NSG 4100 Adult Health III Comprehensive Examination Full
Exam Original Practice Questions with Correct Answers &
Rationales| GAURANTEED PASS WITH 170+ TEST BANK
QUESTIONS 2026 CARRICULUM VERRIFIED TEST INSTANT
PDF DOWNLOAD
1. A patient with cirrhosis is admitted with ascites and peripheral edema. Which
assessment finding indicates the patient may be developing hepatic
encephalopathy?
A. Asterixis
B. Peripheral neuropathy
C. Hypertension
D. Polyuria
Correct Answer: A. Asterixis
Rationale: Asterixis (liver flap) is a characteristic sign of hepatic encephalopathy
caused by accumulation of ammonia and other neurotoxins. It presents as rapid,
non-rhythmic extensions and flexions of the wrist when the arms are extended.
Peripheral neuropathy is not specific to hepatic encephalopathy, hypertension is
not a typical finding, and polyuria is not associated with this condition .
2. A patient with cirrhosis has an elevated serum ammonia level. Which dietary
modification should the nurse include in the teaching plan?
A. Increased protein intake
B. Decreased protein intake
C. Increased sodium intake
D. Decreased carbohydrate intake
Correct Answer: B. Decreased protein intake
,Rationale: In hepatic encephalopathy, protein restriction is implemented to
reduce ammonia production because protein breakdown produces ammonia.
However, protein should not be completely eliminated as it is essential for
healing. Sodium and carbohydrate modifications may be needed for other
complications but do not directly address elevated ammonia levels .
3. The nurse is caring for a patient with cirrhosis who has developed esophageal
varices. What is the priority nursing intervention?
A. Administering lactulose as prescribed
B. Monitoring for signs of bleeding
C. Restricting dietary protein
D. Measuring abdominal girth daily
Correct Answer: B. Monitoring for signs of bleeding
Rationale: Esophageal varices are fragile and at high risk for rupture, which can
cause life-threatening hemorrhage. Priority assessment includes monitoring for
hematemesis, melena, hypotension, tachycardia, and changes in mental status.
Lactulose is for hepatic encephalopathy, protein restriction addresses ammonia
levels, and abdominal girth measurement monitors ascites, but bleeding is the
immediate life threat .
4. Which medication is commonly prescribed to decrease portal hypertension
and reduce the risk of bleeding from esophageal varices?
A. Furosemide
B. Spironolactone
C. Propranolol
D. Lactulose
Correct Answer: C. Propranolol
Rationale: Propranolol, a non-selective beta-blocker, decreases portal pressure
by reducing cardiac output and splanchnic blood flow. This reduces the risk of
variceal bleeding. Furosemide and spironolactone are diuretics used for ascites
management. Lactulose is used to treat hepatic encephalopathy .
,5. A patient with cirrhosis is prescribed lactulose. What is the primary
therapeutic effect of this medication?
A. Decreased serum ammonia levels
B. Decreased portal hypertension
C. Increased urine output
D. Decreased serum potassium levels
Correct Answer: A. Decreased serum ammonia levels
Rationale: Lactulose works by acidifying the colon, which converts ammonia
(NH3) to ammonium (NH4+) that cannot be absorbed, promoting its excretion in
the stool. This reduces serum ammonia levels and helps manage hepatic
encephalopathy. It does not directly affect portal hypertension, urine output, or
potassium levels .
6. The nurse is assessing a patient with cirrhosis. Which finding is most
concerning for the development of spontaneous bacterial peritonitis (SBP)?
A. Abdominal pain and fever
B. Ascites
C. Jaundice
D. Spider angiomas
Correct Answer: A. Abdominal pain and fever
Rationale: Spontaneous bacterial peritonitis is a serious complication of
cirrhosis characterized by infection of ascitic fluid. Signs include abdominal pain,
fever, altered mental status, and abdominal tenderness. Ascites, jaundice, and
spider angiomas are common findings in cirrhosis but do not specifically indicate
SBP .
7. The nurse is caring for a patient with acute liver failure. Which laboratory
value is the best indicator of the patient's prognosis?
A. Serum bilirubin
, B. Prothrombin time
C. Serum albumin
D. Serum AST
Correct Answer: B. Prothrombin time
Rationale: Prothrombin time reflects the liver's ability to synthesize clotting
factors (II, VII, IX, X). Prolonged PT indicates severe liver dysfunction and poor
prognosis. While bilirubin, AST, and albumin are important liver function
indicators, PT is the most reliable predictor of outcome in acute liver failure .
8. The nurse is providing discharge teaching to a patient with cirrhosis. Which
statement by the patient indicates a need for further teaching?
A. "I will avoid alcohol completely."
B. "I should increase my intake of green leafy vegetables."
C. "I should report any bruising or bleeding to my healthcare provider."
D. "I can take acetaminophen for headaches as long as I don't exceed the
recommended dose."
Correct Answer: D. "I can take acetaminophen for headaches as long as I
don't exceed the recommended dose."
Rationale: Patients with cirrhosis should avoid acetaminophen because the
liver's ability to metabolize it is impaired, increasing the risk of hepatotoxicity.
Even at therapeutic doses, acetaminophen can be dangerous. Patients should be
taught to avoid all hepatotoxic medications. Complete alcohol abstinence is
correct. Green leafy vegetables contain vitamin K, which may be beneficial.
Reporting bleeding is appropriate .
