Question 1 of 10
Report content error
Which abdominal assessment abnormality is commonly associated with chronic liver cirrhosis?
-
- Bruising over the left flankBruising on the flank indicates retroperitoneal bleeding associated with pancreatitis.
-
- Rebound tenderness in the periumbilical areaRebound tenderness is indicative of peritoneal inflammation.
- Correct
- Enlarged, knobby organ in right upper quadrantAn enlarged and “knobby” liver with an irregular surface or edge is seen in patients with cirrhosis of the liver.
-
- Acute sharp pain in the upper abdomenAcute sharp pain can accompany many disorders of the abdomen, such as pancreatitis. In liver cirrhosis, pain is dull and may develop later as the disease progresses.
Question 2 of 10
Report content error
Which patient statement indicates an understanding of the mode of transmission of hepatitis C virus?
-
- “I probably got this from infected food.”Hepatitis A is transmitted via the fecal-oral route and is often caused by infected food.
- Correct
- “I must avoid exposing others to my blood or body fluid for the rest of my life.”For chronic carriers of hepatitis C, the infectious period does not end; therefore the patient should anticipate using Standard Precautions for a lifetime.
-
- “I should refrain from sex for 6 months after my symptoms resolve.”Hepatitis B can be transmitted for 4 to 6 months after the resolution of acute illness. Hepatitis C, however, can be transmitted throughout the patient’s lifetime.
-
- “I should inform all of my past and current sexual partners so that they can be tested.”The patient should inform any sexual partners who were involved in exchange of body fluids during the 2 weeks before the onset of symptoms.
Question 3 of 10
Report content error
Which symptom would the nurse expect to see in a patient with acute cholecystitis?
-
- Back painWith chronic cholecystitis, the pain may be referred to the back at the level of the shoulder blades.
-
- IndigestionIndigestion is more common with chronic cholecystitis.
-
- FlatulenceFlatulence is more common with chronic cholecystitis.
- Correct
- Waves of painAcute cholecystitis can present with waves of pain that last from 2-6 hours.
Question 4 of 10
Report content error
Which diagnostic test would be appropriate to evaluate gallbladder function?
-
- Alanine aminotransferase (ALT)ALT is a liver function test that will be slightly elevated with gallbladder disease.
-
- Computed tomography (CT)A CT can help to diagnose gallstones but would not identify issues with gallbladder function.
- Correct
- Hepatic iminodiacetic acid (HIDA) scanA HIDA scan is used to diagnose abnormal contractions or function of the gallbladder.
-
- UltrasonographyAn ultrasound can be used to diagnose gallstones; however, it would not relay issues with overall gallbladder function.
Question 5 of 10
Report content error
The nurse is performing preoperative teaching with a patient before a scheduled laparoscopic cholecystectomy. Which statement made by the patient indicates further education may be required?
- Correct
- “Since my skin is yellow, you are going to check my urine.”If jaundice is present, coagulation times need to be monitored, and vitamin K may need to be administered before surgery to improve the clotting ability of the blood.
-
- “I cannot have anything to eat.”This is correct as patients will need to be NPO (nothing-by-mouth) before surgery.
-
- “You will give me fluids through an IV.”Intravenous fluids will be started to prevent dehydration.
-
- “I might need a tube in my nose if I continue to be nauseous.”A nasogastric tube might be necessary is nausea cannot be controlled with medication.
Question 6 of 10
Report content error
Which recommendation is appropriate for a patient with a T-tube?
-
- Keep the tubing straight so it doesn’t kink.The tubing should be coiled and secured to the abdomen with tape.
- Correct
- Avoid heavy lifting.The patient should avoid heavy lifting and strenuous activities.
-
- Wear tighter clothing to hold the tube in place.The patient should wear comfortable, loose-fitting clothing.
-
- Avoid cleansing the skin around the tube.The patient should carefully change the dressing every day and cleanse the skin around the tube each time.
Question 7 of 10
Report content error
A patient presents to the emergency department (ED) with jaundice, fever, and arthralgias after eating shellfish. Which diagnosis would the nurse suspect?
- Correct
- Hepatitis AHepatitis A can cause malaise, fevers, joint pain, loss of appetite and other symptoms and can be transmitted through contaminated shellfish.
-
- Hepatitis BHepatitis B is transmitted through sexual contact, not shellfish.
-
- Hepatitis CHepatitis C is transmitted through contact with blood and body fluids, sexual contact with a carrier, or through contaminated equipment.
-
- Hepatitis DHepatitis D is transmitted through blood and body fluids, and accompanies hepatitis B.
Question 8 of 10
Report content error
The nurse is caring for a patient with a liver disorder who has an allergy to sulfa. Which order would the nurse question?
-
- TorsemideTorsemide is a loop diuretic commonly used to treat liver disorders.
- Correct
- BumetanideBumetanide is a loop diuretic that should not be given to patients who have a sulfa allergy.
-
- SpironolactoneSpironolactone is a potassium-sparing diuretic used to treat liver disorders.
-
- NeomycinNeomycin is an antibiotic used in the treatment of liver disorders.
Question 9 of 10
Report content error
Which medication is used in the treatment of hepatitis C? Select all that apply. One, some, or all responses may be correct.
- Correct
- RibavirinRibavirin is used in the treatment of hepatitis C because it inhibits viral protein synthesis.
-
- LamivudineLamivudine inhibits the replication of hepatitis B virus.
-
- PhenothiazinesPhenothiazines are not used because of their hepatotoxic effects.
- Correct
- DaclatasvirDaclatasvir is an antiviral used in the treatment of hepatitis C.
- Correct
- SofosbuvirSofosbuvir is an RNA replications inhibitor used in the treatment of hepatitis C.
Question 10 of 10
Report content error
The nurse is caring for a patient with cirrhosis who begins vomiting bright-red blood. Which complication does the nurse suspect has occurred?
-
- Hepatic encephalopathyHepatic encephalopathy is a complication of cirrhosis; however, it does not result in hematemesis.
-
- Portal hypertensionPortal hypertension can occur because of cirrhosis; however, it would not cause hematemesis.
- Correct
- Variceal hemorrhageEsophageal varices can occur with cirrhosis and may eventually rupture and produce hematemesis.
-
- AsterixisAsterixis is when the patient experiences rapid flexing and extensions of the hands and occurs because of hepatic encephalopathy.
