Lewis Liver, Pancreas, and Biliary Tract
Problems UPDATED ACTUAL Questions
and CORRECT Answers
The patient has a diagnosis of a biliary obstruction form gallstones. What type of jaundice is the patient
experiencing and what serum bilirubin results would be expected? - CORRECT ANSWER -
Obstructive jaundice with elevated unconjugated and conjugated bilirubin
The patient experienced a blood transfusion reaction. How should the nurse explain to the patient the
cause of the hemolytic jaundice that occurred? - CORRECT ANSWER - Due to increased
breakdown of RBCs that caused elevated serum unconjugated bilirubin
The patient returned from a 6-week mission trip to Somalia with complaints of nausea, malaise, fatigue,
and achy muscles. Which type of hepatitis is this patient most likely to have contracted? - CORRECT
ANSWER - Hep E
Which type of hepatitis is a DNA virus, can be transmitted via exposure to infectious blood or body
fluids, is required for HDV to replicate, and increase the risk of the chronic carrier for hepatocellular
cancer? - CORRECT ANSWER - Hep B
Serologic findings in viral hepatitis include both the presence of viral antigens and antibodies produced in
response to the viruses. What laboratory result indicates that the nurse is immune to HBV after
vaccination? - CORRECT ANSWER - Surface antibody Anti-HBs
The patient asks why the serologic test of HBV DNA quantitation is being done. What is the best
rationale for the nurse to explain the test to the patients? - CORRECT ANSWER - Indicates viral
replication and effectiveness of therapy for chronic HBV
Although HAV antigens are not tested in the blood, they stimulate specific IgM and IgG antibodies.
Which antibody indicates there is acute HAV infection? - CORRECT ANSWER - Anti-HAV IgM
What test will be done before prescribing treatment for the patient eith positive testing for HCV? -
CORRECT ANSWER - HCV genotyping
, What causes the systemic effects of viral hepatitis? - CORRECT ANSWER - Activation of the
complement system by antigen-antibody complexes
During the incubation period of viral hepatitis, ehat should the nurse expect the patient to report? -
CORRECT ANSWER - Anorexia and right upper quadrant discomfort
The occurrence of acute liver failure is most common in which situation? - CORRECT ANSWER -
Use of acetaminophen with alcohol abuse
Following a needle stick, what is used as prophylaxis against HBV? - CORRECT ANSWER -
HBV vaccine and HBIG
The family members of a patient with hepatitis A ask if there is anything that will prevent them from
developing the disease. What is the best response by the nurse? - CORRECT ANSWER - "Those
who have had household or close contact with the patient should receive immune globulin"
A patient diagnosed with chronic hepatitis B asks about drug therapy to treat the disease. What is the most
appropriate response by the nurse? - CORRECT ANSWER - "Interferon combined with
lamivudine (Epivir) will decrease viral load and prevent complications"
The nurse identifies a need for further teaching when the patient with hepatitis B makes which statement?
- CORRECT ANSWER - "I must avoid all physical contact with my family until the jaundice is
gone."
What is one of the most challenging interventions to promote healing in the patient with viral hepatitis? -
CORRECT ANSWER - Providing adequate nutritional intake
When caring for a patient with autoimmune hepatitis, the nurse understands that what in this patient is
different from the patient who has viral hepatitis? - CORRECT ANSWER - Is treated with
corticosteroids or other immunosuppressive agents
The patient has been newly diagnosed with Wilson's disease and D-penicillamine, a chelating agent, has
been prescribed. What assessment finding should the nurse expect? - CORRECT ANSWER -
Corneal Fleischer rings
Problems UPDATED ACTUAL Questions
and CORRECT Answers
The patient has a diagnosis of a biliary obstruction form gallstones. What type of jaundice is the patient
experiencing and what serum bilirubin results would be expected? - CORRECT ANSWER -
Obstructive jaundice with elevated unconjugated and conjugated bilirubin
The patient experienced a blood transfusion reaction. How should the nurse explain to the patient the
cause of the hemolytic jaundice that occurred? - CORRECT ANSWER - Due to increased
breakdown of RBCs that caused elevated serum unconjugated bilirubin
The patient returned from a 6-week mission trip to Somalia with complaints of nausea, malaise, fatigue,
and achy muscles. Which type of hepatitis is this patient most likely to have contracted? - CORRECT
ANSWER - Hep E
Which type of hepatitis is a DNA virus, can be transmitted via exposure to infectious blood or body
fluids, is required for HDV to replicate, and increase the risk of the chronic carrier for hepatocellular
cancer? - CORRECT ANSWER - Hep B
Serologic findings in viral hepatitis include both the presence of viral antigens and antibodies produced in
response to the viruses. What laboratory result indicates that the nurse is immune to HBV after
vaccination? - CORRECT ANSWER - Surface antibody Anti-HBs
The patient asks why the serologic test of HBV DNA quantitation is being done. What is the best
rationale for the nurse to explain the test to the patients? - CORRECT ANSWER - Indicates viral
replication and effectiveness of therapy for chronic HBV
Although HAV antigens are not tested in the blood, they stimulate specific IgM and IgG antibodies.
Which antibody indicates there is acute HAV infection? - CORRECT ANSWER - Anti-HAV IgM
What test will be done before prescribing treatment for the patient eith positive testing for HCV? -
CORRECT ANSWER - HCV genotyping
, What causes the systemic effects of viral hepatitis? - CORRECT ANSWER - Activation of the
complement system by antigen-antibody complexes
During the incubation period of viral hepatitis, ehat should the nurse expect the patient to report? -
CORRECT ANSWER - Anorexia and right upper quadrant discomfort
The occurrence of acute liver failure is most common in which situation? - CORRECT ANSWER -
Use of acetaminophen with alcohol abuse
Following a needle stick, what is used as prophylaxis against HBV? - CORRECT ANSWER -
HBV vaccine and HBIG
The family members of a patient with hepatitis A ask if there is anything that will prevent them from
developing the disease. What is the best response by the nurse? - CORRECT ANSWER - "Those
who have had household or close contact with the patient should receive immune globulin"
A patient diagnosed with chronic hepatitis B asks about drug therapy to treat the disease. What is the most
appropriate response by the nurse? - CORRECT ANSWER - "Interferon combined with
lamivudine (Epivir) will decrease viral load and prevent complications"
The nurse identifies a need for further teaching when the patient with hepatitis B makes which statement?
- CORRECT ANSWER - "I must avoid all physical contact with my family until the jaundice is
gone."
What is one of the most challenging interventions to promote healing in the patient with viral hepatitis? -
CORRECT ANSWER - Providing adequate nutritional intake
When caring for a patient with autoimmune hepatitis, the nurse understands that what in this patient is
different from the patient who has viral hepatitis? - CORRECT ANSWER - Is treated with
corticosteroids or other immunosuppressive agents
The patient has been newly diagnosed with Wilson's disease and D-penicillamine, a chelating agent, has
been prescribed. What assessment finding should the nurse expect? - CORRECT ANSWER -
Corneal Fleischer rings
