Patho Review
Which information given by a 70-year-old patient during a health history indicates to the nurse that the patient should be screened for hepatitis C? A. The patient had a blood transfusion in 2005. B. The patient used IV drugs about 20 years ago. C. The patient frequently eats in fast-food restaurants. D. The patient traveled to a country with poor sanitation.
What is B (The patient used IV drugs about 20 years ago)
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 helps to prevent hypokalemia? A. Furosemide (Lasix) B. Spironolactone (Aldactone) C. Acetazolamide (Diamox) D. Bumetanide (Bumex)
What is B (Spironolactone/Aldactone)
The nurse is interviewing a patient suspected of having liver dysfunction. An essential question to ask the patient is: A. “What drugs are you taking?” B. “Do you exercise regularly?” C. “Does depression run in your family?” D. “Are milk products a part of your daily diet?”
What is A. “What drugs are you taking?”
For a patient with cirrhosis, which of the following nursing actions can the nurse delegate to unlicensed assistive personnel? A. Assessing the patient for jaundice B. Providing oral hygiene after a meal C. Palpating the abdomen for distention D. Teaching the patient about a low-sodium diet
What is B (Providing oral hygiene after a meal)
A patient with hepatitis A asks whether other family members are at risk for "catching" the disease. The nurse's response will be based on the knowledge that hepatitis A is transmitted primarily: A. during sexual intercourse B. by contact with infected body secretions C. through fecal contamination of food or water D. Through kissing that involves contact with mucous membranes
What is C (through fecal contamination of food or water)
In a patient with cirrhosis, the nursing diagnosis "Risk for injury and bleeding related to prolonged clotting factors" is most appropriate related to which disorder? A. Pruritus B. Vitamin K deficiency C. Hyponatremia D. Ascites
What is B (Vitamin K deficiency)
What instructions should the patient be given before undergoing paracentesis? A. Empty bladder B. Remove dentures C. Take nothing by mouth D. Cleanse bowel with enemas
What is A (empty bladder)
The nurse is caring for a 73-year-old man who has cirrhosis. Which data obtained by the nurse during the assessment will be of most concern? A. The patient complains of right upper-quadrant pain with palpation. B. The patient's hands flap back and forth when the arms are extended. C. The patient has ascites and a 2-kg weight gain from the previous day. D. The patient's skin has multiple spider-shaped blood vessels on the abdomen.
What is B (The patient's hands flap back and forth when the arms are extended)
The nurse anticipates which dietary restrictions to help prevent ascites in the patient with advanced liver disease? A. Sodium B. Potassium C. Thiamine D. Folic acid
What is A (sodium)
A client with alcoholic cirrhosis develops hematemesis. For which intervention will the nurse prepare this client? A. Magnetic resonance imaging B. Upper endoscopy C. Blood transfusion D. Nasogastric tube insertion
What is B (Upper endoscopy)
Which finding indicates to the nurse that lactulose (Cephulac) is effective for a 72-year-old man who has advanced cirrhosis? A. The patient is alert and oriented. B. The patient denies nausea or anorexia. C. The patient's bilirubin level decreases. D. The patient has at least one stool daily.
What is A (The patient is alert and oriented)
The nursing diagnosis that is least likely for the patient with hepatitis A is: A. Ineffective breathing pattern related to abdominal ascites B. Fatigue related to increased metabolic needs and/or anorexia C. Risk for impaired skin integrity related to scratching, pruritus D. Pain: itching, related to impaired bilirubin metabolism/jaundice
What is A (Ineffective breathing pattern related to abdominal ascites)
A patient with cirrhosis of the liver has an albumin level of 2.5 g/dL. The nurse should plan care for this patient to address the patient's risk for developing: A. Peripheral edema B. Prolonged blood congestion C. Jaundice of the skin D. Vitamin A malabsorption
What is A (peripheral edema)
Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following? A. Ammonia B. Calcium C. Bicarbonate D. Alcohol
What is A (Ammonia)
A client is given a diagnosis of hepatic cirrhosis. The client asks the nurse what findings led to this determination. Which of the following clinical manifestations would the nurse correctly identify? Select all that apply. A. Enlarged liver B. Ascites C. Accelerated behaviors and mental processes D. Hemorrhoids E. Excessive storage of Vit.C
What is A-enlarged liver, B-ascites, D-hemorrhoids
A patient with acute hepatitis B will be discharged tomorrow. The nurse should include which measures in the discharge teaching plan? Select all that apply. A. Restrict fluid intake. B. Avoid alcohol. C. Allow for rest periods during the day. D. Gradually increase activity level. E. Eat small meals frequently.
What is B, C, D, and E B. Avoid alcohol. C. Allow for rest periods during the day. D. Gradually increase activity level. E. Eat small meals frequently.
When planning care for a patient with cirrhosis, the nurse will give highest priority to which nursing diagnosis? A. Impaired skin integrity related to edema, ascites, and pruritus B. Imbalanced nutrition: less than body requirements related to anorexia C. Excess fluid volume related to portal hypertension and hyperaldosteronism D. Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume
What is D (Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume)
After paracentesis, which assessment finding should be immediately reported to the physician? A. Nausea and anorexia B. Fatigue and dark-orange urine C. Respirations 20/min and dry mouth D. Rigid abdomen and low urine output
What is D (rigid abdomen and low urine output)