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NRG401 - LIVER FAILURE : 14C G11-G12

Total questions: 30

Worksheet time: 30mins

Name
Class
Date
1.

Which condition is a known cause of cirrhosis? SELECT ALL THAT APPLY

a)

Obesity

b)

Alcohol consumption

c)

Blockage of the bile duct

d)

Hepatitis C

2.

You are explaining the anatomy of the liver. Which of the following will correctly complete the statement. "The liver receives it blood supply from two sources. One of these sources is called the _________________, which is a vessel network that delivers blood _____________ in nutrients but ________ in oxygen."

a)

hepatic artery, low, high

b)

hepatic portal vein, high, low

c)

hepatic lobule, high, low

d)

hepatic vein, low, high

3.

You are taking care of a patient with late-stage cirrhosis who developed portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply:

a)

Increase albumin levels

b)

Fluid volume deficient

c)

Ascites

d)

Esophageal varices

4.

Your patient with cirrhosis has severe splenomegaly. As the nurse you will make it priority to monitor the patient for signs and symptoms of? Select all that apply:

a)

Thrombocytopenia

b)

Vision changes

c)

Increased PT/INR

d)

Leukopenia

5.

You are taking care of a patient is admitted with hepatic encephalopathy secondary to cirrhosis. Which meal option selection below should be avoided with this patient?

a)

Beef tips and broccoli rabe

b)

Pasta noodles and bread

c)

Cucumber sandwich with a side of grapes

d)

Fresh salad with chopped water chestnuts

6.

You are doing your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person and place. In addition while assessing the upper extremities, the patient's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings?

a)

Decreased magnesium level

b)

Increased calcium level

c)

Increased ammonia level

d)

Increased creatinine level

7.

You are receiving endorsement report on a patient with cirrhosis. The nurse tells you the patient’s bilirubin levels are very high. Based on this, what assessment findings may you expect to find during your head-to-toe assessment? Select all that apply:

a)

Dark brown urine

b)

Yellowing of the sclera

c)

Dark brown stool

d)

Jaundice of the skin

8.

You are giving health teaching to a patient with esophageal varices. Which of the following should be avoided? SELECT ALL THAT APPLY

a)

Sleeping on the back

b)

Drinking juice

c)

Straining during a bowel movement

d)

Excessive coughing

9.

You are giving health teaching to a patient regarding the functions of the liver. Which of the following is NOT a role of the liver?

a)

Removing hormones from the body

b)

Producing bile

c)

Absorbing water

d)

Producing albumin

10.

A client with cirrhosis is at risk for developing complications. Which condition is the most serious and potentially life-threatening?

a)

Esophageal varices

b)

Ascites

c)

Asterixis (liver flap)

d)

Peripheral edema

11.

You are taking care or Mr.Nowana who develops hepatic encephalopathy. Which clinical manifestation is most common with this condition?

a)

Hypotension

b)

Altered level of consciousness

c)

Decreased tendon reflex

d)

Increased urine output

12.

You are caring for a male 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)

Purpura and petechiae

c)

Ascites and orthopnea

d)

Gynecomastia and testicular atrophy

13.

Mr. Wangyo was admitted to the hospital with ascites and jaundice. To rule out cirrhosis of the liver: The biopsy of Mr. Wangyo confirms the diagnosis of cirrhosis. Mr. Wangyo is at increased risk for excessive bleeding primarily because of:

a)

Varix formation

b)

Impaired clotting mechanism

c)

Trauma of invasive procedure

d)

Inadequate nutrition

14.

You are assigned in the medical ward with a patient with Liver cirrhosis. Which of the following findings would strongly indicate the possibility of cirrhosis?

a)

Dry skin

b)

Pruritus

c)

Peripheral edema

d)

Hepatomegaly

15.

Nurse Dee-Dee Sy is providing a discharge teaching to a client with chronic cirrhosis. His wife asks her to explain why there is so much emphasis on bleeding precautions. Which of the following provides the most appropriate response?

a)

“The low protein diet will result in reduced clotting.”

b)

“The liver affected by cirrhosis is unable to produce clotting factors.”

c)

“The required medications reduce clotting factors.”

d)

“The increased production of bile decreases clotting factors.”

16.

Which of the following is the lowest possible score of a Glasgow coma scale?

a)

0/15

b)

3/15

c)

8/15

d)

11/15

17.

Which of the following is a precipitating factor that would lead to liver failure? SELECT ALL THAT APPLY

a)

Gender

b)

Age

c)

Obesity

d)

High Cholesterol

18.

Which of the following symptoms where present on patient Odolle who is diagnosed with Chronic Liver disease (NASH)? SELECT ALL THAT APPLY

a)

Hematemesis

b)

Abdominal pain

c)

Difficulty of breathing

d)

Dark colored stool

19.

Which of the following medication is considered as an Osmotic diuretic?

a)

Mannitol

b)

Furosemide

c)

Sodium Phenylbutyrate

d)

Albumin

20.

Which of the following medication is given to maintain the oncotic pressure?

a)

Mannitol

b)

Furosemide

c)

Sodium Phenylbutyrate

d)

Albumin

21.

What is the antidote for acetaminophen overdose?

a)

Acetylcysteine

b)

Epinephrine

c)

Calcium gluconate

d)

Vitamin K

22.

What precaution should be done before giving furosemide to the patient? SELECT ALL THAT APPLY

a)

Check patient Blood pressure

b)

Check patient Urine output

c)

Make sure to give without meals

d)

Identify and verify the correct patient

23.

Mr. Takayama is in end-stage liver failure. Which interventions should the nurse implement when addressing hepatic encephalopathy? (Select all that apply.)

a)

Evaluating the client’s serum ammonia level

b)

Monitoring the client’s handwriting daily

c)

Assessing the client’s neurologic status every 2 hours

d)

Monitoring the client’s hemoglobin and hematocrit levels

24.

Spironolactone (Aldactone) is prescribed for a client with chronic cirrhosis and ascites. The nurse should monitor the client for which of the following medication-related side effects?

a)

Hyperkalemia

b)

Constipation

c)

Jaundice

d)

Tachycardia

25.

Nurse Farrah is providing care for Kristoff who has jaundice. 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 produces pruritus due to impaired bile acid excretion.”

c)

“Jaundice leads to decreased tissue perfusion and subsequent breakdown.”

d)

“Jaundice impairs urea production, which produces pruritus.”

26.

For a client with hepatic cirrhosis who has altered clotting mechanisms, which intervention would be most important?

a)

Increasing nutritional intake

b)

Administering antibiotics as prescribed

c)

Applying pressure to injection sites

d)

Allowing complete independence of mobility

27.

A 52-year-old man was referred to the clinic due to increased abdominal girth. He is 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 in ensuring safe care?

a)

Documenting precise intake and output

b)

Measuring serum potassium for hyperkalemia

c)

Measuring the client’s weight weekly

d)

Assessing the client for hypervolemia

28.

A client diagnosed with chronic cirrhosis who has ascites and pitting peripheral edema also has hepatic encephalopathy. Which of the following nursing interventions are appropriate to prevent skin breakdown?

a)

Turn and reposition every 2 hours

b)

Sit in chair for 30 minutes each shift

c)

Abdominal and foot massages every 2 hours

d)

Range of motion every 4 hours

29.

A client with advanced cirrhosis has been diagnosed with hepatic encephalopathy. The nurse expects to assess for:

a)

Malaise

b)

Hand tremors

c)

Weight loss

d)

Stomatitis

30.

What is the occupation of your Case Patient?

a)

House wife

b)

Call center agent

c)

Retiree

d)

Bank teller