NUR 445 EXAM 2-RENAL AND GI
EXAM QUESTIONS AND ANSWERS
2025/2026
What is thrombocytopenia? - ANSWERSDecreased platelets below average range
(150,000 - 450,000).
What is the main complication of thrombocytopenia? - ANSWERSRisk for hemorrhage.
What are two common types of thrombocytopenia? - ANSWERSDIC and HIT.
What is the bleeding phase? - ANSWERSExcessive bleeding due to inability to form
clots.
What is the medical management for excessive bleeding? - ANSWERSTreatment of
underlying disorder and other disorders.
What are the manifestations of excessive bleeding? - ANSWERSNose bleeds, bleeding
at IV site, gum bleeding, SOB, hypotension, hypoxia, bruising, blood clots, fever,
metabolic acidosis.
How is excessive bleeding treated? - ANSWERSTreat the underlying cause, replace
clotting factors, volume replacement, crystalloid solutions, anticoagulant therapy.
What are the bleeding precautions? - ANSWERSAvoid rectal thermometer, sex, nose
blows, use soft toothbrush, electric razor, and stool softeners.
What medications are contraindicated due to increased bleeding risk? -
ANSWERSNSAIDs.
What is liver disease? - ANSWERSDisease affecting the liver.
What is liver trauma? - ANSWERSLiver injury often caused by motor vehicle accidents.
What are the symptoms of hepatic insufficiency? - ANSWERSJaundice, increased
bilirubin, increased serum transaminase.
What supplements should be taken for liver disease? - ANSWERSIron and vitamin
supplements.
What are the labs indicating liver failure? - ANSWERSIncrease liver enzymes (ALT,
AST), Increased bilirubin, Increase serum ammonia, Decreased albumin
,What are the risk factors for hepatitis? - ANSWERSRisky behaviors (sharing needles,
unprotected sex with multiple partners), Recent travel overseas, Alcohol abuse,
Exposure to some hepatotoxic medications, toxins or autoimmune disease
What is the pathophysiology of hepatitis? - ANSWERSInflammation of liver cells due to
virus, Impairs ability to detox, limits protein production and clotting factors, alters ability
to store vitamins, fats and sugars
What are the clinical manifestations of hepatitis? - ANSWERSIncreased liver enzymes
(ALT, AST), Increased bilirubin (total and direct), Increased serum ammonia, Decreased
albumin, Jaundice, Abdominal pain
How is hepatitis diagnosed? - ANSWERSRecent travel outside U.S
What medications are used for hepatitis? - ANSWERSVaccination for Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C-related
cirrhosis? - ANSWERSHepatitis C-related cirrhosis
What are the major complications after liver transplant? - ANSWERSOrgan rejection
and infection
What assessments are done for liver transplant patients? - ANSWERSIncreased liver
enzymes (ALT and AST), Signs of organ rejection (RUQ pain, changes in bile drainage,
fever, tachycardia, jaundice)
What nursing actions should be taken for hepatitis patients? - ANSWERSRefer patient
to social worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? - ANSWERSNutritional
teaching (balanced diet, decreased fat and protein), Good hand hygiene to decrease
transmission from fecal-oral route, Avoid behaviors that contribute to transmission
(needle sharing, unprotected sex), Importance of vaccinations to prevent hepatitis A and
B, Safe public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - ANSWERSChronic infection with Hep A, B or
C, Chronic alcoholism
What is the pathophysiology of cirrhosis? - ANSWERSIrreversible chronic cell
destruction and fibrosis/scarring of the hepatic tissue
What is ascites? - ANSWERSAccumulation of protein-rich fluid in the abdominal cavity.
What are the signs and symptoms of cirrhosis? - ANSWERSShortness of breath,
jaundice, increased abdominal girth, large spleen, elevated liver enzymes, increased
, risk of bleeding, thrombocytopenia, prolonged PT, hemorrhoids, elevated serum
ammonia, changes in LOC, changes in motor function, hyponatremia.