9. A patient with cirrhosis has a serum albumin level of 2.5 g/dL. The nurse
recognizes this finding is most likely associated with:
A. Portal hypertension
B. Ascites
C. Esophageal varices
D. Hepatic encephalopathy
Exam Original Practice Questions with Correct Answers &
Rationales| GAURANTEED PASS WITH 170+ TEST BANK
QUESTIONS 2026 CARRICULUM VERRIFIED TEST INSTANT
PDF DOWNLOAD
1. A patient with cirrhosis is admitted with ascites and peripheral edema. Which
assessment finding indicates the patient may be developing hepatic
encephalopathy?
A. Asterixis
B. Peripheral neuropathy
C. Hypertension
D. Polyuria
Correct Answer: A. Asterixis
Rationale: Asterixis (liver flap) is a characteristic sign of hepatic encephalopathy
caused by accumulation of ammonia and other neurotoxins. It presents as rapid,
non-rhythmic extensions and flexions of the wrist when the arms are extended.
Peripheral neuropathy is not specific to hepatic encephalopathy, hypertension is
not a typical finding, and polyuria is not associated with this condition .
2. A patient with cirrhosis has an elevated serum ammonia level. Which dietary
modification should the nurse include in the teaching plan?
A. Increased protein intake
B. Decreased protein intake
C. Increased sodium intake
D. Decreased carbohydrate intake
Correct Answer: B. Decreased protein intake
,Rationale: In hepatic encephalopathy, protein restriction is implemented to
reduce ammonia production because protein breakdown produces ammonia.
However, protein should not be completely eliminated as it is essential for
healing. Sodium and carbohydrate modifications may be needed for other
complications but do not directly address elevated ammonia levels .
3. The nurse is caring for a patient with cirrhosis who has developed esophageal
varices. What is the priority nursing intervention?
A. Administering lactulose as prescribed
B. Monitoring for signs of bleeding
C. Restricting dietary protein
D. Measuring abdominal girth daily
Correct Answer: B. Monitoring for signs of bleeding
Rationale: Esophageal varices are fragile and at high risk for rupture, which can
cause life-threatening hemorrhage. Priority assessment includes monitoring for
hematemesis, melena, hypotension, tachycardia, and changes in mental status.
Lactulose is for hepatic encephalopathy, protein restriction addresses ammonia
levels, and abdominal girth measurement monitors ascites, but bleeding is the
immediate life threat .
4. Which medication is commonly prescribed to decrease portal hypertension
and reduce the risk of bleeding from esophageal varices?
A. Furosemide
B. Spironolactone
C. Propranolol
D. Lactulose
Correct Answer: C. Propranolol
Rationale: Propranolol, a non-selective beta-blocker, decreases portal pressure
by reducing cardiac output and splanchnic blood flow. This reduces the risk of
variceal bleeding. Furosemide and spironolactone are diuretics used for ascites
management. Lactulose is used to treat hepatic encephalopathy .
,5. A patient with cirrhosis is prescribed lactulose. What is the primary
therapeutic effect of this medication?
A. Decreased serum ammonia levels
B. Decreased portal hypertension
C. Increased urine output
D. Decreased serum potassium levels
Correct Answer: A. Decreased serum ammonia levels
Rationale: Lactulose works by acidifying the colon, which converts ammonia
(NH3) to ammonium (NH4+) that cannot be absorbed, promoting its excretion in
the stool. This reduces serum ammonia levels and helps manage hepatic
encephalopathy. It does not directly affect portal hypertension, urine output, or
potassium levels .
6. The nurse is assessing a patient with cirrhosis. Which finding is most
concerning for the development of spontaneous bacterial peritonitis (SBP)?
A. Abdominal pain and fever
B. Ascites
C. Jaundice
D. Spider angiomas
Correct Answer: A. Abdominal pain and fever
Rationale: Spontaneous bacterial peritonitis is a serious complication of
cirrhosis characterized by infection of ascitic fluid. Signs include abdominal pain,
fever, altered mental status, and abdominal tenderness. Ascites, jaundice, and
spider angiomas are common findings in cirrhosis but do not specifically indicate
SBP .
7. The nurse is caring for a patient with acute liver failure. Which laboratory
value is the best indicator of the patient's prognosis?
A. Serum bilirubin
, B. Prothrombin time
C. Serum albumin
D. Serum AST
Correct Answer: B. Prothrombin time
Rationale: Prothrombin time reflects the liver's ability to synthesize clotting
factors (II, VII, IX, X). Prolonged PT indicates severe liver dysfunction and poor
prognosis. While bilirubin, AST, and albumin are important liver function
indicators, PT is the most reliable predictor of outcome in acute liver failure .
8. The nurse is providing discharge teaching to a patient with cirrhosis. Which
statement by the patient indicates a need for further teaching?
A. "I will avoid alcohol completely."
B. "I should increase my intake of green leafy vegetables."
C. "I should report any bruising or bleeding to my healthcare provider."
D. "I can take acetaminophen for headaches as long as I don't exceed the
recommended dose."
Correct Answer: D. "I can take acetaminophen for headaches as long as I
don't exceed the recommended dose."
Rationale: Patients with cirrhosis should avoid acetaminophen because the
liver's ability to metabolize it is impaired, increasing the risk of hepatotoxicity.
Even at therapeutic doses, acetaminophen can be dangerous. Patients should be
taught to avoid all hepatotoxic medications. Complete alcohol abstinence is
correct. Green leafy vegetables contain vitamin K, which may be beneficial.
Reporting bleeding is appropriate .
9. A patient with cirrhosis has a serum albumin level of 2.5 g/dL. The nurse
recognizes this finding is most likely associated with:
A. Portal hypertension
B. Ascites
C. Esophageal varices
D. Hepatic encephalopathy
