Advanced MedSurg EAQ #10 Cirrhosis,
Hepatitis Exam Study Guide
The nurse provides discharge instructions to a patient with newly diagnosed cirrhosis.
Which statement made by the patient indicates the need for further teaching?
1 "I should take frequent rest periods."
2 "I can eat anything that appeals to me."
3 "I can do without my glass of wine with dinner."
4 "I should take only medications that have been prescribed." - ANSWER 2
Even though a low-protein diet has been questioned in the treatment of patients with
cirrhosis, it remains in use. In light of this, it is incorrect for the patient to say that he
may eat anything. Patients with cirrhosis must also avoid alcohol. Frequent rest and
limitation of medications to those that have been prescribed are appropriate resolutions
in a newly diagnosed case of cirrhosis and therefore do not indicate the need for further
teaching.
A patient with hepatitis A asks whether other family members are at risk for "catching"
the disease. The nurse's response will be based on the knowledge that hepatitis A is
transmitted primarily in which way?
1 During sexual intercourse
2 By contact with infected body secretions
3 Through fecal contamination of food or water
4 Through kissing that involves contact with mucous membranes - ANSWER 3
Hepatitis A is primarily transmitted through ingestion of organisms on fecally
contaminated hands, food, or water. Care should be taken in the handling of food and
water, as well as contaminated items such as bed linens, bedpans, and toilets. Hand
hygiene and personal protective equipment such as gloves are important in preventing
the spread of infection for hospital personnel. In the home, hand hygiene and good
personal hygiene are important in decreasing the risk of transmission. Sexual
intercourse, contact with infected body secretions, and contact through mucous
membranes all present higher risk for hepatitis B and C than for hepatitis A.
, A patient with cancer that has metastasized to the liver manifests symptoms of fluid
retention, including edema and ascites. To determine the effectiveness of the diuretic
therapy that has been prescribed, what should the nurse assess?
1 Breath sounds
2 Bowel sounds
3 Abdominal girth
4 Recent blood work - ANSWER 3
Daily measurement of the abdominal girth provides a direct indication of ascitic fluid
increase or decrease. Breath and bowel sounds are usually not affected by liver
metastasis until the late stages, when fluid overload and multisystem organ involvement
occur. Reviewing the results of the most recent blood work will not show direct
measurement of the effectiveness of diuretic therapy.
A patient has just undergone a liver transplant and is now in the intensive care unit
(ICU). What nursing interventions are appropriate for this patient to prevent respiratory
complications? Select all that apply.
1 Encourage the patient to cough.
2 Consider repositioning the patient.
3 Instruct the patient to walk around the bed.
4 Encourage the patient to take deep breaths.
5 Administer cough suppressants to prevent coughing. - ANSWER 1, 2, 4
The patient who has had a liver transplant requires highly skilled nursing care in an ICU
or another specialized unit. To prevent respiratory complications, the patient should be
encouraged to use measures such as coughing, deep breathing, and repositioning.
Administering cough suppressants would be counterproductive to recovery. The patient
can be ambulated later, when the condition is stable.
What are the precautions that nurses and hospital staff should follow while handling
patients suffering from hepatitis infections? Select all that apply.
1 The patient must be in a private room, and door should be closed.
2 Dispose of the needles and syringes used on the patient carefully.
3 Wear gloves while handling articles contaminated by urine or feces.
Hepatitis Exam Study Guide
The nurse provides discharge instructions to a patient with newly diagnosed cirrhosis.
Which statement made by the patient indicates the need for further teaching?
1 "I should take frequent rest periods."
2 "I can eat anything that appeals to me."
3 "I can do without my glass of wine with dinner."
4 "I should take only medications that have been prescribed." - ANSWER 2
Even though a low-protein diet has been questioned in the treatment of patients with
cirrhosis, it remains in use. In light of this, it is incorrect for the patient to say that he
may eat anything. Patients with cirrhosis must also avoid alcohol. Frequent rest and
limitation of medications to those that have been prescribed are appropriate resolutions
in a newly diagnosed case of cirrhosis and therefore do not indicate the need for further
teaching.
A patient with hepatitis A asks whether other family members are at risk for "catching"
the disease. The nurse's response will be based on the knowledge that hepatitis A is
transmitted primarily in which way?
1 During sexual intercourse
2 By contact with infected body secretions
3 Through fecal contamination of food or water
4 Through kissing that involves contact with mucous membranes - ANSWER 3
Hepatitis A is primarily transmitted through ingestion of organisms on fecally
contaminated hands, food, or water. Care should be taken in the handling of food and
water, as well as contaminated items such as bed linens, bedpans, and toilets. Hand
hygiene and personal protective equipment such as gloves are important in preventing
the spread of infection for hospital personnel. In the home, hand hygiene and good
personal hygiene are important in decreasing the risk of transmission. Sexual
intercourse, contact with infected body secretions, and contact through mucous
membranes all present higher risk for hepatitis B and C than for hepatitis A.
, A patient with cancer that has metastasized to the liver manifests symptoms of fluid
retention, including edema and ascites. To determine the effectiveness of the diuretic
therapy that has been prescribed, what should the nurse assess?
1 Breath sounds
2 Bowel sounds
3 Abdominal girth
4 Recent blood work - ANSWER 3
Daily measurement of the abdominal girth provides a direct indication of ascitic fluid
increase or decrease. Breath and bowel sounds are usually not affected by liver
metastasis until the late stages, when fluid overload and multisystem organ involvement
occur. Reviewing the results of the most recent blood work will not show direct
measurement of the effectiveness of diuretic therapy.
A patient has just undergone a liver transplant and is now in the intensive care unit
(ICU). What nursing interventions are appropriate for this patient to prevent respiratory
complications? Select all that apply.
1 Encourage the patient to cough.
2 Consider repositioning the patient.
3 Instruct the patient to walk around the bed.
4 Encourage the patient to take deep breaths.
5 Administer cough suppressants to prevent coughing. - ANSWER 1, 2, 4
The patient who has had a liver transplant requires highly skilled nursing care in an ICU
or another specialized unit. To prevent respiratory complications, the patient should be
encouraged to use measures such as coughing, deep breathing, and repositioning.
Administering cough suppressants would be counterproductive to recovery. The patient
can be ambulated later, when the condition is stable.
What are the precautions that nurses and hospital staff should follow while handling
patients suffering from hepatitis infections? Select all that apply.
1 The patient must be in a private room, and door should be closed.
2 Dispose of the needles and syringes used on the patient carefully.
3 Wear gloves while handling articles contaminated by urine or feces.
