NUR 445 EXAM 5 MODULE 7 AND 8 QUESTIONS AND
ANSWERS | NUR 445 EXAM 5 MODULE 7 AND 8 STUDY GUIDE
& PRACTICE TEST 2026/2027
What is tumor lysis syndrome (TLS)? - correct answer ✔✔Rapid cell lysis of tumor, releasing contents
into bloodstream.
What are the manifestations of TLS? - correct answer ✔✔Numbness, cardiac dysrhythmias, renal failure.
What is the most serious complication of TLS? - correct answer ✔✔Dysrhythmias, can cause sudden
death.
How is hyperuricemia treated in TLS? - correct answer ✔✔Rasburicase if uric acid is already elevated.
What medication is given to prevent hyperuricemia in high-risk TLS patients? - correct answer
✔✔Allopurinol.
What medication is used for elevated phosphate in TLS? - correct answer ✔✔Phosphate binder
(Amphojel).
What should be assessed for signs of renal dysfunction in TLS? - correct answer ✔✔Elevated BUN,
creatinine, decreased urine output.
What ECG changes should be assessed for in TLS? - correct answer ✔✔Heart blocks, peaked T waves
(indicative of dangerous hyperkalemia).
What should be limited in the diet during the risk period of TLS? - correct answer ✔✔Potassium and
phosphorus.
What should the diet include during the risk period of TLS? - correct answer ✔✔Adequate protein,
carbs, and calories.
What is thrombocytopenia? - correct answer ✔✔Decreased platelets below average range (150,000 -
450,000).
What is the main complication of thrombocytopenia? - correct answer ✔✔Risk for hemorrhage.
What are two common types of thrombocytopenia? - correct answer ✔✔DIC and HIT.
What is disseminated intravascular coagulation (DIC)? - correct answer ✔✔Hematological disorder
caused by sepsis, burns, cancer, etc.
What do patients with DIC present with? - correct answer ✔✔Both thrombotic and bleeding problems.
,What causes abnormal coagulation in DIC? - correct answer ✔✔Formation of multiple small clots that
consume clotting factors and fibrinogen.
What are the two phases of DIC? - correct answer ✔✔Thrombotic/clotting phase.
What is the bleeding phase? - correct answer ✔✔Excessive bleeding due to inability to form clots.
What is the medical management for excessive bleeding? - correct answer ✔✔Treatment of underlying
disorder and other disorders.
What are the manifestations of excessive bleeding? - correct answer ✔✔Nose bleeds, bleeding at IV site,
gum bleeding, SOB, hypotension, hypoxia, bruising, blood clots, fever, metabolic acidosis.
How is excessive bleeding treated? - correct answer ✔✔Treat the underlying cause, replace clotting
factors, volume replacement, crystalloid solutions, anticoagulant therapy.
What are the bleeding precautions? - correct answer ✔✔Avoid rectal thermometer, sex, nose blows, use
soft toothbrush, electric razor, and stool softeners.
What medications are contraindicated due to increased bleeding risk? - correct answer ✔✔NSAIDs.
What is HIT? - correct answer ✔✔Heparin induced thrombocytopenia - autoimmune allergic response to
heparin.
What are the signs and symptoms of HIT? - correct answer ✔✔Petechiae, ecchymosis, nosebleeds,
bleeding gums, black tarry stool, hematuria, decreased platelets.
How is HIT treated? - correct answer ✔✔Stop heparin administration, use argatroban and lepirudin as
anticoagulants, protamine sulfate as heparin antidote, warfarin is contraindicated.
What is liver disease? - correct answer ✔✔Disease affecting the liver.
What is liver trauma? - correct answer ✔✔Liver injury often caused by motor vehicle accidents.
What are the symptoms of hepatic insufficiency? - correct answer ✔✔Jaundice, increased bilirubin,
increased serum transaminase.
What supplements should be taken for liver disease? - correct answer ✔✔Iron and vitamin supplements.
