NUR 210 (MED/SURG 2 - TEST 1) Study Notes Questions with
Correct Answers (Grade A+)
Question 1: What are some essential functions of the liver?
Answer: 1. Metabolize proteins and carbohydrates 2. Detoxify alcohol and other substances 3. Synthesize
essential blood proteins 4. Convert ammonia to urea for elimination by kidneys
Question 2: If the ammonia levels are high in the body this could indicate what?
Answer: The liver is not functioning properly
Question 3: If a patient have an impaired function of liver cells this can cause reduced bile production
which can lead to what issue?
Answer: Inadequate vitamin K (leads to bleeding tendency)
Question 4: If a patient have an impaired function of liver cells this can cause impaired protein
metabolism and decrease production of albumin which can lead to what issue?
Answer: Clotting issues
Question 5: Cirrhosis
Answer: End stage of progressive and irreversible chronic liver disease
Question 6: What is the most common type of cirrhosis caused by?
Answer: Chronic hepatitis C
Question 7: What is the second most common type of cirrhosis caused by?
Answer: Alcoholic cirrhosis
Question 8: Alcoholic cirrhosis
Answer: A disease involving scarring and deterioration of liver cells as a result of chronic alcohol abuse
Question 9: Biliary cirrhosis
Answer: Cirrhosis caused by bile flow obstruction within the liver or biliary system
Page 1
,Question 10: What a 2 high-risk behaviors that can lead to cirrhosis?
Answer: 1. Excess alcohol use 2. Injection drug use (leads to contraction of hepatitis)
Question 11: What are 4 ways to prevent cirrhosis?
Answer: 1. See HCP regularly 2. Maintain healthy weight 3. Avoid alcoholic beverages and illegal drugs 4.
Take all medications as prescribed
Question 12: What are 6 clinical manifestations seen with cirrhosis during the early stages?
Answer: 1. Enlarged and tender liver 2. Dull, aching pain in the RUQ 3. Weight loss 4. Weakness (flu-like
symptoms) 5. Anorexia 6. Diarrhea or constipation
Question 13: What are 12 clinical manifestations seen when cirrhosis progresses in the late stage?
Answer: 1. Portal hypertension 2. Jaundice 3. Ascites 4. Esophageal varices 5. Hepatomegaly 6.
Splenomegaly 7. Hemorrhoids 8. Edema 9. Changes in mental responsiveness and memory 10. Spider
angiomas 11. Palmar erythema 12. Peripheral neuropathy
Question 14: Portal hypertension
Answer: The elevation of blood pressure within the portal venous system
Question 15: What clinical manifestations are seen with portal hypertension?
Answer: 1. Ascites 2. Peripheral edema 3. Anemia 4. Low WBC count 5. Low platelet count
Question 16: Splenomegaly
Answer: Enlargement of the spleen cause greater rate of destruction of RBCs, WBCs, and platelets which
can lead to anemia, leukopenia, or thrombocytopenia
Question 17: Ascites
Answer: accumulation of serous fluids in the peritoneal (abdominal) cavity
Question 18: Paracentesis
Answer: Surgical puncture to remove fluid from the abdomen
Page 2
, Question 19: What are nursing interventions you should implement before a paracentesis?
Answer: 1. Determine patient's readiness for procedure- 2. Assess pertinent labs 3. Verify that consent has
been signed 4. Gather equipment 5. Have patient void before or insert a catheter 6. Position patient upright,
either on EOB or in high fowlers 7. Review baseline vitals, weight, and abdominal girth 8. Administer
sedation as prescribed 9. Administer IV bolus fluid or albumin, prior or after to restore fluid balance
Question 20: What are the nurses responsibilities during a paracentesis?
Answer: 1. Monitor vital signs 2. Adhere to standard precautions 3. Label lab specimens and send them to
the lab 4. Monitor amount of drainage 5. Notify provider of any complications
Question 21: What are the nurses responsibilities after a paracentesis?
Answer: 1. Maintain pressure at insertion site for several minutes and apply a bandage 2. Check vital signs,
record weight, and measure abdominal girth 3. Continue to monitor site and vitals 4. Monitor temp every 4
hours for 48 hours 5. Assess I&O every 4 hours 6. Administer medications as prescribed 7. Administer IV
fluids or albumin as prescribed 8. Assist patient into a comfortable position with HOB elevated to promote
lung expansion 9. Document color, odor, consistency, and amount of fluid removed, location of insertion
site, evidence of leakage, manifestation of hypovolemia, or changes in mental status 10. Continue
monitoring labs
Question 22: Esophageal varcies
Answer: Enlarged, thin-walled veins that form in submucosa of esophagus as a result from portal
hypertension and can rupture and call massive hemorrhage
Question 23: What drugs are used to treat esophageal varices?
Answer: Beta blockers (-lol)
Question 24: T/F: Anything that can cause pressure on the body can cause esophageal varices to
rupture
Answer: TRUE
Question 25: Portal systemic encephalopathy (Hepatic encephalopathy)
Answer: Accumulation of neurotoxins in the blood resulting from cerebral edema
Question 26: What 9 factors that can contribute to the occurrence of portal systemic encephalopathy
(hepatic encephalopathy)?
Answer: 1. High levels of ammonia in blood 2. Narcotics or tranquilizer medications 3. Constipation 4.
Blood transfusions 5. Gastrointestinal (GI) bleeding 6. Hypoxia 7. High-protein diet 8. Severe infection 9.
