Chapter 61: Care of Patients with Liver Problems

Chapter 61: Care of Patients with Liver Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse correlates which data in the client’s history as a predisposing factor for Laënnec’s cirrhosis?

a.	Gallstones
b.	Alcohol abuse
c.	Viral hepatitis
d.	Heart disease

 

 

ANS:  B

Laënnec’s cirrhosis, also known as alcoholic cirrhosis, is caused by the toxic effect of alcohol on the liver. The nurse should ask the client about a history of alcohol use. The other factors are not related to this type of cirrhosis.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1294

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

2. A client is admitted with cirrhosis and hepatopulmonary syndrome. Which clinical manifestation does the nurse monitor for progression or resolution of this problem?

a.	Right upper quadrant pain
b.	Crackles on auscultation
c.	Skin and scleral jaundice
d.	Nausea and vomiting

 

 

ANS:  B

An increase in intra-abdominal pressure from ascites can lead to hepatopulmonary syndrome. This is manifested by dyspnea and crackles on auscultation. The other symptoms are consistent with liver disease but are not specific to respiratory involvement.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

3. A client is admitted with end-stage cirrhosis and severe vomiting. Which problem should the nurse monitor the client most carefully for?

a.	Intrahepatic bile stasis
b.	Bleeding esophageal varices
c.	Decreased excretion of bilirubin
d.	Accumulation of ascites in the abdomen

 

 

ANS:  B

The portal hypertension that accompanies end-stage cirrhosis predisposes the client to esophageal varices. These varices can rupture from increased pressure in the esophagus caused by coughing or vomiting. Bleeding varices can be life threatening. None of the other assessments take priority over monitoring for bleeding from esophageal varices.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Assessment)

 

4. A client has cirrhosis and has developed ascites and edema. Which laboratory value does the nurse correlate with this condition?

a.	Blood glucose, 120 mg/dL
b.	Serum sodium, 135 mEq/L
c.	Serum albumin, 2.1 g/dL
d.	Blood urea nitrogen, 18 mg/dL

 

 

ANS:  C

Ascites occurs as a result of the inability of the liver to synthesize albumin. Loss of albumin leads to edema. This client’s albumin level is low, which correlates with the condition. Sodium and blood urea nitrogen (BUN) levels are normal. The glucose level is slightly high, but this is not directly related to edema.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Laboratory Values) MSC:           Integrated Process: Nursing Process (Analysis)