Question 1

The nurse is caring for a client with severe cirrhosis who has an episode of bleeding esophageal varices. Which of the following laboratory tests should the nurse monitor to detect possible complications of the bleeding episode?

Accepted Answer

A) Bilirubin 
B) Ammonia 
C) Potassium 
D) Prothrombin time

Question 2

The nurse is obtaining a health history from a client with acute pancreatitis. Which of the following information should the nurse specifically assess when conducting a health history?

Accepted Answer

A) Alcohol use 
B) Diabetes mellitus 
C) High-protein diet 
D) Cigarette smoking

Question 3

The nurse is caring for a client with acute pancreatitis. Which of the following findings is of most concern?

Accepted Answer

A) Absent bowel sounds 
B) Abdominal tenderness 
C) Left upper quadrant pain 
D) Palpable abdominal mass

Question 4

The nurse is educating a client with chronic pancreatitis about the prescribed pancrelipase? At which of the following times should the nurse teach the client to take the medication?

Accepted Answer

A) Bedtime 
B) With every meal 
C) Upon arising in the morning 
D) As soon as abdominal pain starts

Question 5

The nurse is caring for a client with chronic hepatitis C who is prescribed combination therapy of ?-interferon and ribavirin. Which of the following findings should the nurse monitor for the presence of hepatitis C in the client?

Accepted Answer

A) Leukopenia 
B) Hypokalemia 
C) Polycythemia 
D) Hypoglycemia

Question 6

The nurse is caring for a client with acute pancreatitis who has a nasogastric (NG) tube to suction and is NPO. Which of the following information obtained by the nurse indicates that these therapies have been effective?

Accepted Answer

A) Bowel sounds are present. 
B) Grey Turner sign resolves. 
C) Electrolyte levels are normal. 
D) Abdominal pain is decreased.

Question 7

Which of the following laboratory test results is most important for the nurse to monitor when evaluating the effects of therapy for a client who has acute pancreatitis?

Accepted Answer

A) Calcium 
B) Bilirubin 
C) Amylase 
D) Potassium

Question 8

Which of the following findings in a blood specimen indicates that the administration of hepatitis B vaccine to a client has been effective?

Accepted Answer

A) HBsAg 
B) Anti-HBs 
C) Anti-HBc IgG 
D) Anti-HBc IgM

Question 9

The nurse is caring for a client who has had a transjugular intrahepatic portosystemic shunt (TIPS) placement. Which of the following findings indicate that the procedure has been effective?

Accepted Answer

A) Lower indirect bilirubin level 
B) Increase in serum albumin level 
C) Decrease in episodes of variceal bleeding 
D) Improvement in alertness and orientation

Question 10

The nurse is caring for a client following an incisional cholecystectomy for cholelithiasis. Which of the following actions is priority for the nurse to implement?

Accepted Answer

A) Client education about low-fat food choices 
B) Perform leg exercises hourly while awake. 
C) Ambulate the evening of the operative day. 
D) Turn, cough, and deep breathe every 2 hours.

Question 11

The nurse is admitting a client to the emergency department with pancreatitis who has been vomiting blood. Which of the following actions should the nurse take first?

Accepted Answer

A) Insert a large-gauge IV catheter. 
B) Draw blood for coagulation studies. 
C) Check BP, heart rate, and respirations. 
D) Place the client in the supine position.

Question 12

Which of the following actions should be included in the plan of care for a client who has recently been diagnosed with asymptomatic non-alcoholic fatty liver disease (NAFLD)?

Accepted Answer

A) Teach symptoms of variceal bleeding. 
B) Discuss the need to increase caloric intake. 
C) Review the client's current medication list. 
D) Draw blood for hepatitis serology testing.

Question 13

The nurse is admitting a client with acute bleeding from esophageal varices who asks the nurse the purpose for the ordered pantoprazole. Which of the following responses by the nurse is best?

Accepted Answer

A) The medication will reduce the risk for aspiration. 
B) The medication will decrease nausea and anorexia. 
C) The medication will inhibit the development of gastric ulcers. 
D) The medication will prevent irritation to the esophageal varices.

Question 14

During change-of-shift report, the nurse learns about the following four clients. Which client requires the most rapid assessment?

Accepted Answer

A) 50-year-old with chronic pancreatitis who has gnawing abdominal pain 
B) 48-year-old who has compensated cirrhosis and is complaining of anorexia 
C) 45-year-old with cirrhosis and severe ascites who has an oral temperature of 38.8°C (101.8°F) 
D) 56-year-old who is recovering from a laparoscopic cholecystectomy and has severe shoulder pain

Question 15

Which of the following actions should the nurse implement to evaluate the effectiveness of treatment for a client who has hepatic encephalopathy?

Accepted Answer

A) Request that the client stand on one foot. 
B) Ask the client to extend both arms to the front. 
C) Instruct the client to perform the Valsalva manoeuvre. 
D) Have the client walk a few steps with the eyes closed.

Question 16

The nurse is preparing a teaching plan for a young adult client who is diagnosed with early alcoholic cirrhosis. Which of the following topics is most important to include in client teaching?

Accepted Answer

A) Need to abstain from alcohol 
B) Use of vitamin B supplements 
C) Maintenance of a nutritious diet 
D) Treatment with lactulose

Question 17

The nurse is admitting a client who is homeless and has viral hepatitis with symptoms of severe anorexia and fatigue. Which of the following client goals should have the highest priority when the nurse is developing the plan of care?

Accepted Answer

A) Increase activity level. 
B) Maintain adequate nutrition. 
C) Establish a stable home environment. 
D) Identify the source of exposure to hepatitis.

Question 18

The nurse is caring for a client with cirrhosis and esophageal varices who has a new prescription for propranolol. Which of the following assessment findings is the best indicator that the medication has been effective?

Accepted Answer

A) The apical pulse rate is 68 beats/minute. 
B) Stools test negative for occult blood. 
C) The client denies complaints of chest pain. 
D) Blood pressure is less than 140/90 mm Hg.

Question 19

Which of the following assessment findings in a client with acute pancreatitis should the nurse report most quickly to the health care provider?

Accepted Answer

A) Nausea and vomiting 
B) Hypotonic bowel sounds 
C) Abdominal tenderness and guarding 
D) Muscle twitching and finger numbness

Question 20

The nurse is caring for a client with cirrhosis who has scheduled doses of spironolactone and furosemide and has a serum potassium level of 3.2 mmol/L. Which of the following actions should the nurse take?

Accepted Answer

A) Give both drugs as scheduled. 
B) Administer the spironolactone. 
C) Administer the furosemide and withhold the spironolactone. 
D) Withhold both drugs until talking with the health care provider.

Exam 46: Nursing Management Liver