AHII - FINAL EXAM QUESTIONS WITH SOLVED
100% CORRECT ANSWERS!!
During your morning assessment of a pt with cirrhosis, you note the pt is
disoriented to person & place. In addition, while assessing the upper
extremities, the pt's hands demonstrate a flapping motion. What lab result
would explain these abnormal assessment findings?
a) Decreased magnesium level
b) Increased calcium level
c) Increased ammonia level
d) Increased creatinine level Answer - c) Increased ammonia level
The patient is experiencing hepatic encephalopathy. This is due to the buildup
of toxins in the blood, specifically ammonia. The flapping motion of the hands
is called "asterixis"
Flapping motion of the hands Answer - Asterixis
1) Elevated ammonia levels due to liver failure causes _________.
2) This causes __________, _________, ________, & can eventually lead to
seizures & death if left untreated Answer - 1) hepatic encephalopathy (damage
to brain cells)
2) altered mental status, agitation, confusion
,Which medication would be given to promote elimination of ammonia in fecal
matter & to treat hepatic encephalopathy in a patient with cirrhosis?
1. Furosemide (Lasix)
2. Lactulose (Cephulac)
3. Propranolol (Inderal)
4. Spironolactone (Aldactone) Answer - 2. Lactulose (Cephulac)
Lactulose is used to help eliminate ammonia in feces and to prevent or treat
hepatic encephalopathy.
Furosemide - excretion of excess fluid.
Propanolol - reduces pressure in veins, decreasing the risk for bleeding
Spironolactone - to decrease excess fluid
For a client in hepatic coma, which outcome would be the MOST appropriate?
A. The client is oriented to time, place, and person
B. The client exhibits no ecchymotic areas
C. The client increases oral intake to 2,000 calories/day
D. The client exhibits increased serum albumin level Answer - A. The client is
oriented to time, place, & person
Hepatic coma = most advanced stage of hepatic encephalopathy
- As hepatic coma resolves, improvement in the pt's LOC occurs - pt should be
able to express orientation to time, place, & person
, (Ecchymotic areas are related to decreased synthesis of clotting factors.
Although oral intake may be related to LOC, it is more closely related to
anorexia. The serum albumin level reflects hepatic synthetic ability, not LOC)
A client with advanced cirrhosis has been diagnosed with hepatic
encephalopathy. The nurse expects to assess for:
A. Malaise
B. Stomatitis
C. Hand tremors
D. Weight loss Answer - C. Hand tremors
Tall peaked T-waves, flat P-waves, prolonged PR intervals and widened QRS
complexes can present in which of the following conditions?
A. Hypocalemia
B. Hypercalemia
C. Hypokalemia
D. Hyperkalemia Answer - D. Hyperkalemia
Which of the following is indicative of an EKG change in a case of hypokalemia?
A. Widened QRS complex and prolonged PR interval
B. Prolonged ST interval and Widened T-wave
C. Tall T-waves and depressed ST segment
D. ST depression and inverted T-wave Answer - D. ST depression and inverted
T-wave
100% CORRECT ANSWERS!!
During your morning assessment of a pt with cirrhosis, you note the pt is
disoriented to person & place. In addition, while assessing the upper
extremities, the pt's hands demonstrate a flapping motion. What lab result
would explain these abnormal assessment findings?
a) Decreased magnesium level
b) Increased calcium level
c) Increased ammonia level
d) Increased creatinine level Answer - c) Increased ammonia level
The patient is experiencing hepatic encephalopathy. This is due to the buildup
of toxins in the blood, specifically ammonia. The flapping motion of the hands
is called "asterixis"
Flapping motion of the hands Answer - Asterixis
1) Elevated ammonia levels due to liver failure causes _________.
2) This causes __________, _________, ________, & can eventually lead to
seizures & death if left untreated Answer - 1) hepatic encephalopathy (damage
to brain cells)
2) altered mental status, agitation, confusion
,Which medication would be given to promote elimination of ammonia in fecal
matter & to treat hepatic encephalopathy in a patient with cirrhosis?
1. Furosemide (Lasix)
2. Lactulose (Cephulac)
3. Propranolol (Inderal)
4. Spironolactone (Aldactone) Answer - 2. Lactulose (Cephulac)
Lactulose is used to help eliminate ammonia in feces and to prevent or treat
hepatic encephalopathy.
Furosemide - excretion of excess fluid.
Propanolol - reduces pressure in veins, decreasing the risk for bleeding
Spironolactone - to decrease excess fluid
For a client in hepatic coma, which outcome would be the MOST appropriate?
A. The client is oriented to time, place, and person
B. The client exhibits no ecchymotic areas
C. The client increases oral intake to 2,000 calories/day
D. The client exhibits increased serum albumin level Answer - A. The client is
oriented to time, place, & person
Hepatic coma = most advanced stage of hepatic encephalopathy
- As hepatic coma resolves, improvement in the pt's LOC occurs - pt should be
able to express orientation to time, place, & person
, (Ecchymotic areas are related to decreased synthesis of clotting factors.
Although oral intake may be related to LOC, it is more closely related to
anorexia. The serum albumin level reflects hepatic synthetic ability, not LOC)
A client with advanced cirrhosis has been diagnosed with hepatic
encephalopathy. The nurse expects to assess for:
A. Malaise
B. Stomatitis
C. Hand tremors
D. Weight loss Answer - C. Hand tremors
Tall peaked T-waves, flat P-waves, prolonged PR intervals and widened QRS
complexes can present in which of the following conditions?
A. Hypocalemia
B. Hypercalemia
C. Hypokalemia
D. Hyperkalemia Answer - D. Hyperkalemia
Which of the following is indicative of an EKG change in a case of hypokalemia?
A. Widened QRS complex and prolonged PR interval
B. Prolonged ST interval and Widened T-wave
C. Tall T-waves and depressed ST segment
D. ST depression and inverted T-wave Answer - D. ST depression and inverted
T-wave