What are the treatment options for cirrhosis? - ANSWERSDiet/nursing actions,
administering medications (spironolactone, propranolol, lactulose), low protein, low
sodium, and fluid restriction, increased fiber intake.
What assessments should be done for a patient with cirrhosis? - ANSWERSMonitoring
O2 saturation for shortness of breath, monitoring vital signs (especially BP for patients
taking diuretics), watching for signs of organ rejection (RUQ pain, changes in bile
drainage, fever, tachycardia, jaundice).
What should be taught to a patient with cirrhosis? - ANSWERSEducating about
medications metabolized in the liver (avoid NSAIDs, opioids), understanding hepatic
encephalopathy.
What is hepatic encephalopathy? - ANSWERSAltered mental status caused by elevated
ammonia levels.
How is hepatic encephalopathy treated? - ANSWERSDecreased protein intake,
decrease bacterial production of ammonia (neomycin and lactulose), correcting fluid
and electrolyte imbalance.
What is liver cancer? - ANSWERSA type of cancer that affects the liver.
What is the pathophysiology of liver cancer? - ANSWERSLiver cancer usually
progresses rapidly within 6 to 12 months of diagnosis. The only cure is a liver
transplant.
What are the signs and symptoms of late-stage liver cancer? - ANSWERSJaundice,
ascites, and weight loss.
What are the clinical manifestations of liver cancer? - ANSWERSLiver cancer is usually
asymptomatic until liver dysfunction occurs. Symptoms may include abdominal pain,
anorexia, weakness, fatigue, jaundice, ascites, and weight loss.
What diagnostic tests are used for liver cancer? - ANSWERSLiver biopsy to determine
the type and stage of cancer, chest x-ray, PET scan, MRI, and laparoscopy.
What are the signs and symptoms of hepatic insufficiency? - ANSWERSElevated
transaminase and bilirubin levels (AST, ALT, creatinine), decreased albumin, increased
bilirubin, phosphate, AST, ALT, and ammonia.
What nursing actions should be taken for liver cancer patients? - ANSWERSFluid
restriction with strict I&Os, position patient on right side for 6 hours after biopsy, assess
EXAM QUESTIONS AND ANSWERS
2025/2026
What is thrombocytopenia? - ANSWERSDecreased platelets below average range
(150,000 - 450,000).
What is the main complication of thrombocytopenia? - ANSWERSRisk for hemorrhage.
What are two common types of thrombocytopenia? - ANSWERSDIC and HIT.
What is the bleeding phase? - ANSWERSExcessive bleeding due to inability to form
clots.
What is the medical management for excessive bleeding? - ANSWERSTreatment of
underlying disorder and other disorders.
What are the manifestations of excessive bleeding? - ANSWERSNose bleeds, bleeding
at IV site, gum bleeding, SOB, hypotension, hypoxia, bruising, blood clots, fever,
metabolic acidosis.
How is excessive bleeding treated? - ANSWERSTreat the underlying cause, replace
clotting factors, volume replacement, crystalloid solutions, anticoagulant therapy.
What are the bleeding precautions? - ANSWERSAvoid rectal thermometer, sex, nose
blows, use soft toothbrush, electric razor, and stool softeners.
What medications are contraindicated due to increased bleeding risk? -
ANSWERSNSAIDs.
What is liver disease? - ANSWERSDisease affecting the liver.
What is liver trauma? - ANSWERSLiver injury often caused by motor vehicle accidents.
What are the symptoms of hepatic insufficiency? - ANSWERSJaundice, increased
bilirubin, increased serum transaminase.
What supplements should be taken for liver disease? - ANSWERSIron and vitamin
supplements.
