Hepatic Dysfunction NCLEX Style Questions

Hepatic Dysfunction NCLEX Style Questions ScienceMedicineHepatology marla_bellar Save

NCLEX Questions: Liver, Pancreas, a...

Teacher 31 terms rebecca_bowman2 Preview Hepatic & Biliary NCLEX Questions 113 terms A_NonamePreview Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Exam 4 Teacher Reg Which of the following liver function studies is used to show the size of abdominal organs and the presence of masses?

a) Angiography

b) Ultrasonography

c) Electroencephalogram

d) Magnetic resonance imaging

Ultrasonography Explanation: A ultrasonography will show the size of the abdominal organs and the presence of masses. Magnetic resonance imaging is used to detect hepatic neoplasms. An angiography is used to visualize hepatic circulation and detect the presence and nature of hepatic masses. An electroencephalogram is used to detect abnormalities that occur with hepatic coma.A patient has undergone a liver biopsy. Which of the following postprocedure positions is appropriate?

a) On the right side

b) Trendelenburg

c) High Fowler's

d) On the left side

On the right side Explanation: In this position, the liver capsule at the site of penetration is compressed against the chest wall, and the escape of blood or bile through the perforation made for the biopsy is impeded. Positioning the patient on his left side is not indicated. Positioning the patient in the Trendelenburg position may be indicated if the patient is in shock, but is not the position designed for the patient after liver biopsy. High Fowler's position is not indicated for the patient after liver biopsy.

Which type of jaundice seen in adults is the result of increased destruction of red blood cells?

a) Hepatocellular

b) Nonobstructive

c) Obstructive

d) Hemolytic

Hemolytic Explanation: Hemolytic jaundice results because, although the liver is functioning normally, it cannot excrete the bilirubin as quickly as it is formed. Obstructive jaundice is the result of liver disease. Nonobstructive jaundice occurs with hepatitis. Hepatocellular jaundice is the result of liver disease.A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased

bleeding tendency. The nurse suspects the client has:

• appendicitis.
• peptic ulcer disease.
• cholelithiasis.
• cirrhosis.

cirrhosis.Explanation: Muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendencies are all symptoms of cirrhosis. The client may also have mild fever, edema, abdominal pain, and an enlarged liver. Clients with peptic ulcer disease complain of a dull, gnawing epigastric pain that's relieved by eating. Appendicitis is characterized by a periumbilical pain that moves to the right lower quadrant and rebound tenderness. Cholelithiasis is characterized by severe abdominal pain that presents several hours after a large meal.Which of the following indicates an overdose of lactulose?

a) Constipation

b) Watery diarrhea

c) Hypoactive bowel sounds

d) Fecal impaction

Watery diarrhea Explanation: The patient receiving lactulose is monitored closely for the development of watery diarrheal stool, which indicates a medication overdose.Patients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which of the following is a sign of potential hypovolemia?

a) Bradycardia

b) Warm moist skin

c) Hypotension

d) Polyuria

Hypotension Explanation: Signs of potential hypovolemia include cool, clammy skin, tachycardia, decreased blood pressure, and decreased urine output.

The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?

a) Dyspnea and fatigue

b) Gynecomastia and testicular atrophy

c) Purpura and petechiae

d) Ascites and orthopnea

Purpura and petechiae Explanation: A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting factor).Consequently, the nurse should monitor the client for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia.Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from decreased estrogen metabolism by the diseased liver.Which of the following is an age-related change of the hepatobiliary system?

a) Decreased prevalence of gallstones

b) Decreased blood flow

c) Increased drug clearance capability

d) Liver enlargement

Decreased blood flow Explanation: Age-related changes of the hepatobiliary system include decreased blood flow, decreased drug clearance capability, increased presence of gall stones, and a steady decrease in size and weight of the liver.A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect?

a) Serum sodium level of 135 mEq/L

b) Blood pH of 7.25

c) Serum potassium level of 3.5 mEq/L

d) Loss of 2.2 lb (1 kg) in 24 hours

Loss of 2.2 lb (1 kg) in 24 hours Explanation: Daily weight measurement is the most accurate indicator of fluid status; a loss of 2.2 lb (1 kg) indicates loss of 1 L of fluid. Because spironolactone is a diuretic, weight loss is the best indicator of its effectiveness. This client's serum potassium and sodium levels are normal. A blood pH of 7.25 indicates acidosis, an adverse reaction to spironolactone.A client with cirrhosis is at risk for developing esophageal varices. Which of the following instructions should a nurse provide the client to minimize such risk?

a) Increase intake of potassium-rich food.

b) Avoid intake of sodium-rich food.

c) Abstain from drinking alcohol.

d) Use aspirin at least once a day.

Abstain from drinking alcohol.Explanation: A soft diet and elimination of alcohol, aspirin, and other locally irritating substances minimize the risk for developing esophageal varices. Intake of sodium- or potassium-rich food has no effect on the formation of varices.

A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?

a) Hepatitis C increases a person's risk for liver cancer.

b) Infection with hepatitis G is similar to hepatitis A.

c) Hepatitis A is frequently spread by sexual contact.

d) Hepatitis B is transmitted primarily by the oral-fecal route.

Hepatitis C increases a person's risk for liver cancer.Explanation: Infection with hepatitis C increases the risk of a person developing hepatic (liver) cancer. Hepatitis A is transmitted primarily by the oral-fecal route; hepatitis B is frequently spread by sexual contact and infected blood. Hepatitis E is similar to hepatitis A whereas hepatitis G is similar to hepatitis C.The most common cause of esophageal varices includes which of the following?

a) Ascites

b) Portal hypertension

c) Asterixis

d) Jaundice

Portal hypertension Explanation: Esophageal varices are almost always caused by portal hypertension, which results from obstruction of the portal circulation within the damaged liver. Jaundice occurs when the bilirubin concentration in the blood is abnormally elevated. Ascites results from circulatory changes within the diseased liver. Asterixis is an involuntary flapping movement of the hands associated with metabolic liver dysfunction.The mode of transmission of hepatitis A virus (HAV) includes which of the following?

a) Fecal-oral

b) Blood

c) Semen

d) Saliva

Fecal-oral Explanation: The mode of transmission of hepatitis A virus (HAV) occurs through fecal-oral route, primarily through person to person contact and/or ingestion of fecal contaminated food or water. Hepatitis B virus (HBV) is transmitted primarily through blood. HBV can be found in blood, saliva, semen, and can be transmitted through mucous membranes and breaks in the skin.Which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension?

a) Kanamycin (Kantrex)

b) Cyclosporine (Sandimmune)

c) Spironolactone (Aldactone)

d) Lactulose (Cephulac)

Spironolactone (Aldactone) Explanation: For portal hypertension, a diuretic usually an aldosterone antagonist such as spironolactone (Aldactone) is ordered. Kanamycin (Kantrex) would be used to treat hepatic encephalopathy to destroy intestinal microorganisms and decrease ammonia production. Lactulose would be used to reduce serum ammonia concentration in a client with hepatic encephalopathy. Cyclosporine (Sandimmune) would be used to prevent graft rejection after a transplant.