hesi - liver quiz 2
The nurse is providing care to a client with ascites secondary to liver failure. What is appropriate to include in this client's care? Select all that apply. 1. High protein diet 2. Low sodium diet 3. Daily abdominal girth measurements 4. Encourage increased by mouth fluid intake 5. Daily weights
2. Low sodium diet 3. Daily abdominal girth measurements 5. Daily weights
After an acute episode of upper gastrointestinal (GI) bleeding, a client vomits undigested medications and reports severe epigastric and abdominal pain. The client has absent bowel sounds, rigid abdomen, a pulse rate of 134, and shallow respirations of 32 per minute. The primary healthcare provider has been contacted. What should be the nurse's next priority? 1. Keep the client nothing by mouth (NPO) 2. Teach the client coughing and deep breathing 3. Inquire whether any red or black stools have been noted 4. Place the client in the supine position with the legs elevated
1. Keep the client nothing by mouth (NPO)
A client with chronic gastritis is being treated with medication and diet. What should the nurse teach the client when discussing the therapeutic regimen? 1. Lie down after eating when possible 2. Take an antacid preparation with meals 3. Limit high-carbohydrate foods in the diet 4. Avoid using analgesics that contain aspirin
4. Avoid using analgesics that contain aspirin
A client with cirrhosis is scheduled for a liver biopsy. The client asks if there are any risks after the procedure. Which response by the nurse is the best? 1."There are relatively no risks associated with this procedure." 2. "The major risk is infection at the biopsy site." 3. "The major risk is bleeding postprocedure." 4. "The major risk is liver failure postprocedure."
"The major risk is bleeding postprocedure."
A client has a liver biopsy. Which nursing intervention is appropriate for monitoring or preventing a post-liver biopsy complication? 1. Place the client in a left side-lying position. 2. Keep the client supine on bed rest for six hours. 3. Take the client's pulse and blood pressure every shift. 4. Assess the client for pain in the right upper quadrant.
Assess the client for pain in the right upper quadrant.
A client with a long history of alcohol abuse develops cirrhosis of the liver. The client exhibits the presence of ascites. What does the nurse conclude is the most likely cause of this client's ascites? 1. Impaired portal venous return 2. Impaired thoracic lymph channels 3. Excess production of serum albumin 4. Enhanced hepatic deactivation of aldosterone secretion
Impaired portal venous return
A nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations should the nurse assess in the client? Select all that apply. 1 Ascites 2 Hunger 3 Pruritus 4 Jaundice 5 Headache
ascites pruritus jaundice
A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. Which diet can the nurse expect will be prescribed for this client based upon the assessment? 1.No protein 2. Moderate protein 3. High protein 4. Strict protein restriction
moderate protein
A client with liver dysfunction states, "My gums have been bleeding spontaneously." The nurse identifies small hemorrhagic lesions on the client's face. Which vitamin does the nurse conclude the client needs? 1. Vitamin D 2. Vitamin E 3. Vitamin A 4. Vitamin K
vitamin K
A client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. The client reports frequent nausea, pain that increases after meals, and black, tarry stools. The client recently joined Alcoholics Anonymous. The nurse should give priority to which client history item? 1. Black, tarry stools 2. Frequent nausea 3. Joining Alcoholics Anonymous 4. Pain that increases after meals
Black, tarry stools
A client is admitted to the hospital with a history of cancer of the liver and jaundice. In relation to the jaundice, the nurse expects the client to report the presence of what symptom? 1. Pruritus 2. Diarrhea 3. Blurred vision 4. Bleeding gums
pruritus
A client with hepatitis B (HBV) develops cirrhosis and is hospitalized. One potential sequela of chronic liver disease is fluid and electrolyte imbalance. The nurse determines that this may be attributed to a decrease in serum albumin level. Which of these conditions results from this imbalance? 1. Hemorrhage with subsequent anemia 2.Diminished resistance to bacterial insult 3.Malnutrition of cells, especially hepatic cells 4.Reduction of colloidal osmotic pressure in the blood
4.Reduction of colloidal osmotic pressure in the blood
A client who has had right upper quadrant pain for several months now experiences clay-colored stools. Laboratory results reveal elevated liver enzymes, and a needle biopsy of the liver is scheduled. What should the nurse include in the client's teaching about the procedure? 1. The procedure is painless because general anesthesia is used. 2.Disfiguring scars are minimal because a small incision is made. 3. Lying on the right side after the procedure is required because it will decrease the risk of hemorrhage. 4. A light meal should be eaten two hours before the procedure because it stimulates gastrointestinal secretion.
1. Lying on the right side after the procedure is required because it will decrease the risk of hemorrhage.
A nurse is assessing a client with severe liver disease. Which assessment finding will the nurse expect to observe? 1. Icterus 2. Urticaria 3. Uremic frost 4. Hemangioma
icterus