NURS 241 Exam 4- Cirrhosis, Liver Cancer, Drug &
Alcohol Abuse Questions With Complete Solutions
Put the following pathophysiological conditions in order from
least severe to most severe:
____ Cirrhosis
____ Hepatitis
____ Liver cancer
____ NAFLD/FLD
__3__ Cirrhosis
__2__ Hepatitis
__4__ Liver cancer
__1__ NAFLD/FLD
1) Fatty liver condition, either alcoholic or not are common and
not life threatening. Fatty liver can also be related to diet and
obesity and can be reversed by controlling their cause. They
have no symptoms and cannot be detected by labs or physical
assessment
2) Hepatitis is an inflammatory condition that irritates the liver.
Hepatitis can be caused by food/water/feces (A & E), by a virus
( B, C & D) or can be autoimmune (body turning on itself) can
be caused by medications such as minocycline,nitrofurantoin,
hydralazine, methyldopa, statins, fenofibrate, alpha and
betainterferon, infliximab and etanercept.
3) Cirrhosis is the progressive scarring and fibrosis after chronic
,irritation. The number one cause of cirrhosis is alcoholism. It is
largely irreversible.
4) Liver cancer is the progressive degeneration of the liver cells
that lose shape, organization, and function. Such cells, lacking
differentiation, tend to go 'rogue' and become cancerous. It is
hard to treat. Transplantation may help to restore function.
Match the liver malfunction with its assessment finding:
____ Hepatic encephalopathy
____ Medication toxicity
____ Jaundice
____ PT 6, INR 15
____ Folic acid deficiency
____ Central obesity and round face
1. Hormonal dysregulation
2.Clotting dysfunction
3.Lack of vitamin storage
4.Lack of processing and excreting of ammonia
5.Inability to conjugate/excrete bilirubin
6.Inability to reduce drug levels
__4__ Hepatic encephalopathy
__6__ Medication toxicity
__5__ Jaundice
__2__ PT 6, INR 15
__3__ Folic acid deficiency
__1__ Central obesity and round face
,The nurse knows that which of the following is the most likely
presentation of Grade II hepatic encepalopathy?
a) Tremor and dyscoordination
b) Somnolence and/or aggression
c) Gross personality changes
d) Euphoria or anxiety
e) Abnormal changes in neuropsychological tests
c) Gross personality changes
*This is a reminder to review the Bager article! In general I want
you to know what there are different grades of encephalopathy,
and in what direction does 0-4 go. There is a danger with
organic cognitive changes that nurses could think their patient is
just being a jerk, when actually their body chemistry could be
subtly changing. Also read about lactulose use and
administration in this article and know what a TIPS procedure is
(also detailed in Iggy, use both sources).
The nurse assesses the following stool for a patient. Charting
this finding accurately in the electronic medical record may
include which of the following terminology choices?
A) Melena, hematuria, hemorrhage
B) Hyperviscosity, hemmorrhage, black, tarry
C) Melena, asterixis, hemmorrhage
D) Melena, black, tarry, sticky, hematochezia
D) Melena, black, tarry, sticky, hematochezia
, *This contains the best choices to describe this stool. Tarry and
sticky are correct and refer to the consistency, which the nurse
can check with a tongue blade. Hematochezia usually describes
frank/obvious/ red blood, and can describe stool, although
usually is in contrast to the blackness of melena.Stool this color
and consistency should be confirmed for blood by sending a
specimen to the lab.
-ALK. PHOSPHATASE: 178 H (30-120U/L)
-BILIRUBIN - TOTAL: 1.4 H (0.2-1.2MG/DL)
-Unconjugated/indirect Bilirubin: 1.2 H (0.2-0.8MG/DL)
-Conjugated/ direct Bilirubin: 0.4 H (0.1-0.3MG/DL)
-TOTAL PROTEIN: 8.8 H (6.0-8.0G/DL)
-ALBUMIN: 6.6 H(3.6-5.0G/DL)
-GLUCOSE: 55 L (65-99MG/DL)
-AST (SGOT): 107 H (10-40 U/L)
-ALT (SGPT): 68 H (2-45 U/L)
-SODIUM 143 (135-145 MEQ/L)
-POTASSIUM 3.5 (3.5-4.9 MEQ/L)
-AMMONIA 105 H (15-45 MCG/DL)
-CHLORIDE 96 (96-110 MEQ/L)
-LACTATE 3.5 H (0.5-1 Mmol/l)
-PLATELETS 120 L (150K-450K /MIC.L)
-Anti Nuclear Antibody 20:60 H (1:40 to 1:60 titer)
-FIBRINOGEN 100 (150-400 MG/DL)
-CRP 1.8 (>3.0 MG/L)
-BLOOD ALCOHOL LEVEL/ETHANOL 80 H (.08)
Alcohol Abuse Questions With Complete Solutions
Put the following pathophysiological conditions in order from
least severe to most severe:
____ Cirrhosis
____ Hepatitis
____ Liver cancer
____ NAFLD/FLD
__3__ Cirrhosis
__2__ Hepatitis
__4__ Liver cancer
__1__ NAFLD/FLD
1) Fatty liver condition, either alcoholic or not are common and
not life threatening. Fatty liver can also be related to diet and
obesity and can be reversed by controlling their cause. They
have no symptoms and cannot be detected by labs or physical
assessment
2) Hepatitis is an inflammatory condition that irritates the liver.
