Deck 59: Coordinating Care for Patients With Hepatic Disorders
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Deck 59: Coordinating Care for Patients With Hepatic Disorders
1
Which patient statement regarding toxins causing hepatitis indicates the need for further education by the nurse?
A) "Exposure to industrial chemicals is a risk factor for hepatitis."
B) "Exposure to carbon tetrachloride is a risk factor for hepatitis."
C) "Exposure to phosphorus is a risk factor for hepatitis."
D) "Exposure to valproic acid is a risk factor for hepatitis."
A) "Exposure to industrial chemicals is a risk factor for hepatitis."
B) "Exposure to carbon tetrachloride is a risk factor for hepatitis."
C) "Exposure to phosphorus is a risk factor for hepatitis."
D) "Exposure to valproic acid is a risk factor for hepatitis."
"Exposure to valproic acid is a risk factor for hepatitis."
2
Which information should the nurse provide to a patient who will be receiving the hepatitis A vaccine?
A) "The vaccine is considered effective for 15 years or longer."
B) "You will receive a series of three shots over 6 to 12 months."
C) "You will receive one shot with a booster 6 to 12 months later."
D) "The vaccine is recommended for everyone including newborns."
A) "The vaccine is considered effective for 15 years or longer."
B) "You will receive a series of three shots over 6 to 12 months."
C) "You will receive one shot with a booster 6 to 12 months later."
D) "The vaccine is recommended for everyone including newborns."
"You will receive one shot with a booster 6 to 12 months later."
3
The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy.Which clinical manifestation supports the documentation of stage 4?
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
Coma
4
Which patient statement regarding the incubation period of hepatitis requires further education from the nurse?
A) "Hepatitis A has an incubation period of 15 to 50 days."
B) "Hepatitis B has an incubation period of 30 to 60 days."
C) "Hepatitis C has an incubation period of 2 to 25 weeks."
D) "Hepatitis D has an incubation period of 2 to 8 weeks."
A) "Hepatitis A has an incubation period of 15 to 50 days."
B) "Hepatitis B has an incubation period of 30 to 60 days."
C) "Hepatitis C has an incubation period of 2 to 25 weeks."
D) "Hepatitis D has an incubation period of 2 to 8 weeks."
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5
The multidisciplinary care team is meeting to discuss care for a patient who exhibits symptoms of the prodromal phase of hepatitis.Lab results include a positive anti-HAV IgM.The nurse creates an action plan to present to the team.Which intervention is appropriate?
A) Early treatment with lamivudine
B) Referral to the liver transplant team
C) Patient education on acceptable pain medication
D) High-fat,low-calorie,and no-alcohol diet teaching
A) Early treatment with lamivudine
B) Referral to the liver transplant team
C) Patient education on acceptable pain medication
D) High-fat,low-calorie,and no-alcohol diet teaching
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6
A young adult waiter has been treated for viral hepatitis at a health-care clinic.Which patient outcome indicates the need for additional intervention?
A) Body mass index (BMI)changes from 24 to 21.
B) Return demonstration of hand washing is correctly performed.
C) Social Services notified the Health Department of the occurrence.
D) Patient denies abdominal or epigastric pain.
A) Body mass index (BMI)changes from 24 to 21.
B) Return demonstration of hand washing is correctly performed.
C) Social Services notified the Health Department of the occurrence.
D) Patient denies abdominal or epigastric pain.
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7
When planning care for a patient with chronic hepatitis,which collaborative discipline will be most helpful in treating continued alcohol use?
A) Social worker
B) Primary provider
C) Pharmacist
D) Dietitian
A) Social worker
B) Primary provider
C) Pharmacist
D) Dietitian
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8
The nurse is providing information about hepatitis to a high school health occupations class.The students all volunteer examples of how hepatitis is transmitted.Which student statement indicates the need for further education?
A) "Body piercing or tattoo with infected equipment"
B) "Contaminated food or fluids"
C) "Alcoholism or drug overdose"
D) "Bite of an infected mosquito or tick"
A) "Body piercing or tattoo with infected equipment"
B) "Contaminated food or fluids"
C) "Alcoholism or drug overdose"
D) "Bite of an infected mosquito or tick"
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9
Which patient should the nurse plan symptomatic treatment for hepatitis in the plan of care?
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis D
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis D
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10
Which information should the nurse include in a teaching session for a patient who is to receive the hepatitis B vaccine?
A) "You will receive three injections over a 6 to 12 month period."
B) "This vaccine provides protection within two to four weeks of vaccine."
C) "You will receive one shot followed by a booster 6 to 12 months later."
D) "This vaccine is recommended for those who engage in risky behavior,such as illegal injected drug users."
A) "You will receive three injections over a 6 to 12 month period."
B) "This vaccine provides protection within two to four weeks of vaccine."
C) "You will receive one shot followed by a booster 6 to 12 months later."
