MODULE 6 PRACTICE QUESTIONS

Question 1

Which laboratory result is most specific for hepatocellular injury?

Answer 1

Elevated ALT and AST

ALT (Alanine aminotransferase) and AST (Aspartate aminotransferase) are enzymes that indicate liver cell damage when elevated.

Question 2

Which assessment finding is a key indicator of hepatic encephalopathy?

Answer 2

Asterixis

Asterixis is a tremor of the hand when the wrist is extended, often seen in hepatic encephalopathy.

Question 3

What is a primary goal in managing hepatic encephalopathy?

Answer 3

Reduce dietary protein

Reducing protein intake can help lower ammonia levels, which are elevated in hepatic encephalopathy.

Question 4

Which clinical manifestation suggests portal hypertension?

Answer 4

Splenomegaly and esophageal varices

Portal hypertension leads to the enlargement of the spleen and the development of varices in the esophagus.

Question 5

What is the best nursing intervention for a patient with ascites and shortness of breath?

Answer 5

Elevate head of bed

Elevating the head of the bed can relieve pressure on the diaphragm and improve breathing.

Question 6

A client with cirrhosis is prescribed lactulose. What is the expected outcome?

Answer 6

Decreased serum ammonia

Lactulose helps to reduce serum ammonia levels by promoting its excretion through the bowel.

Question 7

Which sign suggests bleeding risk in liver dysfunction?

Answer 7

Petechiae and ecchymosis

These signs are indicative of coagulation issues due to liver dysfunction.

Question 8

Which dietary instruction is appropriate for a patient with cirrhosis and ascites?

Answer 8

Low-sodium, moderate-protein diet

This diet helps to manage fluid retention and prevent further complications.

Question 9

What is the best nursing response to a family asking about prognosis for a patient in irreversible shock?

Answer 9

“We will support your loved one and focus on comfort.”

This response acknowledges the situation while prioritizing palliative care.

Question 10

Which lab value requires immediate attention in a client with cirrhosis?

Answer 10

Ammonia 85 mcg/dL

Elevated ammonia levels indicate a risk for hepatic encephalopathy.

Question 11

Which assessment finding in a patient with hepatitis B is expected?

Answer 11

RUQ pain and jaundice

These are common symptoms associated with hepatitis B infection.

Question 12

Which hepatitis type is most commonly associated with IV drug use?

Answer 12

Hepatitis C

Hepatitis C is frequently transmitted through shared needles among drug users.

Question 13

What indicates understanding of dietary education for gallstones?

Answer 13

I should avoid high-fat meals.

High-fat meals can trigger gallbladder attacks.

Question 14

What is the hallmark symptom of cholelithiasis?

Answer 14

RUQ pain after fatty meals

This pain is often referred to as biliary colic.

Question 15

What additional finding supports cholecystitis in a patient with gallstones presenting with nausea and fever?

Answer 15

Murphy’s sign

Murphy’s sign is a clinical test for gallbladder inflammation.

Question 16

What is the best nursing intervention for a patient complaining of shoulder pain after laparoscopic cholecystectomy?

Answer 16

Encourage early ambulation

Early ambulation can help relieve pain caused by retained CO₂ from the procedure.

Question 17

What lab findings are expected in acute pancreatitis?

Answer 17

Elevated amylase and lipase

These enzymes are typically elevated during acute pancreatitis episodes.

Question 18

Which symptom is most consistent with chronic pancreatitis?

Answer 18

Steatorrhea

Steatorrhea is the presence of excess fat in the stool and is a common symptom of chronic pancreatitis.

Question 19

What is the priority nursing action for a patient with acute pancreatitis who is NPO?

Answer 19

Monitor IV fluids and electrolytes

Maintaining hydration and electrolyte balance is crucial while the patient is not receiving oral intake.

Question 20

Which point should a nurse include when teaching about the Whipple procedure?

Answer 20

Pancreatic enzymes should be taken with meals.

This helps with digestion after the removal of part of the pancreas.

Question 21

What assessment finding in hepatic encephalopathy requires immediate action?

Answer 21

Somnolence progressing to unresponsiveness

This indicates severe deterioration and the need for emergency intervention.

Question 22

What is the purpose of administering vitamin K in liver failure?

Answer 22

Aid in clotting factor synthesis

Vitamin K is essential for the production of clotting factors, which can be impaired in liver failure.

Question 23

What nursing intervention prevents complications in esophageal varices?

Answer 23

Administer beta-blockers

Beta-blockers can help reduce portal pressure and the risk of variceal bleeding.

Question 24

What teaching should the nurse include for hepatitis A prevention?

Answer 24

Avoid contaminated water and wash hands

Hepatitis A is transmitted through the fecal-oral route, making hygiene crucial.

Question 25

Which is a complication of TIPS procedure in portal hypertension?

Answer 25

Hepatic encephalopathy ## Footnote TIPS (Transjugular Intrahepatic Portosystemic Shunt) can lead to increased ammonia levels and encephalopathy.

Question 26

Which symptom suggests post-op liver transplant rejection?

Answer 26

Jaundice and fever ## Footnote These symptoms may indicate that the body is rejecting the transplanted liver.

Question 27

Which test confirms hepatic encephalopathy?

Answer 27

Serum ammonia level ## Footnote Elevated serum ammonia levels are indicative of hepatic encephalopathy.

Question 28

What discharge instruction is appropriate for a patient with cirrhosis and risk of bleeding?

Answer 28

Use electric razors ## Footnote Electric razors minimize the risk of cuts and bleeding.

Question 29

A nurse sees clay-colored stool and dark urine in a client. Which organ is affected?

Answer 29

Liver ## Footnote These findings suggest biliary obstruction or liver dysfunction.

Question 30

What is the primary goal in managing acute pancreatitis?

Answer 30

Rest the pancreas ## Footnote Resting the pancreas involves avoiding food and stimulating activities to reduce inflammation.

Question 31

Which finding should be reported after ERCP?

Answer 31

Severe abdominal pain and fever ## Footnote These symptoms may indicate a complication from the procedure.

Question 32

Which meal is best for a client post-Whipple procedure?

Answer 32

Yogurt with berries and toast ## Footnote Light, low-fat meals are recommended after pancreatic surgery.

Question 33

What should the nurse assess after band ligation of varices?

Answer 33

Gag reflex and bleeding ## Footnote Monitoring for bleeding is critical after the procedure to prevent complications.

Question 34

What is the most critical finding a nurse monitors after paracentesis?

Answer 34

Dizziness and hypotension ## Footnote These symptoms may indicate fluid shifts and need for immediate intervention.

Question 35

What should the nurse do first for a patient with liver cirrhosis reporting confusion?

Answer 35

Check ammonia levels ## Footnote Elevated ammonia can cause confusion in cirrhosis patients.

Question 36

Which nursing diagnosis is priority in liver failure with ascites?

Answer 36

Fluid volume excess ## Footnote Managing fluid overload is critical in patients with liver failure and ascites.

Question 37

What teaching is correct for a patient with chronic pancreatitis?

Answer 37

Low-fat, high-protein meals are recommended ## Footnote This diet helps manage symptoms and nutrient absorption.

Question 38

A client has cirrhosis and new bruises. What lab is most relevant?

Answer 38

PT/INR ## Footnote PT/INR evaluates coagulation status, which can be affected in liver disease.