1. Nurse Albie is caring for a patient with hepatic coma, which outcome would be the most appropriate?
A. The client is oriented to time, place, and person.
B. The client exhibits no ecchymotic areas.
C. The client increases oral intake to 2,000 calories/day.
D. The client exhibits increased serum albumin level.
2. Nurse Heidi is catering a patent with jaundice and who is also experiencing pruritus. Which nursing intervention would be included in the care plan for the client?
A. Administering vitamin K subcutaneously
B. Applying pressure when giving I.M. injections
C. Decreasing the client’s dietary protein intake
D. Keeping the client’s fingernails short and smooth
3. When providing health teaching to a 51-year-old woman who is diagnosed with cholecystitis, which diet, when selected by the client, indicates that the nurse’s teaching has been successful?
A. 4-6 small meals of low-carbohydrate foods daily
B. High-fat, high-carbohydrate meals
C. Low-fat, high-carbohydrate meals
D. High-fat, low protein meals
4. Mila is assigned to a patient who has undergone percutaneous transhepatic cholangiography. which assessment finding indicates complication after the operation?
A. Fever and chills
D. Nausea and diarrhea
5. The doctor orders for discharge to the patient with hepatitis A. When planning home care which preventive measure should be emphasized to protect the client’s family?
A. Keeping the client in complete isolation
B. Using good sanitation with dishes and shared bathrooms
C. Avoiding contact with blood-soiled clothing or dressing
D. Forbidding the sharing of needles or syringes
6. Which instruction would be included in the teaching plan for a patient who is currently taking antacids?
A. “Take the antacids with 8 oz of water.”
B. “Avoid taking other medications within 2 hours of this one.”
C. “Continue taking antacids even when pain subsides.”
D. “Weigh yourself daily when taking this medication.”
7. Lilia is assisting the staff nurse who is conducting assessment to a patient diagnosed with acute cholecystitis. Which clinical manifestation would the nurse expect the client to exhibit?
A. Jaundice, dark urine, and steatorrhea
B. Acute right lower quadrant (RLQ) pain, diarrhea, and dehydration
C. Ecchymosis petechiae, and coffee-ground emesis
D. Nausea, vomiting, and anorexia
8. Which intervention should the nurse include in the care plan for a client who has been diagnosed with acute pancreatitis?
A. Administration of vasopressin and insertion of a balloon tamponade
B. Preparation for a paracentesis and administration of diuretics
C. Maintenance of nothing-by-mouth status and insertion of nasogastric (NG) tube with low intermittent suction
D. Dietary plan of a low-fat diet and increased fluid intake to 2,000 ml/day
9. Today in Geny’s class, they were discussing all about pancreatic function. After the lesson, she understands that pancreatic lipase performs which function?
A. Transports fatty acids into the brush border
B. Breaks down fat into fatty acids and glycerol
C. Triggers cholecystokinin to contract the gallbladder
D. Breaks down protein into dipeptides and amino acids
10. Jerry, a 52-year old patient has been referred to the client due to increased abdominal girth, and is then diagnosed with ascites by the presence of a fluid thrill and shifting dullness on percussion. After administering diuretic therapy, which nursing action would be most effective to be taken by the nurse in ensuring safe care?
A. Measuring serum potassium for hyperkalemia
B. Assessing the client for hypervolemia
C. Measuring the client’s weight weekly
D. Documenting precise intake and output
11.Based on what she has learned in nursing school, Jennie understands that assessment plays a big role in client care.Which assessment finding indicates that lactulose is effective in decreasing the ammonia level in the client with hepatic encephalopathy?
A. Passage of two or three soft stools daily
B. Evidence of watery diarrhea
C. Daily deterioration in the client’s handwriting
D. Appearance of frothy, foul-smelling stools
12. A patient who has jaundice has been admitted under the care of Nurse Matt. Which statement indicates that the nurse understands the rationale for instituting skin care measures for the client?
A. “Jaundice is associated with pressure ulcer formation.”
B. “Jaundice impairs urea production, which produces pruritus.”
C. “Jaundice produces pruritus due to impaired bile acid excretion.”
D. “Jaundice leads to decreased tissue perfusion and subsequent breakdown.”
13. The folks had been asking the nurse about the procedure recently performed to their patient. Which rationale supports explaining the placement of an esophageal tamponade tube in a client who is hemorrhaging?
A. Allowing the client to help insert the tube
B. Beginning teaching for home care
C. Maintaining the client’s level of anxiety and alertness
D. Obtaining cooperation and reducing fear
14. Which nursing intervention would be most helpful when addressing a client with chronic pancreatitis?
A. Allowing liberalized fluid intake
B. Counseling to stop alcohol consumption
C. Encouraging daily exercise
D. Modifying dietary protein
15. Which interventions should the nurse implement when addressing hepatic encephalopathy in a client who is in end-stage liver failure? (Select all that apply.)
A. Assessing the client’s neurologic status every 2 hours
B. Monitoring the client’s hemoglobin and hematocrit levels
C. Evaluating the client’s serum ammonia level
D. Monitoring the client’s handwriting daily
E. Preparing to insert an esophageal tamponade tube
F. Making sure the client’s fingernails are short