Hepatitis can be caused by food/water/feces (A & E), by a virus
( B, C & D) or can be autoimmune (body turning on itself) can
be caused by medications such as minocycline,nitrofurantoin,
hydralazine, methyldopa, statins, fenofibrate, alpha and
betainterferon, infliximab and etanercept.
3) Cirrhosis is the progressive scarring and fibrosis after chronic
,irritation. The number one cause of cirrhosis is alcoholism. It is
largely irreversible.
4) Liver cancer is the progressive degeneration of the liver cells
that lose shape, organization, and function. Such cells, lacking
differentiation, tend to go 'rogue' and become cancerous. It is
hard to treat. Transplantation may help to restore function.
Match the liver malfunction with its assessment finding:
____ Hepatic encephalopathy
____ Medication toxicity
____ Jaundice
____ PT 6, INR 15
____ Folic acid deficiency
____ Central obesity and round face
1. Hormonal dysregulation
2.Clotting dysfunction
3.Lack of vitamin storage
4.Lack of processing and excreting of ammonia
5.Inability to conjugate/excrete bilirubin
6.Inability to reduce drug levels
__4__ Hepatic encephalopathy
__6__ Medication toxicity
__5__ Jaundice
__2__ PT 6, INR 15
__3__ Folic acid deficiency
__1__ Central obesity and round face
,The nurse knows that which of the following is the most likely
presentation of Grade II hepatic encepalopathy?
a) Tremor and dyscoordination
b) Somnolence and/or aggression
c) Gross personality changes
d) Euphoria or anxiety
e) Abnormal changes in neuropsychological tests
c) Gross personality changes
*This is a reminder to review the Bager article! In general I want
you to know what there are different grades of encephalopathy,
and in what direction does 0-4 go. There is a danger with
organic cognitive changes that nurses could think their patient is
just being a jerk, when actually their body chemistry could be
subtly changing. Also read about lactulose use and
administration in this article and know what a TIPS procedure is
(also detailed in Iggy, use both sources).
The nurse assesses the following stool for a patient. Charting
this finding accurately in the electronic medical record may
include which of the following terminology choices?
A) Melena, hematuria, hemorrhage
B) Hyperviscosity, hemmorrhage, black, tarry
C) Melena, asterixis, hemmorrhage
D) Melena, black, tarry, sticky, hematochezia
D) Melena, black, tarry, sticky, hematochezia
, *This contains the best choices to describe this stool. Tarry and
sticky are correct and refer to the consistency, which the nurse
can check with a tongue blade. Hematochezia usually describes
frank/obvious/ red blood, and can describe stool, although
usually is in contrast to the blackness of melena.Stool this color
and consistency should be confirmed for blood by sending a
specimen to the lab.
-ALK. PHOSPHATASE: 178 H (30-120U/L)
-BILIRUBIN - TOTAL: 1.4 H (0.2-1.2MG/DL)
-Unconjugated/indirect Bilirubin: 1.2 H (0.2-0.8MG/DL)
-Conjugated/ direct Bilirubin: 0.4 H (0.1-0.3MG/DL)
-TOTAL PROTEIN: 8.8 H (6.0-8.0G/DL)
-ALBUMIN: 6.6 H(3.6-5.0G/DL)
-GLUCOSE: 55 L (65-99MG/DL)
-AST (SGOT): 107 H (10-40 U/L)
-ALT (SGPT): 68 H (2-45 U/L)
-SODIUM 143 (135-145 MEQ/L)
-POTASSIUM 3.5 (3.5-4.9 MEQ/L)
-AMMONIA 105 H (15-45 MCG/DL)
-CHLORIDE 96 (96-110 MEQ/L)
-LACTATE 3.5 H (0.5-1 Mmol/l)
-PLATELETS 120 L (150K-450K /MIC.L)
-Anti Nuclear Antibody 20:60 H (1:40 to 1:60 titer)
-FIBRINOGEN 100 (150-400 MG/DL)
-CRP 1.8 (>3.0 MG/L)
-BLOOD ALCOHOL LEVEL/ETHANOL 80 H (.08)
