GI Alterations NCLEX Questions and answers completed and graded A+

Which of the following symptoms during the icteric phase of viral hepatitis should the nurse expect the client to exhibit? A. Watery stool B. Yellow sclera C. Tarry stool D. Shortness of breath B. Yellow sclera Rationale: Liver inflammation and obstruction block the normal flow of bile. Excess bilirubin turns the skin and sclera yellow and the urine dark and frothy. A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response? A. "You may have eaten contaminated restaurant food." B. "You could have gotten it by using I.V. drugs." C. "You must have received an infected blood transfusion." D. "You probably got it by engaging in unprotected sex." A. "You may have eaten contaminated restaurant food." Rationale: Hepatitis A virus typically is transmitted by the oral-fecal route — commonly by consuming food contaminated by infected food handlers. The virus isn't transmitted by the I.V. route, blood transfusions, or unprotected sex. Hepatitis B can be transmitted by I.V. drug use or blood transfusion. Hepatitis C can be transmitted by unprotected sex. 00:07 01:08 A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are: A. Whole blood and albumin. B. Platelets and packed red blood cells. C. Fresh frozen plasma and whole blood. D. Cryoprecipitate and fresh frozen plasma. D. Cryoprecipitate and fresh frozen plasma. The liver is vital in the synthesis of clotting factors, so when it's diseased or dysfunctional, as in hepatitis C, bleeding occurs. Treatment consists of administering blood products that aid clotting. These include fresh frozen plasma containing fibrinogen and cryoprecipitate, which have most of the clotting factors. Although administering whole blood, albumin, and packed cells will contribute to hemostasis, those products aren't specifically used to treat hemostasis. Platelets are helpful, but the best answer is cryoprecipitate and fresh frozen plasma. Tony was diagnosed with hepatitis A. The information from the health history that is most likely linked to hepatitis A is: A. Exposed with arsenic compounds at work B. Working as local plumber C. Working at hemodialysis clinic D. Dish washer in restaurants B. Working as a local plumber Rationale: Hepatitis A is primarily spread via fecal-oral route. Sewage polluted water may harbor the virus. Dr. Smith has determined that the client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D A. Hepatitis A Rationale: Hepatitis A is transmitted by the fecal-oral route via contaminated food or infected food handlers. Hepatitis B, C, and D are transmitted most commonly via infected blood or body fluids. Tiffany Black is diagnosed with type A hepatitis. What special precautions should the nurse take when caring for this patient? A. Put on a mask and gown before entering the patient's room. B. Wear gloves and a gown when removing the patient's bedpan. C. Prevent the droplet spread of the organism. D. Use caution when bringing food to the patient. B. Wear gloves and a gown when removing the patient's bedpan. Rationale: The nurse should wear gloves and a gown when removing the patient's bedpan because the type A hepatitis virus occurs in stools. It may also occur in blood, nasotracheal secretions, and urine. Type A hepatitis isn't transmitted through the air by way of droplets. Special precautions aren't needed when feeding the patient, but disposable utensils should be used. A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis? A. Elevated hemoglobin level B. Elevated serum bilirubin level C. Elevated blood urea nitrogen level D. Decreased erythrocycle sedimentation rate B. Elevated serum bilirubin level Rationale: Laboratory indicators of hepatitis include elevated liver enzyme levels, elevated serum bilirubin levels, elevated erythrocyte sedimentation rates, and leukopenia. An elevated blood urea nitrogen level may indicate renal dysfunction. A hemoglobin level is unrelated to this diagnosis. A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note: A. Severe abdominal pain radiating to the shoulder. B. Anorexia, nausea, and vomiting. C. Eructation and constipation. D. Abdominal ascites. B. Anorexia, nausea and vomiting. Rationale: Hallmark signs and symptoms of hepatitis A include anorexia, nausea, vomiting, fatigue, and weakness. Abdominal pain may occur but doesn't radiate to the shoulder. Eructation and constipation are common in gallbladder disease, not hepatitis A. Abdominal ascites is a sign of advanced hepatic disease, not an early sign of hepatitis A. Nurse Rachel teaches a client who has been recently diagnosed with hepatitis A about untoward signs and symptoms related to Hepatitis that may develop. The one that should be reported immediately to the physician is: A. Restlessness B. Yellow urine C. Nausea D. Clay- colored stools C. Clay colored stools Rationale: Clay colored stools are indicative of hepatic obstruction. Which of the following is not a specific element of Hepatitis C? A. Vaccine available B. May be transmitted with sexual contact C. Inflammation of the liver D. Lifetime carrier A. Vaccine available A client is hospitalized with hepatitis A. Which of the client's regular medications is contraindicated due to the current illness? A. Prilosec (omeprazole) B. Synthroid (levothyroxine) C. Premarin (conjugated estrogens) D. Lipitor (atorvastatin) D. Lipitor (atorvastatin) Rationale: Lipid-lowering agents are contraindicated in the client with active liver disease. Answers A, B, and C are incorrect because they are not contraindicated in the client with active liver disease. In the United States, nurses performing invasive procedures need to be up-to-date with their immunizations, particularly A. Hepatitis E. B. Hepatitis A. C. Hepatitis C. D. Hepatitis B. D. Hepatitis B. Rationale: Hepatitis B is transmitted through contact with infected blood or plasma.