Med Surg Exam 3 Test Bank 2024/2025

Med Surg Exam 3 Test Bank 2024/2025 1. The nurse is caring for a patient with liver failure. The nurse understands that patients in liver failure often require vitamin therapy. Which vitamin does the liver require for the synthesis of prothrombin? A) Vitamin B12 B) Vitamin A C) Vitamin D D) Vitamin K - ANSWER-D) Vitamin K 2. The nursing instructor is teaching the beginning nursing students how to palpate a liver. What technique will the student nurse use to palpate a patient's liver? A) Place hand under left lower rib cage and press down lightly with the other hand. B) Place the left hand over the abdomen and behind the left side at the 11th rib. C) Place hand under right lower rib cage and press down lightly with the other hand. D) Hold hand 90 degrees to abdomen and push down firmly - ANSWER-C) Place hand under right lower rib cage and press down lightly with the other hand. 3. A patient with portal hypertension has been admitted to the floor you work on. What will you assess for related to portal hypertension? A) Bowel obstruction B) Vitamin A deficiency C) Ascites D) Hepatic encephalopathy - ANSWER-C) Ascites 4. The nurse is caring for a patient with cancer of the liver. The patient has a percutaneous biliary drainage system. What assessments should the nurse record in the patient's chart? A) Amount and color of drainage B) Temperature of drainage C) Odor of drainage D) Consistency of drainage - ANSWER-A) Amount and color of drainage 5. A patient who has undergone liver transplantation is ready to be discharged home. The nurse is providing discharge teaching. Which topic will the nurse emphasize the most related to discharge teaching? A) The patient will obtain measurement of drainage from the T-tube. B) The patient will exercise three times a week. C) The patient will take immunosuppressive agents as required. D) The patient will monitor for signs of liver dysfunction. - ANSWER-C) The patient will take immunosuppressive agents as required. 6. The triage nurse in the emergency department is assessing a patient who presented with complaints of not feeling well. The patient has ascites and an enlarged liver. The patient reports a history of drinking a 12 pack of beer every evening for the past 15 years. The nurse is aware that the patient is at risk for which disease? A) Cirrhosis B) Renal failure C) Hepatitis D) Cardiovascular disease - ANSWER-A) Cirrhosis 7. The nurse is reviewing the history of a patient newly admitted to the unit. This patient has been ordered vasopressin for bleeding esophageal varices. The nurse calls the physician to question the use of vasopressin when she reads that the patient has a history of what? A) Diabetes mellitus B) Chronic kidney disease C) Arthritis D) Coronary artery disease - ANSWER-D) coronary artery disease 8. The nurse is caring for a patient with hepatic encephalopathy. While making the initial shift assessment the nurse notes that the patient has a flapping tremor of the hands. What will the nurse document this condition as in the patient's chart? A) Asterixis B) Constructional apraxia C) Fetor hepaticus D) Palmar erythema - ANSWER-A) Asterixis 9. A patient with a history of postnecrotic cirrhosis is being cared for on your unit. What is this type of cirrhosis often the result of? A) A previous bout of acute viral hepatitis B) Chronic alcoholism C) Biliary obstruction D) Cholangitis - ANSWER-A) A previous bout of acute viral hepatitis 10. The nursing instructor is teaching the senior nursing students about liver disease. What would the instructor teach the students is the most common surgical procedure for liver cancer? A) Cryosurgery B) Liver transplantation C) A lobectomy D) Laser hyperthermia - ANSWER-C) A lobectomy 11. A patient with liver cancer is at the clinic to talk with the physician. The physician tells the patient that it is to risky to do surgery on their hepatic tumor. The patient asks the nurse why surgery is so risky for them. The nurse explains that while surgical resection of the liver tumor is possible in some patients, the risks associated with this procedure increase when the patient has a history of what? A) Oral contraceptive use B) Cirrhosis C) Hypertension D) Prior abdominal surgery - ANSWER-B) Cirrhosis 12. The nurse is caring for a patient with hepatic encephalopathy. The nurse's assessment reveals that the patient exhibits episodes of confusion, is difficult to arouse from sleep, has rigid extremities, and shows EEG abnormalities. Based upon these clinical findings, what is the patient's stage of hepatic encephalopathy? A) Stage 1 B) Stage 2 C) Stage 3 D) Stage 4 - ANSWER-C) Stage 3 13. A patient has been admitted to the step-down unit with a diagnosis of liver malignancy. The critical care nurse caring for this patient is aware that an early manifestation of liver malignancy, in addition to pain, is what? A) A continuous dull ache in the right upper quadrant, epigastrium, or back B) Weight gain C) An increase in appetite D) Jaundice - ANSWER-A) A continuous dull ache in the right upper quadrant, epigastrium, or back 14. A nurse is assessing a 77-year-old male admitted to the unit for suspected liver dysfunction. What assessment finding will the nurse expect to find? A) Liver function results change dramatically in the older adult. B) Metabolism of medications is delayed primarily by the liver. C) The liver is enlarged with hard edges. D) The liver is decreased in size and weight. - ANSWER-D) The liver is decreased in size and weight. 15. You are caring for a patient with a blocked bile duct from a tumor. What would you document about the patient's urine? A) Urine is dark amber and concentrated. B) Urine is orange and foamy. C) Urine is rust colored and concentrated. D) Urine is pale yellow and dilute. - ANSWER-B) Urine is orange and foamy. 16. What liver function test is a sensitive indicator of injury to liver cells and useful in detecting acute liver disease such as hepatitis? A) Clotting factors B) Serum aminotransferases C) GGT Continues......