Surgery
Page 3
Correct Answers (Grade A+)
Question 1: What are some essential functions of the liver?
Answer: 1. Metabolize proteins and carbohydrates 2. Detoxify alcohol and other substances 3. Synthesize
essential blood proteins 4. Convert ammonia to urea for elimination by kidneys
Question 2: If the ammonia levels are high in the body this could indicate what?
Answer: The liver is not functioning properly
Question 3: If a patient have an impaired function of liver cells this can cause reduced bile production
which can lead to what issue?
Answer: Inadequate vitamin K (leads to bleeding tendency)
Question 4: If a patient have an impaired function of liver cells this can cause impaired protein
metabolism and decrease production of albumin which can lead to what issue?
Answer: Clotting issues
Question 5: Cirrhosis
Answer: End stage of progressive and irreversible chronic liver disease
Question 6: What is the most common type of cirrhosis caused by?
Answer: Chronic hepatitis C
Question 7: What is the second most common type of cirrhosis caused by?
Answer: Alcoholic cirrhosis
Question 8: Alcoholic cirrhosis
Answer: A disease involving scarring and deterioration of liver cells as a result of chronic alcohol abuse
Question 9: Biliary cirrhosis
Answer: Cirrhosis caused by bile flow obstruction within the liver or biliary system
Page 1
,Question 10: What a 2 high-risk behaviors that can lead to cirrhosis?
Answer: 1. Excess alcohol use 2. Injection drug use (leads to contraction of hepatitis)
Question 11: What are 4 ways to prevent cirrhosis?
Answer: 1. See HCP regularly 2. Maintain healthy weight 3. Avoid alcoholic beverages and illegal drugs 4.
Take all medications as prescribed
Question 12: What are 6 clinical manifestations seen with cirrhosis during the early stages?
Answer: 1. Enlarged and tender liver 2. Dull, aching pain in the RUQ 3. Weight loss 4. Weakness (flu-like
symptoms) 5. Anorexia 6. Diarrhea or constipation
Question 13: What are 12 clinical manifestations seen when cirrhosis progresses in the late stage?
Answer: 1. Portal hypertension 2. Jaundice 3. Ascites 4. Esophageal varices 5. Hepatomegaly 6.
Splenomegaly 7. Hemorrhoids 8. Edema 9. Changes in mental responsiveness and memory 10. Spider
angiomas 11. Palmar erythema 12. Peripheral neuropathy
Question 14: Portal hypertension
Answer: The elevation of blood pressure within the portal venous system
Question 15: What clinical manifestations are seen with portal hypertension?
Answer: 1. Ascites 2. Peripheral edema 3. Anemia 4. Low WBC count 5. Low platelet count
Question 16: Splenomegaly
Answer: Enlargement of the spleen cause greater rate of destruction of RBCs, WBCs, and platelets which
can lead to anemia, leukopenia, or thrombocytopenia
Question 17: Ascites
Answer: accumulation of serous fluids in the peritoneal (abdominal) cavity
Question 18: Paracentesis
Answer: Surgical puncture to remove fluid from the abdomen
Page 2
, Question 19: What are nursing interventions you should implement before a paracentesis?
Answer: 1. Determine patient's readiness for procedure- 2. Assess pertinent labs 3. Verify that consent has
been signed 4. Gather equipment 5. Have patient void before or insert a catheter 6. Position patient upright,
either on EOB or in high fowlers 7. Review baseline vitals, weight, and abdominal girth 8. Administer
sedation as prescribed 9. Administer IV bolus fluid or albumin, prior or after to restore fluid balance
Question 20: What are the nurses responsibilities during a paracentesis?
Answer: 1. Monitor vital signs 2. Adhere to standard precautions 3. Label lab specimens and send them to
the lab 4. Monitor amount of drainage 5. Notify provider of any complications
Question 21: What are the nurses responsibilities after a paracentesis?
Answer: 1. Maintain pressure at insertion site for several minutes and apply a bandage 2. Check vital signs,
record weight, and measure abdominal girth 3. Continue to monitor site and vitals 4. Monitor temp every 4
hours for 48 hours 5. Assess I&O every 4 hours 6. Administer medications as prescribed 7. Administer IV
fluids or albumin as prescribed 8. Assist patient into a comfortable position with HOB elevated to promote
lung expansion 9. Document color, odor, consistency, and amount of fluid removed, location of insertion
site, evidence of leakage, manifestation of hypovolemia, or changes in mental status 10. Continue
monitoring labs
Question 22: Esophageal varcies
Answer: Enlarged, thin-walled veins that form in submucosa of esophagus as a result from portal
hypertension and can rupture and call massive hemorrhage
Question 23: What drugs are used to treat esophageal varices?
Answer: Beta blockers (-lol)
Question 24: T/F: Anything that can cause pressure on the body can cause esophageal varices to
rupture
Answer: TRUE
Question 25: Portal systemic encephalopathy (Hepatic encephalopathy)
Answer: Accumulation of neurotoxins in the blood resulting from cerebral edema
Question 26: What 9 factors that can contribute to the occurrence of portal systemic encephalopathy
(hepatic encephalopathy)?
Answer: 1. High levels of ammonia in blood 2. Narcotics or tranquilizer medications 3. Constipation 4.
Blood transfusions 5. Gastrointestinal (GI) bleeding 6. Hypoxia 7. High-protein diet 8. Severe infection 9.
Surgery
Page 3
