Patho Review
Increasing pressure in the portal vein can be evidenced by: A. Distended veins along the gastrointestinal tract B. Elevated blood pressure C. Signs of infection D. Jaundice
What is A (Distended veins along the gastrointestinal tract)
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)
A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following findings should the nurse expect? A. Pain in right upper quadrant radiating to the right shoulder B. Report of pain being better when lying flat C. Pain relieved with defecation D. Epigastric pain radiating to the left shoulder
What is D (Epigastric pain radiating to the left shoulder)
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?”
The best explanation for fluid volume excess in patients with hepatic dysfunction is: A. Extreme thirst B. Decreased excretion of aldosterone C. Excessive salt intake caused by increased water intake D. Shifting of fluid from vascular to interstitial space
What is D (shifting of fluid from vascular to interstitial space)
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)
A nurse is completing the admission assessment of a client who has acute pancreatitis. Which of the following findings is a priority to report? A. History of cholelithiasis B. Elevated serum amylase level C. Decreased bowel sounds upon auscultation D. Hand spasms present when blood pressure is checked.
What is D (Hand spasms present when blood pressure is checked)
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 patient with advanced cirrhosis asks why his or her skin is so yellow. The nurse's response is based on the knowledge that A. Decreased peristalsis in the gastrointestinal tract contributes to a buildup of bile salts B. Jaundice results from the body's inability to conjugate and excrete bilirubin C. A lack of clotting factors promotes the collection of blood under the skin surface D. Decreased colloidal oncotic pressure from hypoalbuminemia causes the yellowish skin discoloration
What is B (jaundice results from the body's inability to conjugate and excrete bilirubin)
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)
A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find? A. Increased serum calcium levels B. Elevated urine amylase levels C. Decreased liver enzyme levels D. Decreased white blood cell count
What is B (elevated urine amylase levels)
A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk? A. Monitor pulse oximetry every hour. B. Withhold analgesics unless necessary C. Instruct the client to cough only when necessary D. Use incentive spirometry every hour
What is D (Use incentive spirometry every hour)
Which enzyme aids in the digestion of fats? A. Amylase B. Lipase C. Tripsyn D. Secretin
What is B (Lipase)
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 nurse is assessing a client who has pancreatitis. Which of the following actions should the nurse take to assess the presence of Cullen's sign? A. Tap lightly on the clients cheek B. Palpate the right lower quadrant C. Inspect the skin around the umbilicus D. Auscultate the area below the scapula
What is C (Inspect the skin around the umbilicus)
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)
The nurse should recognize that the liver performs which functions? Select all that apply. A. Bile storage B. Detoxification C. Protein metabolism D. Steroid metabolism E. Red blood cell (RBC) destruction
What is B, C, D, and E Detoxification Protein metabolism Steroid metabolism Red blood cell (RBC) destruction
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.
A nurse is completing nutrition teaching for a client who has pancreatitis. Which statement by the client indicates and understanding of the teaching? Select all that apply A."I will plan to eat small, frequent meals." B. "I will eat easy-to-digest foods with limited spice." C. "I will use skim milk when cooking." D. "I plan to drink regular cola." E. "I will limit alcohol intake to 2 drinks per day."
What is A. B. and C.
A. "I will plan to eat small, frequent meals." B. "I will eat easy-to-digest foods with limited spice." C. "I will use skim milk when cooking."
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)