patho exam 5

In alcoholic cirrhosis, hepatocellular damage is caused by: a. Acetaldehyde accumulation b. Bile toxicity c. Acidosis d. Fatty infiltrations

ANS: A Alcoholic cirrhosis is caused by the toxic effects of alcohol metabolism on the liver. Alcohol is transformed to acetaldehyde, and excessive amounts significantly alter hepatocyte function and activate hepatic stellate cells, a primary cell involved in liver fibrosis

A 60-year-old female with a history of alcoholism complains of recent weight gain and right flank pain. Physical examination reveals severe ascites. This condition is caused by decreased: a. Albumin and lack of cellular integrity b. Capillary filtration pressure c. Capillary permeability d. Antidiuretic hormone secretion

ANS: A Ascites is due to decreased albumin and lack of cellular integrity.

An increase in the rate of red blood cell breakdown causes which form of jaundice? a. Obstructive b. Hemolytic c. Hepatocellular d. Metabolic

ANS: B Excessive hemolysis (breakdown) of red blood cells can cause hemolytic jaundice (prehepatic jaundice).

When an infant has increased bilirubin production and impaired hepatic excretion of bilirubin, what does the nurse suspect is occurring in the patient? a. Biliary hypertrophy b. Physiologic jaundice c. Hepatitis A d. Infantile cirrhosis

ANS: B Impaired excretion of bilirubin can lead to physiologic jaundice.

A 54-year-old male complains that he has been vomiting blood. Tests reveal portal hypertension. Which of the following is the most likely cause of his condition? a. Thrombosis in the spleen b. Cirrhosis of the liver c. Left ventricular failure d. Renal stenosis

ANS: B Portal hypertension occurs secondarily to cirrhosis of the liver.

The function of the acinar cells of the pancreas is to secrete: a. Bicarbonate b. Enzymes c. Mucus d. Electrolytes

ANS: B The exocrine pancreas is composed of acinar cells that secrete enzymes.

The icteric phase of hepatitis is characterized by which of the following clinical manifestations? a. Fatigue, malaise, vomiting b. Jaundice, dark urine, enlarged liver c. Resolution of jaundice, liver function returns to normal d. Fulminant liver failure, hepatorenal syndrome

ANS: B The icteric phase is manifested by jaundice, dark urine, and clay-colored stools. The liver is enlarged, smooth, and tender, and percussion causes pain; this is the actual phase of illness.

The nurse assessing the patient with biliary atresia would expect to find which primary clinical manifestation? a. Anemia b. Jaundice c. Hypobilirubinemia d. Ascites

ANS: B The primary clinical manifestation is jaundice

A 7-month-old female presents with jaundice, clay-colored stool, and failure to gain weight. She is diagnosed with biliary atresia. The nurse realizes the treatment for this disorder will most likely be: a. Immunoglobulins b. Liver transplant c. Bone marrow transplant d. Dietary modifications

ANS: B The treatment for biliary atresia is liver transplant.

Complete obstruction of bile flow to the liver would be manifested by: a. Elevated hemoglobin and hematocrit b. Lower-leg edema c. Clay-colored stools d. Hypotension

ANS: C Complete obstruction of bile flow leads to clay-colored stools.

Where does the nurse expect the obstruction to be in a patient with extrahepatic portal hypertension? a. Sinusoids b. Bile ducts c. Hepatic portal vein d. Hepatic artery

ANS: C Extrahepatic (prehepatic) portal venous obstruction causes 50% to 70% of extrahepatic portal hypertension in children.

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of: a. Hyperbilirubinemia and jaundice b. Fluid and electrolyte imbalances c. Impaired ammonia metabolism d. Decreased cerebral blood flow

ANS: C Impaired ammonia metabolism leads to the symptoms of hepatic encephalopathy

A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy, and mild jaundice secondary to cirrhosis. The most likely cause of his condition is: a. Bacterial infection b. Viral infection c. Alcoholism d. Drug overdose

ANS: C The most common cause of cirrhosis is alcoholism.

The most common clinical manifestation of portal hypertension is _____ bleeding. a. Rectal b. Duodenal c. Esophageal d. Intestinal

ANS: C Vomiting of blood from bleeding esophageal varices is the most common clinical manifestation of portal hypertension.

A 7-month-old female presents with jaundice, clay-colored stool, and failure to gain weight. Testing reveals the absence of intrahepatic bile ducts. This condition is referred to as _____ atresia. a. Hepatic b. Portal c. Sinusoidal d. Biliary

ANS: D Jaundice is the primary clinical manifestation of biliary atresia, along with hepatomegaly and acholic (clay-colored) stools.