) Loss of 2.2 lb (1 kg) in 24 hours

The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? 1) Dyspnea and fatigue 2) Ascites and orthopnea 3) Purpura and petechiae 4) Gynecomastia and testicular atrophy

3) Purpura and petechiae

A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has: 1) cirrhosis. 2) appendicitis. 3) cholelithiasis. 4) peptic ulcer disease.

1) cirrhosis.

Ammonia, the major etiologic factor in the development of encephalopathy, inhibits neurotransmission. Increased levels of ammonia are damaging to the body. The largest source of ammonia is from: 1) Excessive diuresis and dehydration. 2)Excess potassium loss subsequent to prolonged use of diuretics. 3) The digestion of dietary and blood proteins. 4) Severe infections and high fevers.

3) The digestion of dietary and blood proteins.

The assessment of a client admitted with increased ascites related to cirrhosis reveals the following: pulse 86 beats per minute and weak, respirations 28 breaths per minute, blood pressure 130/88 mm Hg, and pulse oximetry 90%. Which nursing diagnosis should receive top priority? 1) Fatigue 2)Imbalanced nutrition: less than body requirements 3)Ineffective breathing pattern 4) Excess fluid volume

3)Ineffective breathing pattern

A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds him very difficult to arouse. The diagnostic information which best explains the client's behavior is: 1) subnormal clotting factors and platelet count. 2) elevated liver enzymes and low serum protein level. 3) elevated blood urea nitrogen and creatinine levels and hyperglycemia. 4) subnormal serum glucose and elevated serum ammonia levels.

4) subnormal serum glucose and elevated serum ammonia levels.

A client with cirrhosis has a massive hemorrhage from esophageal varices. Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives the highest priority to which goal? 1) Maintaining fluid volume 2) Relieving the client's anxiety 3) Maintaining the airway 4) Controlling bleeding

3) Maintaining the airway

A client with severe and chronic liver disease is showing manifestations related to inadequate vitamin intake and metabolism. He reports difficulty driving at night because he cannot see well. Which of the following vitamins is most likely deficient for this client? 1) Vitamin K 2) Thiamine 3) Vitamin A 4) Riboflavin

3) Vitamin A

A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include? 1) Infection with hepatitis G is similar to hepatitis A. 2) Hepatitis B is transmitted primarily by the oral-fecal route. 3) Hepatitis C increases a person's risk for liver cancer. 4) Hepatitis A is frequently spread by sexual contact.

3) Hepatitis C increases a person's risk for liver cancer.

A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis? 1) A liver biopsy 2) A CT scan 3) A prothrombin time 4) Platelet count

1) A liver biopsy

The nurse is assessing a client with cirrhosis of the liver. Which stool characteristic would the nurse expect the client to report? 1) Clay-colored or whitish 2)Yellow-green 3)Blood tinged 4)Black and tarry

1) Clay-colored or whitish

A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition? 1) Hepatic encephalopathy 2) Asterixis 3) Portal hypertension 4) Cirrhosis

1) Hepatic encephalopathy

After undergoing a liver biopsy, a client should be placed in which position? 1) Right lateral decubitus position 2) Prone position 3) Supine position 4) Semi-Fowler's position

1) Right lateral decubitus position

Which of the following is the most effective strategy to prevent hepatitis B infection? 1) Barrier protection during intercourse 2) Vaccine 3) Covering open sores 4) Avoid sharing toothbrushes

2) Vaccine

A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation? 1) The client didn't take his morning dose of lactulose (Cephulac). 2) The client is avoiding the nurse. 3) The client is relaxed and not in pain. 4) The client's hepatic function is decreasing.

4) The client's hepatic function is decreasing.