NURS 241 Exam 4- Cirrhosis, Liver Cancer, Drug & Alcohol Abuse Exam Questions With Correct Answers

NURS 241 Exam 4- Cirrhosis, Liver
Cancer, Drug & Alcohol Abuse Exam
Questions With Correct Answers
Put the following pathophysiological conditions in order from least severe to most
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severe:
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____ Cirrhosis
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____ Hepatitis
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____ Liver cancer
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____ NAFLD/FLD - CORRECT ANSWER✔✔-__3__ Cirrhosis
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__2__ Hepatitis |




__4__ Liver cancer
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__1__ NAFLD/FLD |




1) Fatty liver condition, either alcoholic or not are common and not life
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threatening. Fatty liver can also be related to diet and obesity and can be
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reversed by controlling their cause. They have no symptoms and cannot be
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detected by labs or physical assessment
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2) Hepatitis is an inflammatory condition that irritates the liver. Hepatitis can be
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caused by food/water/feces (A & E), by a virus ( B, C & D) or can be autoimmune
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(body turning on itself) can be caused by medications such as
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minocycline,nitrofurantoin, hydralazine, methyldopa, statins, fenofibrate, alpha | | | | | |


and betainterferon, infliximab and etanercept.
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3) Cirrhosis is the progressive scarring and fibrosis after chronic irritation. The
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number one cause of cirrhosis is alcoholism. It is largely irreversible.
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,4) Liver cancer is the progressive degeneration of the liver cells that lose shape,
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organization, and function. Such cells, lacking differentiation, tend to go 'rogue'
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and become cancerous. It is hard to treat. Transplantation may help to restore
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function.


Match the liver malfunction with its assessment finding:
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____ Hepatic encephalopathy
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____ Medication toxicity
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____ Jaundice
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____ PT 6, INR 15
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____ Folic acid deficiency
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____ Central obesity and round face
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1. Hormonal dysregulation
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2.Clotting dysfunction |




3.Lack of vitamin storage
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4.Lack of processing and excreting of ammonia
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5.Inability to conjugate/excrete bilirubin
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6.Inability to reduce drug levels - CORRECT ANSWER✔✔-__4__ Hepatic
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encephalopathy
__6__ Medication toxicity
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__5__ Jaundice|




__2__ PT 6, INR 15
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__3__ Folic acid deficiency
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,__1__ Central obesity and round face
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The nurse knows that which of the following is the most likely presentation of
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Grade II hepatic encepalopathy?
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a) Tremor and dyscoordination
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b) Somnolence and/or aggression
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c) Gross personality changes
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d) Euphoria or anxiety
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e) Abnormal changes in neuropsychological tests - CORRECT ANSWER✔✔-c)
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Gross personality changes
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*This is a reminder to review the Bager article! In general I want you to know
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what there are different grades of encephalopathy, and in what direction does 0-
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4 go. There is a danger with organic cognitive changes that nurses could think
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their patient is just being a jerk, when actually their body chemistry could be
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subtly changing. Also read about lactulose use and administration in this article
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and know what a TIPS procedure is (also detailed in Iggy, use both sources).
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The nurse assesses the following stool for a patient. Charting this finding
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accurately in the electronic medical record may include which of the following
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terminology choices? |




A) Melena, hematuria, hemorrhage
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B) Hyperviscosity, hemmorrhage, black, tarry
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C) Melena, asterixis, hemmorrhage
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D) Melena, black, tarry, sticky, hematochezia - CORRECT ANSWER✔✔-D) Melena,
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black, tarry, sticky, hematochezia
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, *This contains the best choices to describe this stool. Tarry and sticky are correct
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and refer to the consistency, which the nurse can check with a tongue blade.
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Hematochezia usually describes frank/obvious/ red blood, and can describe stool,
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although usually is in contrast to the blackness of melena.Stool this color and
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consistency should be confirmed for blood by sending a specimen to the lab.
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-ALK. PHOSPHATASE: 178 H (30-120U/L)
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-BILIRUBIN - TOTAL: 1.4 H (0.2-1.2MG/DL)
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-Unconjugated/indirect Bilirubin: 1.2 H (0.2-0.8MG/DL) | | | |




-Conjugated/ direct Bilirubin: 0.4 H (0.1-0.3MG/DL)
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-TOTAL PROTEIN: 8.8 H (6.0-8.0G/DL)
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-ALBUMIN: 6.6 H(3.6-5.0G/DL)| |




-GLUCOSE: 55 L (65-99MG/DL) | | |




-AST (SGOT): 107 H (10-40 U/L)
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-ALT (SGPT): 68 H (2-45 U/L)
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-SODIUM 143 (135-145 MEQ/L)
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-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)
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-PLATELETS 120 L (150K-450K /MIC.L)
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-Anti Nuclear Antibody 20:60 H (1:40 to 1:60 titer)
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-FIBRINOGEN 100 (150-400 MG/DL) | | |