In the liver, free bilirubin moves from the plasma in the sinusoids into the hepatocytes, where it
is converted into:
a.conjugated bilirubin.
b.unconjugated bilirubin.
c.urobilinogen.
d.biliverdin. - Answers A
The autopsy of a 55-year-old revealed an inflamed and fatty liver, with necrotic hepatocytes.
What is the most likely cause of this condition?
a.Viral infection
b.Bacterial infection
c.Alcoholic steatohepatitis
d.Drug overdose - Answers C
The presence of bright red stools is referred to as:
a.hematochezia.
b.hematemesis.
c.melena.
d.occult bleeding - Answers A
Which of the following data obtained by the nurse during the assessment of a client with
cirrhosis is of most concern?
a.The client's hands flap back and forth when the arms are extended.
b.The client complains of right upper-quadrant pain with abdominal palpation.
c.The client's skin has multiple spider-shaped blood vessels on the abdomen.
d.The client has ascites and a 2-kg weight gain from the previous day. - Answers A
A 54-year-old reports vomiting blood. Tests reveal portal hypertension. Which of the following is
the most likely cause of this condition?
a.Renal stenosis
,b.Cirrhosis of the liver
c.Left ventricular failure
d.Thrombosis in the spleen - Answers B
In alcoholic cirrhosis, hepatocellular damage is caused by:
a.acidosis.
b.bile toxicity.
c.fatty infiltrations.
d.acetaldehyde accumulation. - Answers D
During change-of-shift report, the nurse learns about the following four clients. Which client
requires the most rapid assessment?
a.45-year-old with cirrhosis and severe ascites who has an oral temperature of 38.8°C (101.8°F)
b.56-year-old who is recovering from a laparoscopic cholecystectomy and has severe shoulder
pain
c.48-year-old who has compensated cirrhosis and is complaining of anorexia
d.50-year-old with chronic pancreatitis who has gnawing abdominal pain - Answers A
A 52-year-old female presents with continuous abdominal pain that intensifies after eating. She
is diagnosed with chronic pancreatitis. Contributing factors include which of the following?
(Select all that apply.)
a.Smoking
b.History of gallstones
c.Bulimia
d.Alcohol abuse
e.Trauma - Answers A, B, D
The nurse is caring for a client with severe cirrhosis who has an episode of bleeding esophageal
varices. Which of the following laboratory tests should the nurse monitor to detect possible
complications of the bleeding episode?
a.Potassium
b.Ammonia
, c.Bilirubin
d.Prothrombin time - Answers B
An increase in the rate of red blood cell breakdown causes which form of jaundice?
a.Hemolytic
b.Metabolic
c.Hepatocellular
d.Obstructive - Answers A
A 50-year-old male reports episodes of frequently recurring crampy abdominal pain, diarrhea,
and bloody stools. What might a possible diagnosis be?
a.Hiatal hernia
b.Ulcerative colitis
c.Pyloric obstruction
d.Achalasia - Answers B
Manifestations associated with hepatic encephalopathy from chronic liver disease are the result
of:
a.impaired ammonia metabolism.
b.fluid and electrolyte imbalances.
c.hyperbilirubinemia and jaundice.
d.decreased cerebral blood flow. - Answers A
The nurse is obtaining a health history and physical assessment from a client with possible
multiple sclerosis (MS). Which of the following assessments should the nurse include?
a.Inquire about any urinary tract problems
.b.Inspect the skin for rashes or discolouration.
c.Question the client about any increase in libido.
d.Assess for the presence of chest pain. - Answers A
A patient is newly diagnosed with multiple sclerosis (MS). What physiological change is causing
the patient's symptoms?