QUIZLET Ch.49 (M/S) HEPATIC DISORDERS
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? Acetazolamide (Diamox) Bumetanide (Bumex) Furosemide (Lasix) Spironolactone (Aldactone)
Spironolactone (Aldactone)
The nurse is preparing to interview a client with cirrhosis. Based on an understanding of this disorder, which question would be most important to include? "Have you had an infection recently?" "What type of over-the-counter pain reliever do you use?" "Does your work expose you to chemicals?" "How often do you drink alcohol?"
"How often do you drink alcohol?"
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? "You must have the second one in 1 month and the third in 6 months." "You must have the second one in 6 months and the third in 1 year." "You must have the second one in 2 weeks and the third in 1 month." "You must have the second one in 1 year and the third the following year."
"You must have the second one in 2 weeks and the third in 1 month."
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. Suboptimal sanitary habits Ingestion of undercooked beef Consumption of sewage-contaminated water or shellfish Infection at school Sexual activity
- Suboptimal sanitary habits - Consumption of sewage-contaminated water or shellfish - Sexual activity
A nurse is responsible for monitoring the diet of a client with hepatic encephalopathy. Which daily protein intake should this 185-pound (84-kilogram) male consume? 16 to 49 grams 100 to 126 grams 50 to 75 grams 76 to 99 grams
100 to 126 grams
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? Upper endoscopy Abdominal paracentesis Thoracentesis Abdominal CT scan
Abdominal paracentesis
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: Dextromethorphan Acetaminophen Benadryl Ibuprofen
Acetaminophen
The nurse is assessing a client with hepatic cirrhosis for mental deterioration. For what clinical manifestations will the nurse monitor? Select all that apply. Insomnia Report of headache Agitation Alterations in mood Decreased deep tendon reflexes SUBMIT ANSWER
Alterations in mood Agitation Insomnia
When assessing a client with obstructive jaundice, which of the following stool characteristics is the client likely to report? Blood tinged Yellow-green Black and tarry Clay-colored or whitish
Clay-colored or whitish
A nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice? Reduced hematocrit Clay-colored stools Straw-colored urine Elevated urobilinogen in the urine
Clay-colored stools
Which is an age-related change of the hepatobiliary system? Increased drug clearance capability Enlarged liver Decreased blood flow Decreased prevalence of gallstones
Decreased blood flow
The mode of transmission of hepatitis A virus (HAV) includes which of the following? Blood Saliva Semen Fecal-oral
Fecal-oral
The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction? Nonobstructive Obstructive Hepatocellular Hemolytic
Hemolytic
A 33-year-old male patient with a history of IV heroin and cocaine use has been admitted to the medical unit for the treatment of endocarditis. The nurse should recognize that this patient is also likely to test positive for which of the following hepatitis viruses? Hepatitis A Hepatitis D Hepatitis C Hepatitis B
Hepatitis C
A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include? Hepatitis A is frequently spread by sexual contact. Infection with hepatitis G is similar to hepatitis A. Hepatitis B is transmitted primarily by the oral-fecal route. Hepatitis C increases a person's risk for liver cancer.
Hepatitis C increases a person's risk for liver cancer.
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? Liver biopsy Coagulation studies Magnetic resonance imaging Radioisotope liver scan
Liver biopsy
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? Loss of 2.2 lb (1 kg) in 24 hours Blood pH of 7.25 Serum sodium level of 135 mEq/L Serum potassium level of 3.5 mEq/L
Loss of 2.2 lb (1 kg) in 24 hours
When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider? Ask the client about food intake. Measure abdominal girth according to a set routine. Provide the client with nonprescription laxatives. Report the condition to the physician immediately.
Measure abdominal girth according to a set routine.
A client is actively bleeding from esophageal varices. Which medication would the nurse mostexpect to be administered to this client? Octreotide Spironolactone Propranolol Lactulose
Octreotide
What initial measure can the nurse implement to reduce risk of injury for a client with liver disease? Prevent visitors, so as not to agitate the client Pad the side rails on the bed Apply soft wrist restraints Raise all four side rails on the bed
Pad the side rails on the bed
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? Dyspnea and fatigue Ascites and orthopnea Purpura and petechiae Gynecomastia and testicular atrophy SUBMIT ANSWER
Purpura and petechiae
A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide? Cure the cirrhosis. Treat the esophageal varices. Reduce fluid accumulation and venous pressure. Promote optimal neurologic function.
Reduce fluid accumulation and venous pressure.
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? Skin assessment related to increase in bile salts Urinary output related to increased sodium retention Respiratory assessment related to increased thoracic pressure Peripheral vascular assessment related to immobility
Respiratory assessment related to increased thoracic pressure
Clients with chronic liver dysfunction have problems with insufficient vitamin intake. Which may occur as a result of vitamin C deficiency? Scurvy Night blindness Hypoprothrombinemia Beriberi
Scurvy
Which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension? Kanamycin (Kantrex) Lactulose (Cephulac) Cyclosporine (Sandimmune) Spironolactone (Aldactone)
Spironolactone (Aldactone)
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? The client didn't take his morning dose of lactulose (Cephulac). The client is relaxed and not in pain. The client's hepatic function is decreasing. The client is avoiding the nurse.
The client's hepatic function is decreasing.
Which of the following liver function studies is used to show the size of abdominal organs and the presence of masses? Ultrasonography Magnetic resonance imaging Electroencephalogram Angiography
Ultrasonography
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? Vitamin K Thiamine Riboflavin Vitamin A
Vitamin A
Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? Spironolactone Cimetidine Nitroglycerin Vasopressin
Vasopressin
A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery? Vitamin B Oral bile acids Potassium Vitamin K
Vitamin K
A client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note: abdominal ascites. severe abdominal pain radiating to the shoulder. eructation and constipation. anorexia, nausea, and vomiting.
anorexia, nausea, and vomiting.
What is the recommended dietary treatment for a client with chronic cholecystitis? high-fiber diet low-protein diet low-residue diet low-fat diet
low-fat diet
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: subnormal clotting factors and platelet count. elevated liver enzymes and low serum protein level. elevated blood urea nitrogen and creatinine levels and hyperglycemia. subnormal serum glucose and elevated serum ammonia levels.
subnormal serum glucose and elevated serum ammonia levels.
When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider? Measure abdominal girth according to a set routine. Ask the client about food intake. Report the condition to the physician immediately. Provide the client with nonprescription laxatives.
Measure abdominal girth according to a set routine.
Which is the most common cause of esophageal varices Jaundice Portal hypertension Ascites Asterixis
Portal hypertension