What are the labs indicating liver failure? - ANSWERSIncrease liver enzymes (ALT,
AST), Increased bilirubin, Increase serum ammonia, Decreased albumin
,What are the risk factors for hepatitis? - ANSWERSRisky behaviors (sharing needles,
unprotected sex with multiple partners), Recent travel overseas, Alcohol abuse,
Exposure to some hepatotoxic medications, toxins or autoimmune disease
What is the pathophysiology of hepatitis? - ANSWERSInflammation of liver cells due to
virus, Impairs ability to detox, limits protein production and clotting factors, alters ability
to store vitamins, fats and sugars
What are the clinical manifestations of hepatitis? - ANSWERSIncreased liver enzymes
(ALT, AST), Increased bilirubin (total and direct), Increased serum ammonia, Decreased
albumin, Jaundice, Abdominal pain
How is hepatitis diagnosed? - ANSWERSRecent travel outside U.S
What medications are used for hepatitis? - ANSWERSVaccination for Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C-related
cirrhosis? - ANSWERSHepatitis C-related cirrhosis
What are the major complications after liver transplant? - ANSWERSOrgan rejection
and infection
What assessments are done for liver transplant patients? - ANSWERSIncreased liver
enzymes (ALT and AST), Signs of organ rejection (RUQ pain, changes in bile drainage,
fever, tachycardia, jaundice)
What nursing actions should be taken for hepatitis patients? - ANSWERSRefer patient
to social worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? - ANSWERSNutritional
teaching (balanced diet, decreased fat and protein), Good hand hygiene to decrease
transmission from fecal-oral route, Avoid behaviors that contribute to transmission
(needle sharing, unprotected sex), Importance of vaccinations to prevent hepatitis A and
B, Safe public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - ANSWERSChronic infection with Hep A, B or
C, Chronic alcoholism
What is the pathophysiology of cirrhosis? - ANSWERSIrreversible chronic cell
destruction and fibrosis/scarring of the hepatic tissue
What is ascites? - ANSWERSAccumulation of protein-rich fluid in the abdominal cavity.
What are the signs and symptoms of cirrhosis? - ANSWERSShortness of breath,
jaundice, increased abdominal girth, large spleen, elevated liver enzymes, increased
, risk of bleeding, thrombocytopenia, prolonged PT, hemorrhoids, elevated serum
ammonia, changes in LOC, changes in motor function, hyponatremia.
What are the treatment options for cirrhosis? - ANSWERSDiet/nursing actions,
administering medications (spironolactone, propranolol, lactulose), low protein, low
sodium, and fluid restriction, increased fiber intake.
What assessments should be done for a patient with cirrhosis? - ANSWERSMonitoring
O2 saturation for shortness of breath, monitoring vital signs (especially BP for patients
taking diuretics), watching for signs of organ rejection (RUQ pain, changes in bile
drainage, fever, tachycardia, jaundice).
What should be taught to a patient with cirrhosis? - ANSWERSEducating about
medications metabolized in the liver (avoid NSAIDs, opioids), understanding hepatic
encephalopathy.
What is hepatic encephalopathy? - ANSWERSAltered mental status caused by elevated
ammonia levels.
How is hepatic encephalopathy treated? - ANSWERSDecreased protein intake,
decrease bacterial production of ammonia (neomycin and lactulose), correcting fluid
and electrolyte imbalance.
What is liver cancer? - ANSWERSA type of cancer that affects the liver.
What is the pathophysiology of liver cancer? - ANSWERSLiver cancer usually
progresses rapidly within 6 to 12 months of diagnosis. The only cure is a liver
transplant.
What are the signs and symptoms of late-stage liver cancer? - ANSWERSJaundice,
ascites, and weight loss.
What are the clinical manifestations of liver cancer? - ANSWERSLiver cancer is usually
asymptomatic until liver dysfunction occurs. Symptoms may include abdominal pain,
anorexia, weakness, fatigue, jaundice, ascites, and weight loss.
What diagnostic tests are used for liver cancer? - ANSWERSLiver biopsy to determine
the type and stage of cancer, chest x-ray, PET scan, MRI, and laparoscopy.
What are the signs and symptoms of hepatic insufficiency? - ANSWERSElevated
transaminase and bilirubin levels (AST, ALT, creatinine), decreased albumin, increased
bilirubin, phosphate, AST, ALT, and ammonia.
What nursing actions should be taken for liver cancer patients? - ANSWERSFluid
restriction with strict I&Os, position patient on right side for 6 hours after biopsy, assess
