MEDSURG TEST 2: CH 43 - Hepatitis and Cirrhosis

MEDSURG TEST #2: CH 43 - Hepatitis and Cirrhosis

ScienceMedicineNursing kelly_jameson1 Save a patient with hep. A is in the acute phase. the nurse plans care for the patient based on the knowledge that

• pruritus is a common problem with jaundice in this phase.
• the patient is most likely to transmit the disease during this phase.
• GI symptoms are not as severe in hep A as they are in hep B
• extrahepatic manifestations of glomerulonephritis and plyarteritis are common in this

phase

• pruritus is a common problem with jaundice in this phase.

a patient with acute hep. b is being discharged in 2 days. the discharge teaching plan should include instructions to

• avoid alcohol for first 3 weeks
• use condoms
• have family members get an injection of immunoglobulin
• follow a low-protein, moderate-carbohydrate, moderate0fat diet
• use condoms

a patient has been told that she has elevated liver enzymes caused by NAFLD. the nursing teaching plan should include

• having genetic testing done
• recommending a heart-healthy diet
• the necessity to reduce weight rapidly
• avoiding alcohol until liver enzymes return to normalb
• recommending a heart-healthy diet

the patient with advanced cirrhosis asks why his abdomen is so swollen. the nurse's response is based on the knowledge that

• a lack of clotting factors promotes the collection of blood in the abdominal cavity.
• portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space
• decreased peristalsis in the GI tract contributes to gas formation and distention of the

bowel

• bile salts in the blood irritate the peritoneal membranes, causing edema and pocketing of

fluid

• portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space

The nurse is caring for a woman recently diagnosed with viral hepatitis A. Which individual should the nurse refer for an immunoglobulin (IG) injection?

• A caregiver who lives in the same household with the patient
• A friend who delivers meals to the patient and family each week
• A relative with a history of hepatitis A who visits the patient daily
• A child living in the home who received the hepatitis A vaccine 3 months ago
• A caregiver who lives in the same household with the patient

The nurse provides discharge instructions for a 64-yr-old woman with ascites and peripheral edema related to cirrhosis. Which patient statement indicates teaching was effective?

• "Lactulose should be taken every day to prevent constipation."
• "It is safe to take acetaminophen up to four times a day for pain."
• "Herbs and other spices should be used to season my foods instead of salt."
• "I will eat foods high in potassium while taking spironolactone (Aldactone)."
• "Herbs and other spices should be used to season my foods instead of salt."

The health care provider orders lactulose for a patient with hepatic encephalopathy. Which finding indicates the medication has been effective?

• Relief of constipation
• Relief of abdominal pain
• Decreased liver enzymes
• decreased ammonia levels
• decreased ammonia levels

The family of a patient newly diagnosed with hepatitis A asks the nurse what they can do to prevent becoming ill. Which response by the nurse is most appropriate?

• "You will need to be tested first; then treatment can be determined."
• "The hepatitis vaccine will provide immunity from this and future exposures."
• "There is nothing you can do since the patient was infectious before admission."
• "An immunoglobulin injection will be given to prevent infection or limit symptoms."
• "An immunoglobulin injection will be given to prevent infection or limit symptoms."

When planning care for a patient with cirrhosis, the nurse will give highest priority to which nursing diagnosis?

• Impaired skin integrity related to edema, ascites, and pruritus

b. Imbalanced nutrition: less than body requirements related to anorexia

• Excess fluid volume related to portal hypertension and hyperaldosteronism
• Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume
• Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume

A patient with hepatitis B surface antigen (HBsAg) present in the serum is being discharged with pain medication after knee surgery. Which medication order should the nurse question?

• Tramadol
• Hydromorphone (Dilaudid)
• Oxycodone with aspirin (Percodan)
• Hydrocodone with acetaminophen
• Hydrocodone with acetaminophen

When teaching the patient with acute hepatitis C (HCV), which statement demonstrates understanding of the disease process?

• "I will use care when kissing my wife to prevent giving it to her."
• "I will need to take adefovir (Hepsera) to prevent chronic HCV."
• "Now that I have had HCV, I will have immunity and not get it again."
• "I will need to be monitored for chronic HCV and other liver problems."
• "I will need to be monitored for chronic HCV and other liver problems."