Health and healing IV Test 3 PART 1 Questions With
Complete Solutions
The nurse is caring for a patient with cirrhosis who has 4+
pitting edema of the feet and legs. Which of the following
assessments is priority for the nurse to monitor?
a. Hemoglobin
b. Temperature
c. Activity level
d. Albumin
d. Albumin
The nurse is preparing a teaching plan for a young adult patient
who is diagnosed with early alcoholic cirrhosis. Which of the
following topics is most important to include in patient
teaching?
a. Need to abstain from alcohol
b. Use of vitamin B supplements
c. Maintenance of a nutritious diet
d. Treatment with lactulose
a. Need to abstain from alcohol
The nurse is caring for a patient with cirrhosis who has
scheduled doses of spironolactone and furosemide and has a
serum potassium level of 3.2 mmol/L. Which of the following
actions should the nurse take?
a. Give both drugs as scheduled.
b. Administer the spironolactone.
,c. Administer the furosemide and withhold the spironolactone.
d. Withhold both drugs until talking with the health care
provider
b. Administer the spironolactone.
Which of the following actions should the nurse implement to
evaluate the effectiveness of treatment for a patient who has
hepatic encephalopathy?
a. Request that the patient stand on one foot.
b. Ask the patient to extend both arms to the front.
c. Instruct the patient to perform the Valsalva manoeuvre.
d. Have the patient walk a few steps with the eyes closed.
b. Ask the patient to extend both arms to the front.
The nurse is caring for a patient who has advanced cirrhosis and
is receiving lactulose. Which of the following findings by the
nurse indicates that the medication is effective?
a. The patient is alert and oriented.
b. The patient denies nausea or anorexia.
c. The patient's bilirubin level decreases.
d. The patient has at least one stool daily.
a. The patient is alert and oriented.
Which of the following nursing actions should be included in the
plan of care for a patient who is being treated for bleeding
esophageal varices with balloon tamponade using a device such
as a Blakemore tube?
a. Monitor the patient for shortness of breath.
b. Encourage the patient to cough every 4 hours.
,c. Deflate the gastric balloon every 8-12 hours.
d. Verify the position of the balloon every 6 hours.
a. Monitor the patient for shortness of breath.
The nurse is caring for a patient with severe cirrhosis who has an
episode of bleeding esophageal varices. Which of the following
laboratory tests should the nurse monitor to detect possible
complications of the bleeding episode
a. Bilirubin
b. Ammonia
c. Potassium
d. Prothrombin time
b. Ammonia
Which of the following nursing actions should be included in the
plan of care for a patient with cirrhosis who has ascites and 4+
edema of the feet and legs?
a. Weekly weight of patient.
b. Reposition the patient every 4 hours.
c. Restrict sodium intake.
d. Perform passive range-of-motion QID.
c. Restrict sodium intake.
The nurse is caring for a patient who has had a transjugular
intrahepatic portosystemic shunt (TIPS) placement. Which of
the following indicate that the procedure has been effective?
a. Lower indirect bilirubin level
b. Increase in serum albumin level
, c. Decrease in episodes of variceal bleeding
d. Improvement in alertness and orientation
c. Decrease in episodes of variceal bleeding
The health care provider plans a paracentesis for a patient with
ascites caused by liver cancer. Which of the following actions
should the nurse implement to prepare the patient for the
procedure?
a. Place the patient on NPO status.
b. Assist the patient to lie flat in bed.
c. Ask the patient to empty the bladder.
d. Position the patient on the right side.
c. Ask the patient to empty the bladder.