D) "This vaccine is recommended for those who engage in risky behavior,such as illegal injected drug users."
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11
Which laboratory data supports the patient's diagnosis of liver failure?
A) Decreased AST
B) Elevated albumin
C) Elevated ammonia
D) Decreased total bilirubin
A) Decreased AST
B) Elevated albumin
C) Elevated ammonia
D) Decreased total bilirubin
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12
The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy.Which clinical manifestation supports the documentation of stage 3?
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
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13
A patient is diagnosed with viral hepatitis transmitted by the fecal-oral route.Which conditions may be acquired by this mode of transmission?
A) Hepatitis A (HAV)
B) Hepatitis B (HBV)
C) Hepatitis C (HCV)
D) Hepatitis D (HDV)
A) Hepatitis A (HAV)
B) Hepatitis B (HBV)
C) Hepatitis C (HCV)
D) Hepatitis D (HDV)
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14
The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy.Which clinical manifestation supports the documentation of stage 1?
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
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15
Which data collected by the nurse after a liver biopsy indicates the need for immediate action by the nurse?
A) The patient is awake and alert.
B) The patient's blood pressure is 90/60 mm Hg.
C) The patient's heart rate is 80 beats per minute.
D) The patients respiratory rate is 16 breaths per minute.
A) The patient is awake and alert.
B) The patient's blood pressure is 90/60 mm Hg.
C) The patient's heart rate is 80 beats per minute.
D) The patients respiratory rate is 16 breaths per minute.
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16
The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy.Which clinical manifestation supports the documentation of stage 2?
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
A) Coma
B) Tremors
C) Disorientation
D) Difficulty to awaken
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17
The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy.Which term should the nurse use to document a sweet fecal smell of the breath?
A) Asterixis
B) Euphoria
C) Fetor hepaticus
D) Rigid extremities
A) Asterixis
B) Euphoria
C) Fetor hepaticus
D) Rigid extremities
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18
Which medication noted in the patient's health history interview is a risk factor for developing hepatitis?
A) Aspirin
B) Ibuprofen
C) Acetaminophen
D) Naproxen sodium
A) Aspirin
B) Ibuprofen
C) Acetaminophen
D) Naproxen sodium
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19
The nurse is planning education for an adolescent patient recently diagnosed with hepatitis.The patient moved back to the parent's home.Which recommendation to the patient's parents will best prevent them from acquiring hepatitis B (HBV)?
A) Refuse to donate blood
B) Avoid contaminated water
C) Obtain postexposure prophylaxis
D) Abstain from alcohol
A) Refuse to donate blood
B) Avoid contaminated water
C) Obtain postexposure prophylaxis
D) Abstain from alcohol
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20
Which information found in the patient's health history supports the current diagnosis of cirrhosis?
A) Biliary disease
B) Social alcohol use
C) Hepatitis D infection
D) Chronic intravenous drug use
A) Biliary disease
B) Social alcohol use
C) Hepatitis D infection
D) Chronic intravenous drug use
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21
Which assessment data indicates to the nurse that the patient may be experiencing an increased ammonia level,a complication of cirrhosis?
A) Epistaxis
B) Yellow skin
C) Clay-colored stool
D) Personality changes
A) Epistaxis
B) Yellow skin
C) Clay-colored stool
D) Personality changes
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22
Which is a common cause of death for a patient who presents for care in the emergency department (ED)with liver trauma suffered as a result of a motor vehicle accident?
A) Infection
B) Hemorrhage
C) Cardiac arrest
D) Respiratory arrest
A) Infection
B) Hemorrhage
C) Cardiac arrest
D) Respiratory arrest
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23
Which assessment data indicates to the nurse that the patient may be experiencing decreased clotting factors as a complication of cirrhosis?
A) Epistaxis
B) Yellow skin
C) Clay-colored stool
D) Personality changes
A) Epistaxis
B) Yellow skin
C) Clay-colored stool
D) Personality changes
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24
Which clinical manifestation assessed by the nurse supports the patient's diagnosis of liver cancer?
A) Increased appetite
B) Shortness of breath
C) Decreased liver enzymes
D) Pain in the left upper quadrant
A) Increased appetite
B) Shortness of breath
C) Decreased liver enzymes
D) Pain in the left upper quadrant
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25
Which oral agent should the nurse include in the plan of care for a patient who is diagnosed with hepatitis B?
A) Ribavirin
B) Tenofovir
C) Interferon-alpha
D) Pegylated interferon
A) Ribavirin
B) Tenofovir
C) Interferon-alpha
D) Pegylated interferon
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26
Which therapeutic prescription should the nurse question when providing care to a patient who is diagnosed with ascites?
A) Furosemide
B) Spironolactone
C) Placement of a shunt
D) Three gram per day sodium diet
A) Furosemide
B) Spironolactone
C) Placement of a shunt
D) Three gram per day sodium diet
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