INTRODUCTION
This comprehensive exam review guide has been specifically designed for nursing
students preparing for NSG 3800 exams covering hepatobiliary and medical-
surgical nursing content. The questions cover key concepts related to liver
disorders, gallbladder diseases, pancreatic conditions, and associated nursing
interventions, medications, and patient education.
Question 1
The nurse working at a public health department has been informed of a cook at a
local restaurant who has been diagnosed with hepatitis A virus (HAV). Which of the
following instructions should the nurse give to household members and sexual
contacts of the client?
A) "We will administer immunoglobulin injections to all household members and
sexual partners."
B) "Your ill family member needs a class on how to safely prepare and dispense
food for the public."
C) "You will need to isolate your household members from others for at least 10-14
days."
D) "An antiviral medication will be prescribed and should be taken until isolation is
completed."
Correct Answer: A) "We will administer immunoglobulin injections to all
household members and sexual partners."
,Explanation: Hepatitis A is transmitted via the fecal-oral route .
Immunoglobulin (IG) provides passive immunity and is recommended for
household members and sexual contacts of individuals with HAV. IG should
be administered within 2 weeks of exposure . The ill family member is the
cook, not the household members. Isolation is not typically required for
household contacts. Antiviral medications are not used for HAV post-
exposure prophylaxis.
Question 2
The nurse is caring for a client who has acute cholecystitis and has received their
dinner tray. Which of the following food selections by the client requires the nurse
to follow up?
A) Baked lemon-butter tilapia, brown rice, and green beans.
B) Bacon cheeseburger casserole and chocolate milk.
C) Baked potato, broiled chicken, and tea.
D) Garden salad, grilled chicken, and a dinner roll.
Correct Answer: B) Bacon cheeseburger casserole and chocolate milk.
Explanation: Clients with acute cholecystitis should follow a low-fat diet to
avoid stimulating the gallbladder . Fatty foods like bacon, cheese, and
chocolate milk can trigger gallbladder contraction and biliary colic . The
other options (A, C, D) are low-fat or low-fat choices. A low-fat diet is
essential to reduce gallbladder stimulation and prevent pain.
Question 3
The nurse is assessing a client who has a diagnosis of liver disease and has
,marked hypoalbuminemia with a serum albumin level of 2.4 mg/dL. Which of the
following assessment findings should the nurse expect to see in this client?
A) Increased thirst and dry skin.
B) Jaundice and fluid retention.
C) Weight loss.
D) Bleeding from previous puncture sites.
Correct Answer: B) Jaundice and fluid retention.
Explanation: Hypoalbuminemia leads to decreased oncotic pressure, causing
fluid retention (edema and ascites) . Jaundice is common with liver disease
due to impaired bilirubin excretion . Normal serum albumin is 3.5-5.0 g/dL
(35-50 g/L); 2.4 mg/dL is critically low . Increased thirst and dry skin are
signs of dehydration. Weight loss is not expected with fluid retention.
Bleeding is related to clotting factor deficiency, not albumin.
Question 4
The nurse is teaching a group of nursing students about the risk of contracting
the hepatitis virus B (HVB). Which of the following preventive measures should the
nurse include in the teaching?
A) Disinfect any needles and lancets with full-strength alcohol before first use.
B) Implement droplet precautions immediately after exposure.
C) Infected linens should be bagged and marked for special handling.
D) All personnel must wear gloves when handling blood or body fluids.
Correct Answer: D) All personnel must wear gloves when handling blood or
body fluids.
, Explanation: HVB is a bloodborne pathogen . Standard precautions include
gloves when handling blood or body fluids. Needles and lancets must be
disposed of properly, not disinfected . Droplet precautions are not indicated
for HVB. Infected linens should be bagged, but this is not the primary
preventive measure —gloving is the most direct intervention.
Question 5
The nurse is caring for a client who is scheduled to have an endoscopic
retrograde cholangiopancreatography (ERCP) in the morning. Which of the
following client statements indicates the need for additional teaching?
A) "I will avoid eating or drinking liquids for 1 or 2 days following this procedure."
B) "I will not be able to eat or drink anything after midnight tonight."
C) "I may experience difficulty swallowing due to the anesthetic spray in my
throat."
D) "I will need to make arrangements to have someone drive me due to the
sedation."
Correct Answer: A) "I will avoid eating or drinking liquids for 1 or 2 days
following this procedure."
Explanation: After ERCP, the client will need to remain NPO for only a few
hours, not 1-2 days . Eating or drinking too soon after ERCP can lead to
aspiration . NPO after midnight is correct. Difficulty swallowing is expected
due to topical anesthetic spray. Sedation requires a driver.