The nurse is assessing a patient who had a liver transplant a
week previously and obtains the following data. Which of the
following findings is most important to communicate to the
health care provider?
a. Dry lips and oral mucosa
b. Crackles at both lung bases
c. Temperature 38.2°C (100.8°F)
d. No bowel movement for 4 days
c. Temperature 38.2°C (100.8°F)
Which of the following laboratory test results is most important
for the nurse to monitor when evaluating the effects of therapy
for a patient who has acute pancreatitis?
a. Calcium
b. Bilirubin
Complete Solutions
The nurse is caring for a patient with cirrhosis who has 4+
pitting edema of the feet and legs. Which of the following
assessments is priority for the nurse to monitor?
a. Hemoglobin
b. Temperature
c. Activity level
d. Albumin
d. Albumin
The nurse is preparing a teaching plan for a young adult patient
who is diagnosed with early alcoholic cirrhosis. Which of the
following topics is most important to include in patient
teaching?
a. Need to abstain from alcohol
b. Use of vitamin B supplements
c. Maintenance of a nutritious diet
d. Treatment with lactulose
a. Need to abstain from alcohol
The nurse is caring for a patient with cirrhosis who has
scheduled doses of spironolactone and furosemide and has a
serum potassium level of 3.2 mmol/L. Which of the following
actions should the nurse take?
a. Give both drugs as scheduled.
b. Administer the spironolactone.
,c. Administer the furosemide and withhold the spironolactone.
d. Withhold both drugs until talking with the health care
provider
b. Administer the spironolactone.
Which of the following actions should the nurse implement to
evaluate the effectiveness of treatment for a patient who has
hepatic encephalopathy?
a. Request that the patient stand on one foot.
b. Ask the patient to extend both arms to the front.
c. Instruct the patient to perform the Valsalva manoeuvre.
d. Have the patient walk a few steps with the eyes closed.
b. Ask the patient to extend both arms to the front.
The nurse is caring for a patient who has advanced cirrhosis and
is receiving lactulose. Which of the following findings by the
nurse indicates that the medication is effective?
a. The patient is alert and oriented.
b. The patient denies nausea or anorexia.
c. The patient's bilirubin level decreases.
d. The patient has at least one stool daily.
a. The patient is alert and oriented.
Which of the following nursing actions should be included in the
plan of care for a patient who is being treated for bleeding
esophageal varices with balloon tamponade using a device such
as a Blakemore tube?
a. Monitor the patient for shortness of breath.
b. Encourage the patient to cough every 4 hours.
,c. Deflate the gastric balloon every 8-12 hours.
d. Verify the position of the balloon every 6 hours.
a. Monitor the patient for shortness of breath.
The nurse is caring for a patient with severe cirrhosis who has an
episode of bleeding esophageal varices. Which of the following
laboratory tests should the nurse monitor to detect possible
complications of the bleeding episode
a. Bilirubin
b. Ammonia
c. Potassium
d. Prothrombin time
b. Ammonia
Which of the following nursing actions should be included in the
plan of care for a patient with cirrhosis who has ascites and 4+
edema of the feet and legs?
a. Weekly weight of patient.
b. Reposition the patient every 4 hours.
c. Restrict sodium intake.
d. Perform passive range-of-motion QID.
c. Restrict sodium intake.
The nurse is caring for a patient who has had a transjugular
intrahepatic portosystemic shunt (TIPS) placement. Which of
the following indicate that the procedure has been effective?
a. Lower indirect bilirubin level
b. Increase in serum albumin level
, c. Decrease in episodes of variceal bleeding
d. Improvement in alertness and orientation
c. Decrease in episodes of variceal bleeding
The health care provider plans a paracentesis for a patient with
ascites caused by liver cancer. Which of the following actions
should the nurse implement to prepare the patient for the
procedure?
a. Place the patient on NPO status.
b. Assist the patient to lie flat in bed.
c. Ask the patient to empty the bladder.
d. Position the patient on the right side.
c. Ask the patient to empty the bladder.
The nurse is assessing a patient who had a liver transplant a
week previously and obtains the following data. Which of the
following findings is most important to communicate to the
health care provider?
a. Dry lips and oral mucosa
b. Crackles at both lung bases
c. Temperature 38.2°C (100.8°F)
d. No bowel movement for 4 days
c. Temperature 38.2°C (100.8°F)
Which of the following laboratory test results is most important
for the nurse to monitor when evaluating the effects of therapy
for a patient who has acute pancreatitis?
a. Calcium
b. Bilirubin
