Chapter 43 Review

The nurse is educating a patient with cirrhosis about the importance of maintaining a low-sodium diet. Which statement made by the patient indicates that the education is effective? a. "peanut butter will be a good option for me since it will also add protein" b. "fresh fruit like the pear I ate for lunch will be a low-sodium option" c. "it's alright if I just have a couple of hot dogs with ketchup at dinner" d. "canned soup is a light meal that will be low in calories and healthy"

b. "fresh fruit like the pear I ate for lunch will be a low-sodium option"

A patient must begin receiving the hepatitis B series of injections. The patient asks when the next two injections should be administered. Which is the best response by the nurse? a" you must have the second one in 2 weeks and the third in 1 month b. "you must have the second one in 1 month and the third in 6 months c. "you must have the second one in 6 months and the third in 1 year" d. :you must have the second one in 1 year and the third the following year"

b. "you must have the second one in 1 month and the third in 6 months

HBV is transmitted primarily through ____

bleeding

The nurse is caring for a patient with ascities as a result of hepatic dysfunction. Which intervention will the nurse provide to determine if the ascities is increasing? SATA a. measure urine output every 8 hours b. assess and document vital signs every 4 hours c. measure abdominal girth daily d. perform daily weights e. monitor number of bowel movements per day

c. measure abdominal girth daily d. perform daily weights

A patient who had a recent myocardial infarction was brought to the emergency department with bleeding esophageal varices and is presently receiving fluid resuscitation. Which first-line pharmacologic therapy will the nurse prepare to administer to control the bleeding from the varices? a. vasopressin b. epinephrine c. octreotide d. glucagon

c. octreotide

_______ is the most common single cause of death in patients with cirrhosis

ruptured esophagus varices

liver function tests are not abnormal until ___% of the liver is revealed to be damaged.

70%

hepatic lobectomy for cancer can be successful when the primarily site is localized. Because of the regenerative capacity of the liver, a surgeon can remove up to ____% of liver tissue

90%

A patient is scheduled for a diagnostic paracentesis, but when coagulation studies are reviewed, the nurse observes results outside of normal parameters. How will the nurse proceed with preparation for the paracentesis? a. an ultrasound-guided paracentesis will be performed b. the procedure will be canceled the laboratory results are within normal parameters c. the paracentesis will be performed at the bedside d. the nurse will administer packed red blood cells prior to the paracentesis

a. an ultrasound-guided paracentesis will be performed

The nurse provides care to a patient with gross ascites who is maintaining a position of comfort in the high semi-fowlers position. Which is the nurse's priority assessment of this patient? a. respiratory assessment related to increased thoracic pressure b. urinary output related to increased sodium retention c. peripheral vascular assessment related to immobility d. skin assessment related to increase in bile salts

a. respiratory assessment related to increased thoracic pressure

A patient with bleeding esophageal varices has had pharmacologic therapy with octreotide and endoscopic therapy with esophageal varices banding but continues to bleed. Which procedure will the nurse prepare for that will lower portal pressure? a. transjugular intrahepatic portosystemic shunting (TIPS) b. administration of vasopressin c. sclerotherapy d. balloon tamponade

a. transjugular intrahepatic portosystemic shunting (TIPS

The nurse is administering lactulose to decrease the ammonia level in a patient who has hepatic encephalopathy. Which will the nurse carefully monitor for that may indicate a medication overdose? a. watery diarrhea b. vomiting c. ringing in the ears d. the presence of asterixis

a. watery diarrhea

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. Which diuretic may be prescribed that spares potassium and prevents hypokalemia? A. furosemide b. spironolactone c. acetazolamise d. bumentanide

b. spironolactone

A patient with suspected esophageal varices is scheduled for an upper endoscopy with moderate sedation. After the procedure is performed, how long will the nurse withhold food and fluids? a. for 2 hours after the last dose of medication is given b. until the gag reflex returns c. until the patient expresses thirst d. for 6 hours after the procedure

b. until the gag reflex returns

The two major complication of a liver biopsy are ____ and ____

bleeding and bile peritonitis

The nurse is educating a patient being treated for hepatic encephalopathy about dietary restrictions to prevent ammonia accumulation. Which statement made by the patient indicates that the patient understand the education? a. "I will decrease the amount of fats in my diet b. "I need to eat foods that are high in potassium" c. "I need to decrease the amount of protein in my diet" d. "it is necessary to increase the amount of magnesium in my diet"

c. "I need to decrease the amount of protein in my diet"

the substance necessary for the manufacture of bile salts by hepatocytes is _____

cholesterol

Hepatocellular carcinoma is caused by ____, ____, ____, and ____

chronic liver disease, hepatitis B, hepatitis C, and cirrhosis

The nurse is caring for a patient with cirrhosis of the liver and observes that the patient is having hand-flapping tremors. How will the nurse document this finding? a. constructional apraxia b. fetor hepaticus c. ataxia d. asterixis

d. asterixis

The nurse is caring for a patient with ascites. Which intervention will the nurse perform to correct the decrease in effective arterial blood volume that will lead to sodium retention? a. administer diuretic therapy b. assist with a therapeutic paracentesis c. infuse platelets d. infuse albumin

d. infuse albumin

The nurse is caring for a patient with ascites due to cirrhosis of the liver. Which position does the nurse determine will activate the renin-angiotensin-aldosterone and sympathetic nervous system and decrease responsiveness to diuretic therapy? a. prone b. supine c. left lateral sims d. upright

d. upright

A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. Which vitamin deficiency does the nurse identify the patient may be experiencing? a. riboflavin deficiency b. folic acid deficiency c. vitamin A deficiency d. vitamin K deficiency

d. vitamin K deficiency

___ caused by contaminated needles shared by drug users is also the most common reason for liver transplantation

hepatitis C

the most common reason for liver transplantation is exposure to ____

hepatitis C

the leading cause of death after liver transplantation is ___

infection

the majority of blood supply to the liver, which is rich in nutrients from the gastrointestinal tract comes from the ____

portal vein

the liver synthesizes prothrombin only if there is enough ___

vitamin K