What are the labs indicating liver failure? - correct answer ✔✔Increase liver enzymes (ALT, AST),
Increased bilirubin, Increase serum ammonia, Decreased albumin
What are the risk factors for hepatitis? - correct answer ✔✔Risky behaviors (sharing needles,
unprotected sex with multiple partners), Recent travel overseas, Alcohol abuse, Exposure to some
hepatotoxic medications, toxins or autoimmune disease
, What is the pathophysiology of hepatitis? - correct answer ✔✔Inflammation of liver cells due to virus,
Impairs ability to detox, limits protein production and clotting factors, alters ability to store vitamins, fats
and sugars
What are the clinical manifestations of hepatitis? - correct answer ✔✔Increased liver enzymes (ALT,
AST), Increased bilirubin (total and direct), Increased serum ammonia, Decreased albumin, Jaundice,
Abdominal pain
How is hepatitis diagnosed? - correct answer ✔✔Recent travel outside U.S
What medications are used for hepatitis? - correct answer ✔✔Vaccination for Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C-related cirrhosis? - correct
answer ✔✔Hepatitis C-related cirrhosis
What are the major complications after liver transplant? - correct answer ✔✔Organ rejection and
infection
What assessments are done for liver transplant patients? - correct answer ✔✔Increased liver enzymes
(ALT and AST), Signs of organ rejection (RUQ pain, changes in bile drainage, fever, tachycardia, jaundice)
What nursing actions should be taken for hepatitis patients? - correct answer ✔✔Refer patient to social
worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? - correct answer ✔✔Nutritional teaching
(balanced diet, decreased fat and protein), Good hand hygiene to decrease transmission from fecal-oral
route, Avoid behaviors that contribute to transmission (needle sharing, unprotected sex), Importance of
vaccinations to prevent hepatitis A and B, Safe public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - correct answer ✔✔Chronic infection with Hep A, B or C, Chronic
alcoholism
What is the pathophysiology of cirrhosis? - correct answer ✔✔Irreversible chronic cell destruction and
fibrosis/scarring of the hepatic tissue
What is ascites? - correct answer ✔✔Accumulation of protein-rich fluid in the abdominal cavity.
What are the signs and symptoms of cirrhosis? - correct answer ✔✔Shortness of breath, jaundice,
increased abdominal girth, large spleen, elevated liver enzymes, increased risk of bleeding,
thrombocytopenia, prolonged PT, hemorrhoids, elevated serum ammonia, changes in LOC, changes in
motor function, hyponatremia.
What are the treatment options for cirrhosis? - correct answer ✔✔Diet/nursing actions, administering
medications (spironolactone, propranolol, lactulose), low protein, low sodium, and fluid restriction,
increased fiber intake.
ANSWERS | NUR 445 EXAM 5 MODULE 7 AND 8 STUDY GUIDE
& PRACTICE TEST 2026/2027
What is tumor lysis syndrome (TLS)? - correct answer ✔✔Rapid cell lysis of tumor, releasing contents
into bloodstream.
What are the manifestations of TLS? - correct answer ✔✔Numbness, cardiac dysrhythmias, renal failure.
What is the most serious complication of TLS? - correct answer ✔✔Dysrhythmias, can cause sudden
death.
How is hyperuricemia treated in TLS? - correct answer ✔✔Rasburicase if uric acid is already elevated.
What medication is given to prevent hyperuricemia in high-risk TLS patients? - correct answer
✔✔Allopurinol.
What medication is used for elevated phosphate in TLS? - correct answer ✔✔Phosphate binder
(Amphojel).
What should be assessed for signs of renal dysfunction in TLS? - correct answer ✔✔Elevated BUN,
creatinine, decreased urine output.
What ECG changes should be assessed for in TLS? - correct answer ✔✔Heart blocks, peaked T waves
(indicative of dangerous hyperkalemia).
What should be limited in the diet during the risk period of TLS? - correct answer ✔✔Potassium and
phosphorus.
What should the diet include during the risk period of TLS? - correct answer ✔✔Adequate protein,
carbs, and calories.
What is thrombocytopenia? - correct answer ✔✔Decreased platelets below average range (150,000 -
450,000).
What is the main complication of thrombocytopenia? - correct answer ✔✔Risk for hemorrhage.
What are two common types of thrombocytopenia? - correct answer ✔✔DIC and HIT.
What is disseminated intravascular coagulation (DIC)? - correct answer ✔✔Hematological disorder
caused by sepsis, burns, cancer, etc.
What do patients with DIC present with? - correct answer ✔✔Both thrombotic and bleeding problems.
,What causes abnormal coagulation in DIC? - correct answer ✔✔Formation of multiple small clots that
consume clotting factors and fibrinogen.
What are the two phases of DIC? - correct answer ✔✔Thrombotic/clotting phase.
What is the bleeding phase? - correct answer ✔✔Excessive bleeding due to inability to form clots.
