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GNRS 558: EXAM 3| GNRS 558: EXAM 4
(PHARMACOLOGY FOR ADVANCED NURSING)
PRACTICE QUESTIONS WITH VERIFIED
SOLUTIONS NEW MODIFIED
Which information from a 70-yr-old patient during a health history indicates to the nurse that
the patient should be screened for hepatitis C? a. The patient had a blood transfusion in 2005.
b. The patient used IV drugs about 30 years ago.
c. The patient frequently eats in fast-food restaurants.
d. The patient traveled to a country with poor sanitation. --CORRECT ANSWER--ANS: B
Any patient with a history of IV drug use should be tested for hepatitis C. Blood transfusions
given after 1992 (when an antibody test for hepatitis C became available) do not pose a risk
for hepatitis C. Hepatitis C is not spread by the oral-fecal route and therefore is not caused by
contaminated food or by traveling in underdeveloped countries.
A patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function
studies, but serologic testing is negative for viral causes of hepatitis. Which question would
the nurse ask?
a. ―Have you taken corticosteroids?‖
b. ―Do you have a history of IV drug use?‖
c. ―Do you use any over-the-counter drugs?‖
d. ―Have you recently traveled to another country?‖ --CORRECT ANSWER--ANS: C The
patient's symptoms, lack of antibodies for hepatitis, and the abrupt onset of symptoms suggest
toxic hepatitis, which can be caused by commonly used over-the-counter drugs such as
acetaminophen (Tylenol). Travel to a foreign country and a history of IV drug use are risk
factors for viral hepatitis. Corticosteroid use does not cause acute liver dysfunction.
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A patient has cirrhosis and 4+ pitting edema. Which focused data would the nurse assess?
a. Hemoglobin
b. Temperature
c. Activity level
d. Albumin level --CORRECT ANSWER--ANS: D The low oncotic pressure caused by
hypoalbuminemia is a major pathophysiologic factor in the development of edema. The other
parameters are not directly associated with the patient's edema.
Which topic is most important for the nurse to include in teaching for a 41-yr-old patient
diagnosed with early alcoholic cirrhosis?
a. Taking lactulose
b. Avoiding all alcohol use
c. Maintaining good nutrition
d. Using vitamin B supplements --CORRECT ANSWER--ANS: B The disease progression
can be stopped or reversed by alcohol abstinence. The other interventions may be used when
cirrhosis becomes more severe to decrease symptoms or complications, but the priority for
this patient is to stop the progression of the disease.
A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis
who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which
action would the nurse take?
a. Withhold both drugs.
b. Administer both drugs.
c. Administer the furosemide.
d. Administer the spironolactone. --CORRECT ANSWER--ANS: D Spironolactone is a
potassium-sparing diuretic and will help increase the patient's potassium level. The
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furosemide will further decrease the patient's potassium level and should be held until the
nurse talks with the health care provider.
Which action would the nurse take to evaluate treatment effectiveness for a patient who has
hepatic encephalopathy?
a. Request that the patient stand on one foot.
b. Ask the patient to extend both arms forward.
c. Request that the patient walk with eyes closed.
d. Ask the patient to perform the Valsalva maneuver. --CORRECT ANSWER--ANS: B
Extending the arms allows the nurse to check for asterixis, a classic sign of hepatic
encephalopathy. The other tests might be done as part of the neurologic assessment but would
not be diagnostic for hepatic encephalopathy.
A young adult contracts hepatitis from contaminated food. Which result would the nurse
expect serologic testing to reveal during the acute (icteric) phase of the patient's illness?
a. Antibody to hepatitis D (anti-HDV)
b. Hepatitis B surface antigen (HBsAg)
c. Anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM) --CORRECT ANSWER--
ANS: D Hepatitis A is transmitted through the oral-fecal route, and antibody to HAV IgM
appears during the acute phase of hepatitis A. The patient would not have antigen for
hepatitis B or antibody for hepatitis D. Anti-HAV IgG would indicate past infection and
lifelong immunity
The nurse evaluates that administration of hepatitis B vaccine to a healthy patient was
effective when the patient's later blood specimen reveals the presence of
a. HBsAg.
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b. anti-HBs.
c. anti-HBc IgG.
d. anti-HBc IgM. --CORRECT ANSWER--ANS: B The presence of surface antibody to
hepatitis B (anti-HBs) is a marker of a positive response to the vaccine or previous illness
with hepatitis B. The other laboratory values indicate current infection with hepatitis B.
A patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. Which
action would the nurse take?
a. Schedule the patient for HCV genotype testing.
b. Administer the HCV vaccine and immune globulin.
c. Teach the patient about direct-acting antiviral treatment.
d. Explain that the infection will resolve over a few months. --CORRECT ANSWER--ANS:
A Genotyping of HCV has an important role in managing treatment and is done before drug
therapy is initiated. Because most patients with acute HCV infection convert to the chronic
state, the nurse should not teach the patient that the HCV will resolve in a few months.
Immune globulin or vaccine is not available for HCV. Direct-acting antiviral drugs are used
for chronic HCV infection.
