NCLEX Review Questions (Wagner) - Chapter (22)

Chapter 22: Alterations in Liver Function NCLEX® Review This activity contains 10 questions. A nurse is developing an informational session about hepatitis B infection. Which information should the nurse include? Select all that apply. Hepatitis B is endemic in the United States. Hepatitis B can be considered a sexually transmitted infection. Hepatitis B is spread by contaminated food or water. Hepatitis B is rarely seen in middle-aged adults. A vaccination against hepatitis B is available. A 14-year-old students presents at the school nurse's office and asks, "Is it okay if I take an aspirin? My throat is sore." How should the nurse respond? "Yes, but only take one tablet." "Do your parents let you take aspirin?" "Are you allergic to anything?" "No, children and young people should not take aspirin." A client has developed HELLP syndrome and the last liver function tests suggest acute liver failure is beginning. The nurse should prepare for which intervention? Administration of penicillin G Delivery by cesarean section Administration of acyclovir Insertion of a intrahepatic shunt A client was admitted 2 days ago after overdosing on acetaminophen. The laboratory technician calls the unit and reports that today's liver enzymes results are: ALT 1,500 units/L; AST 1,500 units/L; and Alk Phos 140 units/L. What should the nurse do? Immediately collaborate with the client's physician. Ask the lab to redraw these tests. Chart the results. Increase the client's IV rate. The results of a client's ammonia levels are normal, but the client is demonstrating asterixis. What should the nurse do? Check the source of the blood used for the ammonia levels. Have the laboratory rerun the sample. Ask the laboratory technician whether the sample appeared diluted. Assess the client again in 1 hour. A client who has acute liver failure has developed cerebral edema. Which nursing interventions should be instituted? Select all that apply. Closely monitor the client's vital signs. Position the client flat in bed. Wrap the client in several warmed blankets. Instruct the client to cough and take a deep breath every hour. Prepare to sedate the client chemically. A client is bleeding from esophageal varices and requires placement of a Sengstaken-Blakemore tube. How should the nurse explain the use of this tube to the client's family? Select all that apply. "Your loved one will not be able to talk while this tube is in place." "This tube acts as a shunt to divert bleeding away from the lungs." "This tube has a balloon on it that will be inflated to put pressure on the area that is bleeding." "The physician will be placing the tube in a few minutes." "Using this tube eliminates the need for surgery." A client has developed massive ascites. The nurse will monitor this client for the development of which priority finding? Increased temperature Diarrhea Difficulty breathing Diuresis A client has hepatic encephalopathy (HE) that is currently grade I. Which reflex findings would the nurse expect if the client's HE progresses to grade II? A positive Babinski Absence of reflexes Normal reflexes Reflexes are brisker than normal. Overall reflexes are diminished. A client has acute liver failure. The nurse would assess for which skin changes? Select all that apply. Poor wound healing Presence of petechiae Pale mucous membranes Dark-brownish discolorations on the chest Presence of pruritus