What is the medical management for excessive bleeding? - correct answer ✔✔Treatment of underlying
disorder and other disorders.
What are the manifestations of excessive bleeding? - correct answer ✔✔Nose bleeds, bleeding at IV site,
gum bleeding, SOB, hypotension, hypoxia, bruising, blood clots, fever, metabolic acidosis.
How is excessive bleeding treated? - correct answer ✔✔Treat the underlying cause, replace clotting
factors, volume replacement, crystalloid solutions, anticoagulant therapy.
What are the bleeding precautions? - correct answer ✔✔Avoid rectal thermometer, sex, nose blows, use
soft toothbrush, electric razor, and stool softeners.
What medications are contraindicated due to increased bleeding risk? - correct answer ✔✔NSAIDs.
What is HIT? - correct answer ✔✔Heparin induced thrombocytopenia - autoimmune allergic response to
heparin.
What are the signs and symptoms of HIT? - correct answer ✔✔Petechiae, ecchymosis, nosebleeds,
bleeding gums, black tarry stool, hematuria, decreased platelets.
How is HIT treated? - correct answer ✔✔Stop heparin administration, use argatroban and lepirudin as
anticoagulants, protamine sulfate as heparin antidote, warfarin is contraindicated.
What is liver disease? - correct answer ✔✔Disease affecting the liver.
What is liver trauma? - correct answer ✔✔Liver injury often caused by motor vehicle accidents.
What are the symptoms of hepatic insufficiency? - correct answer ✔✔Jaundice, increased bilirubin,
increased serum transaminase.
What supplements should be taken for liver disease? - correct answer ✔✔Iron and vitamin supplements.
What are the labs indicating liver failure? - correct answer ✔✔Increase liver enzymes (ALT, AST),
Increased bilirubin, Increase serum ammonia, Decreased albumin
What are the risk factors for hepatitis? - correct answer ✔✔Risky behaviors (sharing needles,
unprotected sex with multiple partners), Recent travel overseas, Alcohol abuse, Exposure to some
hepatotoxic medications, toxins or autoimmune disease
, What is the pathophysiology of hepatitis? - correct answer ✔✔Inflammation of liver cells due to virus,
Impairs ability to detox, limits protein production and clotting factors, alters ability to store vitamins, fats
and sugars
What are the clinical manifestations of hepatitis? - correct answer ✔✔Increased liver enzymes (ALT,
AST), Increased bilirubin (total and direct), Increased serum ammonia, Decreased albumin, Jaundice,
Abdominal pain
How is hepatitis diagnosed? - correct answer ✔✔Recent travel outside U.S
What medications are used for hepatitis? - correct answer ✔✔Vaccination for Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C-related cirrhosis? - correct
answer ✔✔Hepatitis C-related cirrhosis
What are the major complications after liver transplant? - correct answer ✔✔Organ rejection and
infection
What assessments are done for liver transplant patients? - correct answer ✔✔Increased liver enzymes
(ALT and AST), Signs of organ rejection (RUQ pain, changes in bile drainage, fever, tachycardia, jaundice)
What nursing actions should be taken for hepatitis patients? - correct answer ✔✔Refer patient to social
worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? - correct answer ✔✔Nutritional teaching
(balanced diet, decreased fat and protein), Good hand hygiene to decrease transmission from fecal-oral
route, Avoid behaviors that contribute to transmission (needle sharing, unprotected sex), Importance of
vaccinations to prevent hepatitis A and B, Safe public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - correct answer ✔✔Chronic infection with Hep A, B or C, Chronic
alcoholism
What is the pathophysiology of cirrhosis? - correct answer ✔✔Irreversible chronic cell destruction and
fibrosis/scarring of the hepatic tissue
What is ascites? - correct answer ✔✔Accumulation of protein-rich fluid in the abdominal cavity.
What are the signs and symptoms of cirrhosis? - correct answer ✔✔Shortness of breath, jaundice,
increased abdominal girth, large spleen, elevated liver enzymes, increased risk of bleeding,
thrombocytopenia, prolonged PT, hemorrhoids, elevated serum ammonia, changes in LOC, changes in
motor function, hyponatremia.
What are the treatment options for cirrhosis? - correct answer ✔✔Diet/nursing actions, administering
medications (spironolactone, propranolol, lactulose), low protein, low sodium, and fluid restriction,
increased fiber intake.
