PrepU: CH 49- Assessment and Management of Patients with Hepatic Disorders

Most of the liver's metabolic functions are performed by: a. Parenchymal cells. b. Kupffer cells. c. Canaliculi cells. d. Islets of Langerhans.

a. Parenchymal cells

Which of the following is the most effective strategy to prevent hepatitis B infection? a. Vaccine b. Avoid sharing toothbrushes c. Covering open sores d. Barrier protection during intercourse

a. Vaccine

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? a. Riboflavin deficiency b. Vitamin K deficiency c. Folic acid deficiency d. Vitamin A deficiency

b. Vitamin K deficiency

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? a. Nitroglycerin b. Spironolactone c. Vasopressin d. Cimetidine

c. Vasopressin

Clients with chronic liver dysfunction have problems with insufficient vitamin intake. Which may occur as a result of vitamin C deficiency? a. Night blindness b. Hypoprothrombinemia c. Beriberi d. Scurvy

d. Scurvy

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor? a. "You must have the second one in 6 months and the third in 1 year." b. "You must have the second one in 2 weeks and the third in 1 month." c. "You must have the second one in 1 month and the third in 6 months." d. "You must have the second one in 1 year and the third the following year."

c. "You must have the second one in 1 month and the third in 6 months."

A client with cirrhosis is at risk for developing esophageal varices. Which of the following instructions should a nurse provide the client to minimize such risk? a. Use aspirin at least once a day. b. Avoid intake of sodium-rich food. c. Abstain from drinking alcohol. d. Increase intake of potassium-rich food.

c. Abstain from drinking alcohol.

The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient? a. Urinary output related to increased sodium retention b. Skin assessment related to increase in bile salts c. Respiratory assessment related to increased thoracic pressure d. Peripheral vascular assessment related to immobility

c. Respiratory assessment related to increased thoracic pressure

The nurse is completing a morning assessment of a client with cirrhosis. Which information obtained by the nurse will be of most concern? a. The client has gained 2 kg from the previous day. b. The client reports nausea and anorexia. c. The skin on the client's abdomen has multiple spider-shaped blood vessels. d. The client's hands flap back and forth when the arms are extended.

d. The client's hands flap back and forth when the arms are extended.

An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is: a. Acetaminophen b. Dextromethorphan c. Ibuprofen d. Benadryl

a. Acetaminophen

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? a. Abdominal CT scan b. Upper endoscopy c. Thoracentesis d. Abdominal paracentesis

d. Abdominal paracentesis

The nurse is caring for a patient with cirrhosis of the liver and observes that the patient is having hand-flapping tremors. What does the nurse document this finding as? a. Asterixis b. Constructional apraxia c. Fetor hepaticus d. Ataxia

a. Asterixis

Clients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia? a. Hypotension b. Warm moist skin c. Polyuria d. Bradycardia

a. Hypotension

A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation of the disorder? a. Liver biopsy b. Magnetic resonance imaging c. Coagulation studies d. Radioisotope liver scan

a. Liver biopsy

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

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

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? a. Cimetidine b. Vasopressin c. Nitroglycerin d. Spironolactone

b. Vasopressin

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? a. Vitamin A b. Thiamine c. Riboflavin d. Vitamin K

a. Vitamin A

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? a. Cholestyramine b. Kanamycin c. Spironolactone d. Lactulose

d. Lactulose

A patient who had a recent myocardial infarction was brought to the emergency department with bleeding esophageal varices and is presently receiving fluid resuscitation. What first-line pharmacologic therapy does the nurse anticipate administering to control the bleeding from the varices? a. Glucagon b. Epinephrine c. Vasopressin (Pitressin) d. Octreotide (Sandostatin)

d. Octreotide (Sandostatin)