NUR 414 Final Exam Questions and
Answers Graded A+
The physician orders Lactulose 30 mL by mouth per day for a client with cirrhosis.
What finding below demonstrates the medication is working effectively?
A.
Improvement in level of consciousness
B.
Presence of asterixis
C.
Decreased albumin levels
D.
Absence of fruity breath - Correct answer-A. Improvement in level of
consciousness
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,A patient with cirrhosis may experience a complication called hepatic
encephalopathy. This will cause the patient to become confused (they may enter
into a coma), have pungent, musty smelling breath (fetor hepaticus), asterixis
(involuntary flapping of the hands). This is due to the buildup of ammonia in the
blood, which affects the brain. Lactulose can be prescribed to help decrease the
ammonia levels. Therefore, if the medication is working properly to decrease the
level of ammonia the patient would have improving mental status, decreased
ammonia blood level, decreasing or absence of asterixis, and decreased ammonia
blood level. Fruity breath is associated with DKA not hepatic encephalopathy.
During the morning assessment of a client with cirrhosis, you note the client is
disoriented to person and place. In addition, while assessing the upper extremities,
the client's hands demonstrate a flapping motion. What lab result would explain
these abnormal assessment findings?
A.
Ammonia level of 68 µ/dL
B.
Creatinine level of 2.9 mg/dL
C.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,Potassium level of 3.7 mmol/L
D.
Calcium level of 10.9 mg/dL - Correct answer-A. Ammonia level of 68 µ/dL
Based on the assessment findings and the fact the client has cirrhosis, the client is
experiencing hepatic encephalopathy. This is due to the buildup of toxins in the
blood, specifically ammonia. The flapping motion of the hands is called "asterixis".
Therefore, an increased ammonia level would confirm these abnormal assessment
findings
(Normal ammonia: 10-80)
A patient diagnosed with hepatitis develops splenomegaly. When reviewing the
laboratory report, which of the following results will the healthcare provider
anticipate?
A.
Polycythemia
B.
Leukocytosis
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, C.
Thrombocytopenia
D.
Neutrophilia - Correct answer-C. Thrombocytopenia
The spleen acts as a reservoir for platelets. When the spleen is enlarged, as with
splenomegaly, up to 90 percent of a person's thrombocytes can be sequestered
within the enlarged spleen.
A client diagnosed with viral hepatitis develops liver failure and hepatic
encephalopathy. Which of these measures should the healthcare provider include in
this client's plan of care?
A.
Provide high-protein feedings
B.
Monitor the blood glucose
C.
Institute droplet precautions
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
Answers Graded A+
The physician orders Lactulose 30 mL by mouth per day for a client with cirrhosis.
What finding below demonstrates the medication is working effectively?
A.
Improvement in level of consciousness
B.
Presence of asterixis
C.
Decreased albumin levels
D.
Absence of fruity breath - Correct answer-A. Improvement in level of
consciousness
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,A patient with cirrhosis may experience a complication called hepatic
encephalopathy. This will cause the patient to become confused (they may enter
into a coma), have pungent, musty smelling breath (fetor hepaticus), asterixis
(involuntary flapping of the hands). This is due to the buildup of ammonia in the
blood, which affects the brain. Lactulose can be prescribed to help decrease the
ammonia levels. Therefore, if the medication is working properly to decrease the
level of ammonia the patient would have improving mental status, decreased
ammonia blood level, decreasing or absence of asterixis, and decreased ammonia
blood level. Fruity breath is associated with DKA not hepatic encephalopathy.
During the morning assessment of a client with cirrhosis, you note the client is
disoriented to person and place. In addition, while assessing the upper extremities,
the client's hands demonstrate a flapping motion. What lab result would explain
these abnormal assessment findings?
A.
Ammonia level of 68 µ/dL
B.
Creatinine level of 2.9 mg/dL
C.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,Potassium level of 3.7 mmol/L
D.
Calcium level of 10.9 mg/dL - Correct answer-A. Ammonia level of 68 µ/dL
Based on the assessment findings and the fact the client has cirrhosis, the client is
experiencing hepatic encephalopathy. This is due to the buildup of toxins in the
blood, specifically ammonia. The flapping motion of the hands is called "asterixis".
Therefore, an increased ammonia level would confirm these abnormal assessment
findings
(Normal ammonia: 10-80)
A patient diagnosed with hepatitis develops splenomegaly. When reviewing the
laboratory report, which of the following results will the healthcare provider
anticipate?
A.
Polycythemia
B.
Leukocytosis
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, C.
Thrombocytopenia
D.
Neutrophilia - Correct answer-C. Thrombocytopenia
The spleen acts as a reservoir for platelets. When the spleen is enlarged, as with
splenomegaly, up to 90 percent of a person's thrombocytes can be sequestered
within the enlarged spleen.
A client diagnosed with viral hepatitis develops liver failure and hepatic
encephalopathy. Which of these measures should the healthcare provider include in
this client's plan of care?
A.
Provide high-protein feedings
B.
Monitor the blood glucose
C.
Institute droplet precautions
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