Which topic would the nurse plan to teach the patient diagnosed with acute hepatitis B?
a. Administering a-interferon
b. Measures for improving appetite
c. Side effects of nucleotide analogs
d. Ways to increase activity and exercise --CORRECT ANSWER--ANS: B Maintaining
adequate nutritional intake is important for regeneration of hepatocytes. Interferon and
antivirals may be used for chronic hepatitis B, but they are not prescribed for acute hepatitis
B infection. Rest is recommended
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GNRS 558: EXAM 3| GNRS 558: EXAM 4
(PHARMACOLOGY FOR ADVANCED NURSING)
PRACTICE QUESTIONS WITH VERIFIED
SOLUTIONS NEW MODIFIED
Which information from a 70-yr-old patient during a health history indicates to the nurse that
the patient should be screened for hepatitis C? a. The patient had a blood transfusion in 2005.
b. The patient used IV drugs about 30 years ago.
c. The patient frequently eats in fast-food restaurants.
d. The patient traveled to a country with poor sanitation. --CORRECT ANSWER--ANS: B
Any patient with a history of IV drug use should be tested for hepatitis C. Blood transfusions
given after 1992 (when an antibody test for hepatitis C became available) do not pose a risk
for hepatitis C. Hepatitis C is not spread by the oral-fecal route and therefore is not caused by
contaminated food or by traveling in underdeveloped countries.
A patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function
studies, but serologic testing is negative for viral causes of hepatitis. Which question would
the nurse ask?
a. ―Have you taken corticosteroids?‖
b. ―Do you have a history of IV drug use?‖
c. ―Do you use any over-the-counter drugs?‖
d. ―Have you recently traveled to another country?‖ --CORRECT ANSWER--ANS: C The
patient's symptoms, lack of antibodies for hepatitis, and the abrupt onset of symptoms suggest
toxic hepatitis, which can be caused by commonly used over-the-counter drugs such as
acetaminophen (Tylenol). Travel to a foreign country and a history of IV drug use are risk
factors for viral hepatitis. Corticosteroid use does not cause acute liver dysfunction.
Page 1 of 237
,MEDSTUDY.COM
A patient has cirrhosis and 4+ pitting edema. Which focused data would the nurse assess?
a. Hemoglobin
b. Temperature
c. Activity level
d. Albumin level --CORRECT ANSWER--ANS: D The low oncotic pressure caused by
hypoalbuminemia is a major pathophysiologic factor in the development of edema. The other
parameters are not directly associated with the patient's edema.
Which topic is most important for the nurse to include in teaching for a 41-yr-old patient
diagnosed with early alcoholic cirrhosis?
a. Taking lactulose
b. Avoiding all alcohol use
c. Maintaining good nutrition
d. Using vitamin B supplements --CORRECT ANSWER--ANS: B The disease progression
can be stopped or reversed by alcohol abstinence. The other interventions may be used when
cirrhosis becomes more severe to decrease symptoms or complications, but the priority for
this patient is to stop the progression of the disease.
A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis
who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which
action would the nurse take?
a. Withhold both drugs.
b. Administer both drugs.
c. Administer the furosemide.
d. Administer the spironolactone. --CORRECT ANSWER--ANS: D Spironolactone is a
potassium-sparing diuretic and will help increase the patient's potassium level. The
Page 2 of 237
,MEDSTUDY.COM
furosemide will further decrease the patient's potassium level and should be held until the
nurse talks with the health care provider.
Which action would the nurse take to evaluate treatment effectiveness for a patient who has
hepatic encephalopathy?
a. Request that the patient stand on one foot.
b. Ask the patient to extend both arms forward.
c. Request that the patient walk with eyes closed.
d. Ask the patient to perform the Valsalva maneuver. --CORRECT ANSWER--ANS: B
Extending the arms allows the nurse to check for asterixis, a classic sign of hepatic
encephalopathy. The other tests might be done as part of the neurologic assessment but would
not be diagnostic for hepatic encephalopathy.
A young adult contracts hepatitis from contaminated food. Which result would the nurse
expect serologic testing to reveal during the acute (icteric) phase of the patient's illness?
a. Antibody to hepatitis D (anti-HDV)
b. Hepatitis B surface antigen (HBsAg)
c. Anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM) --CORRECT ANSWER--
ANS: D Hepatitis A is transmitted through the oral-fecal route, and antibody to HAV IgM
appears during the acute phase of hepatitis A. The patient would not have antigen for
hepatitis B or antibody for hepatitis D. Anti-HAV IgG would indicate past infection and
lifelong immunity
The nurse evaluates that administration of hepatitis B vaccine to a healthy patient was
effective when the patient's later blood specimen reveals the presence of
a. HBsAg.
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b. anti-HBs.
c. anti-HBc IgG.
d. anti-HBc IgM. --CORRECT ANSWER--ANS: B The presence of surface antibody to
hepatitis B (anti-HBs) is a marker of a positive response to the vaccine or previous illness
with hepatitis B. The other laboratory values indicate current infection with hepatitis B.
A patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. Which
action would the nurse take?
a. Schedule the patient for HCV genotype testing.
b. Administer the HCV vaccine and immune globulin.
c. Teach the patient about direct-acting antiviral treatment.
d. Explain that the infection will resolve over a few months. --CORRECT ANSWER--ANS:
A Genotyping of HCV has an important role in managing treatment and is done before drug
therapy is initiated. Because most patients with acute HCV infection convert to the chronic
state, the nurse should not teach the patient that the HCV will resolve in a few months.
Immune globulin or vaccine is not available for HCV. Direct-acting antiviral drugs are used
for chronic HCV infection.
Which topic would the nurse plan to teach the patient diagnosed with acute hepatitis B?
a. Administering a-interferon
b. Measures for improving appetite
c. Side effects of nucleotide analogs
d. Ways to increase activity and exercise --CORRECT ANSWER--ANS: B Maintaining
adequate nutritional intake is important for regeneration of hepatocytes. Interferon and
antivirals may be used for chronic hepatitis B, but they are not prescribed for acute hepatitis
B infection. Rest is recommended
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