NOV 3

QUESTION 1

1. A patient with chronic hepatitis C, secondary cirrhosis, & hepatic enceplaopathy

is in the emergency department for increased confusion, acites and epigastric
pain. The patient suddenly vomits 250 ml of bright red blood. Which of the
following should the nurse do first?
Insert a nasogastric tube
Check stool for occult blood (hemacult)
Place patient in high fowlers position
Contact the physician
Obtain patient consent & complete the consent form for a blood
transfusion
6.67 points

QUESTION 2

1. A client is scheduled for a liver biopsy, and the nurse reviews the results of the
laboratory tests prescribed for the client. The nurse would contact the physician if
which laboratory result is noted?
Hematocrit: 40%.
Platelets: 200,000 mm3.
Thrombin time: 23 seconds.
Hemoglobin: 14 g/dL.
6.67 points

QUESTION 3

1. A client with a history of cirrhosis is in the emergency department with actively

bleeding esophageal varices. The nurse anticipates which of the following will
most likely be ordered?
Liver biopsy
Paracentesis
Sengstaken-Blakemore tube
Nasogastric Salem Sump to intermittent suction
Anticoagulant therapy
6.67 points

QUESTION 4

1. A nurse anticipates which of the following vaccines to be ordered for a patient

with a Hepatitis B exposure? (select all that apply)
Havrix vaccine
Recombinant Hepatitis B Vaccine series
Immune Gobulin (IG)
Hepatitis B Immune Gobulin (HBIG)
6.67 points

QUESTION 5

1. Immediately after a liver biopsy, the client is placed on the right side. The nurse
explains that this position should be maintained because it will:
Reduce the fluid trapped in the biliary ducts.

Restore circulating blood volume.

Help stop the bleeding if any occurs.
Be the position of greatest comfort.
6.67 points

QUESTION 6

1. A client with cirrhosis of the liver and malnutrition begins to develop slurred
speech, confusion, drowsiness, and tremors. With these symptoms the diet
would be limited to:
80 g protein, 1000 calories.
100 g protein, 2500 calories.
20 g protein, 2000 calories.
150 g protein, 1200 calories.
6.67 points

QUESTION 7

1. :
Shunting of the blood from the portal vessels into vessels with lower
pressure.
Inadequate formation, use, and storage of vitamins A, C, and K.
Decreased concentration of plasma albumin.

Decreased production of aldosterone, causing sodium and water

retention.
6.67 points

QUESTION 8

1. The nurse instructs a client diagnosed with hepatitis A about untoward signs and
symptoms related to hepatitis that may develop. The one that should be reported
to the physician would be:
Yellow urine.
Anorexia.
Clay-colored stools.
Fatigue.
6.67 points

QUESTION 9

1. The serum ammonia level of a client with hepatic cirrhosis and ascites is
elevated. The priority nursing intervention should be to:
Weigh the client daily.
Restrict the clients oral fluid intake.
Observe the client for increasing confusion.
Measure the clients urine specific gravity.
6.67 points

QUESTION 10

1. A nurse is caring for a patient undergoing an abdominal paracentesis. Which of

the following does the nurse instruct the patient to do?
empty the bladder before the procedure
remain in semifowlers position for the procedure
Increase fluid intake to 4 liters p.o. after procedure
sign the consent form after the procedure
remain NPO for 6 hours prior to the procedure
6.67 points

Q UES TI O N 11

1. A client with a long history of alcohol abuse is admitted to the hospital with
ascites, jaundice, and confusion. A diagnosis of hepatic cirrhosis is made. A
nursing priority would be to:
Institute safety measures.
Measure abdominal girth daily.
Monitor respiratory status.
Test stool specimens for blood.
6.67 points

QUESTION 12

1. A nurse would determine that teaching about chronic Hepatitis C is effective

when the patient states which of the following?
"I will be sure to wash my hands well when I prepare food for my family

and limit our intake of shellfish"

"I will reduce my alcohol intake and only use acetaminophen for pain
relief"
"I will not donate blood and will use barrier protection during sexual
intercourse"
"The vaccine for this disease will prevent transmission and improve my
quality of life and symptoms"
6.67 points

QUESTION 13

1. A patient with hepatitis A is in the Prodromal (preicteric) phase. The nurse plans
care for the patient based on the knowledge that:
The patient is most likely to transmit the disease during this phase.
(fever)
Extrahepatic manifestations of Glomerulonephritis and polyarthritis are
common in this phase.
Gastrointestinal symptoms are not as severe in hepatitis A as they are in
hepatitis B.
Pruritus is a common problem with jaundice in this phase.
6.67 points

QUESTION 14

1. A mother whose son has hepatitis A states that there is only one bathroom in
their home and she is worried that other members of the family could get
hepatitis. The nurses best reply would be:
There is no problem with your son sharing the same bathroom with

everyone else.
Your son may use the bathroom, but you need to use disposable toilet
covers.
It is important that your son and all family members wash their hands
after using the bathroom.
I suggest that you buy a commode exclusively for your sons use.
6.67 points

QUESTION 15

1. A patient with hepatitis B is being discharged in 2 days. Which of the following

should be included in the discharge plans and instructions?
Avoid alcohol for 3 weeks.
Follow a low-protein, moderate carbohydrate, moderate-fat diet.
Use a condom during sexual intercourse.
Have family members get an injection of immunoglobulin.