Ch. 43: Liver, Biliary Tract, Pancreas
1. A 24-year-old female contracts hepatitis from contaminated food. During the acute (icteric) phase of the
patient’s illness, the nurse would expect serologic testing to reveal
a. antibody to hepatitis D (anti-HDV)
b. hepatitis B surface antigen (HBsAg)
c. anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)
2. Administration of hepatitis B vaccine to a healthy 18-year-old patient has been effective when a specimen
of the patient's blood reveals
a. HBsAg
b. anti-HBs
c. anti-HBc-IgG
d. anti-HBc IgM
3. A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection.
Which action by the nurse is appropriate?
a. Schedule the patient for HCV genotype testing
b. Administer the HCV vaccine and immunoglobulin
c. Teach the patient about ribavirin (Rebetol) treatment
d. Explain that the infection will resolve over a few months
4. The nurse will plan to teach the patient diagnosed with acute hepatitis B about
a. side effects of nucleotide analogs
b. measures for improving the appetite
c. ways to increase activity and exercise
d. administering alpha interferon (Intron A)
5. The nurse administering alpha interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C will
plan to monitor for
a. Leukopenia
b. hypokalemia
c. polycythemia
d. hypoglycemia
6. Which information given by a 70-year-old patient during a health history indicates to the nurse that the
patient should be screened for hepatitis C?
a. The patient had a blood transfusion in 2005
b. The patient used IV drugs about 20 years ago
c. The patient frequently eats in fast-food restaurants
d. The patient traveled to a country with poor sanitation
7. A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function
studies but serological testing is negative for viral causes of hepatitis. Which question by the nurse is most
appropriate?
a. “Is there any history of IV drug use?”
b. “Do you use any over the counter drugs?”
c. “Are you taking corticosteroids for any reason?”
, d. “Have you recently traveled to a foreign country?”
8. Which data will the nurse monitor in relation to the 4+ pitting edema assessed in a patient with cirrhosis?
a. Hemoglobin
b. Temperature
c. Activity level
d. Albumin level
9. Which topic is most important to include in patient teaching for a 41-year-old patient diagnosed with early
alcoholic cirrhosis?
a. Maintaining good nutrition
b. Avoiding alcohol ingestion
c. Taking Lactulose (Cephulac)
d. Using vitamin B supplements
10. A serum potassium level of 3.2 mEq (3.2 mmol/L) is reported for a patient with cirrhosis who has
scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which action should the nurse
take?
a. Administer both drugs
b. Administer the spironolactone
c. Withhold the spironolactone and administer the furosemide
d. Withhold both drugs until discussed with the health care provider
11. Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic
encephalopathy?
a. Request that the patient stand on one foot
b. Ask the patient to extend both arms forward
c. Request that the patient walk with eyes closed
d. Ask the patient to perform the Valsalva maneuver
12. Which finding indicates to the nurse that Lactulose (Cephulac) is effective for a 72-year-old man who has
advanced cirrhosis?
a. The patient is alert and oriented
b. The patient denies nausea or anorexia
c. The patient's bilirubin level decreases
d. The patient has at least one stool daily
13. A 53-year-old patient is being treated for bleeding esophageal varices with balloon tamponade. Which
nursing action will be included in the plan of care?
a. Instruct the patient to cough every hour
b. Monitor the patient for shortness of breath
c. Verify the position of the balloon every 4 hours
d. Deflate the gastric balloon if the patient reports nausea
14. To detect possible complications in a patient with severe cirrhosis who has bleeding esophageal varices, it
is most important for the nurse to monitor
a. bilirubin levels
b. ammonia levels
c. potassium levels
d. prothrombin time
1. A 24-year-old female contracts hepatitis from contaminated food. During the acute (icteric) phase of the
patient’s illness, the nurse would expect serologic testing to reveal
a. antibody to hepatitis D (anti-HDV)
b. hepatitis B surface antigen (HBsAg)
c. anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)
2. Administration of hepatitis B vaccine to a healthy 18-year-old patient has been effective when a specimen
of the patient's blood reveals
a. HBsAg
b. anti-HBs
c. anti-HBc-IgG
d. anti-HBc IgM
3. A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection.
Which action by the nurse is appropriate?
a. Schedule the patient for HCV genotype testing
b. Administer the HCV vaccine and immunoglobulin
c. Teach the patient about ribavirin (Rebetol) treatment
d. Explain that the infection will resolve over a few months
4. The nurse will plan to teach the patient diagnosed with acute hepatitis B about
a. side effects of nucleotide analogs
b. measures for improving the appetite
c. ways to increase activity and exercise
d. administering alpha interferon (Intron A)
5. The nurse administering alpha interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C will
plan to monitor for
a. Leukopenia
b. hypokalemia
c. polycythemia
d. hypoglycemia
6. Which information given by a 70-year-old patient during a health history indicates to the nurse that the
patient should be screened for hepatitis C?
a. The patient had a blood transfusion in 2005
b. The patient used IV drugs about 20 years ago
c. The patient frequently eats in fast-food restaurants
d. The patient traveled to a country with poor sanitation
7. A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function
studies but serological testing is negative for viral causes of hepatitis. Which question by the nurse is most
appropriate?
a. “Is there any history of IV drug use?”
b. “Do you use any over the counter drugs?”
c. “Are you taking corticosteroids for any reason?”
, d. “Have you recently traveled to a foreign country?”
8. Which data will the nurse monitor in relation to the 4+ pitting edema assessed in a patient with cirrhosis?
a. Hemoglobin
b. Temperature
c. Activity level
d. Albumin level
9. Which topic is most important to include in patient teaching for a 41-year-old patient diagnosed with early
alcoholic cirrhosis?
a. Maintaining good nutrition
b. Avoiding alcohol ingestion
c. Taking Lactulose (Cephulac)
d. Using vitamin B supplements
10. A serum potassium level of 3.2 mEq (3.2 mmol/L) is reported for a patient with cirrhosis who has
scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which action should the nurse
take?
a. Administer both drugs
b. Administer the spironolactone
c. Withhold the spironolactone and administer the furosemide
d. Withhold both drugs until discussed with the health care provider
11. Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic
encephalopathy?
a. Request that the patient stand on one foot
b. Ask the patient to extend both arms forward
c. Request that the patient walk with eyes closed
d. Ask the patient to perform the Valsalva maneuver
12. Which finding indicates to the nurse that Lactulose (Cephulac) is effective for a 72-year-old man who has
advanced cirrhosis?
a. The patient is alert and oriented
b. The patient denies nausea or anorexia
c. The patient's bilirubin level decreases
d. The patient has at least one stool daily
13. A 53-year-old patient is being treated for bleeding esophageal varices with balloon tamponade. Which
nursing action will be included in the plan of care?
a. Instruct the patient to cough every hour
b. Monitor the patient for shortness of breath
c. Verify the position of the balloon every 4 hours
d. Deflate the gastric balloon if the patient reports nausea
14. To detect possible complications in a patient with severe cirrhosis who has bleeding esophageal varices, it
is most important for the nurse to monitor
a. bilirubin levels
b. ammonia levels
c. potassium levels
d. prothrombin time
