RNSG-233 Adult Health exam questions with answers
2022
A nurse is performing an admission assessment of a patient with a diagnosis of
cirrhosis. What technique should the nurse use to palpate the patient's liver?
A) Place hand under the right lower abdominal quadrant 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 right side of the abdomen and push down
firmly. Ans: C
Feedback:
To palpate the liver, the examiner places one hand under the right lower rib cage
and presses downward with light pressure with the other hand. The liver is not on
the left side or in the right lower abdominal quadrant.
7. A triage nurse in the emergency department is assessing a patient who presented
with complaints of general malaise. Assessment reveals the presence of jaundice
and increased abdominal girth. What assessment question best addresses the
possible etiology of this patient's presentation?
A) “How many alcoholic drinks do you typically consume in a week?”
B) “To the best of your knowledge, are your immunizations up to date?”
C) “Have you ever worked in an occupation where you might have been exposed
to toxins?”
D) “Has anyone in your family ever experienced symptoms similar to yours?”
Ans: A
Feedback:
Signs or symptoms of hepatic dysfunction indicate a need to assess for alcohol use.
Immunization status, occupational risks, and family history are also relevant
,RNSG-233 Adult Health exam questions with answers
2022
considerations, but alcohol use is a more common etiologic factor in liver disease.
8. A nurse is participating in the emergency care of a patient who has just developed
variceal bleeding. What intervention should the nurse anticipate?
A) Infusion of intravenous heparin
B) IV administration of albumin
C) STAT administration of vitamin K by the intramuscular route
D) IV administration of octreotide (Sandostatin)
Ans: D
Feedback:
Octreotide (Sandostatin)—a synthetic analog of the hormone somatostatin—is
effective in decreasing bleeding from esophageal varices, and lacks the
vasoconstrictive effects of vasopressin. Because of this safety and efficacy profile,
octreotide is considered the preferred treatment regimen for immediate control of
variceal bleeding. Vitamin K and albumin are not administered and heparin would
exacerbate, not alleviate, bleeding.
Page 2
11. A participant in a health fair has asked the nurse about the role of drugs in liver
disease. What health promotion teaching has the most potential to prevent drug-
induced hepatitis?
A) Finish all prescribed courses of antibiotics, regardless of symptom resolution.
B) Adhere to dosing recommendations of OTC analgesics.
,RNSG-233 Adult Health exam questions with answers
2022
C) Ensure that expired medications are disposed of safely.
D) Ensure that pharmacists regularly review drug regimens for potential interactions.
Ans: B
Feedback:
Although any medication can affect liver function, use of acetaminophen (found in
many over-the-counter medications used to treat fever and pain) has been identified as
the leading cause of acute liver failure. Finishing prescribed antibiotics and avoiding
expired medications are unrelated to this disease. Drug interactions are rarely the cause
of drug-induced hepatitis.
14. A patient is being discharged after a liver transplant and the nurse is performing
discharge education. When planning this patient's continuing care, the nurse
should prioritize which of the following risk diagnoses?
A) Risk for Infection Related to Immunosuppressant Use
B) Risk for Injury Related to Decreased Hemostasis
C) Risk for Unstable Blood Glucose Related to Impaired Gluconeogenesis
D) Risk for Contamination Related to Accumulation of Ammonia
Ans: A
Feedback:
Infection is the leading cause of death after liver transplantation. Pulmonary and
fungal infections are common; susceptibility to infection is increased by the
immunosuppressive therapy that is needed to prevent rejection. This risk exceeds the
threats of injury and unstable blood glucose. The diagnosis of Risk for Contamination
relates to environmental toxin exposure.
Page 3
, RNSG-233 Adult Health exam questions with answers
2022
15. A patient with a liver mass is undergoing a percutaneous liver biopsy. What action
should the nurse perform when assisting with this procedure?
A) Position the patient on the right side with a pillow under the costal margin after
the procedure.
B) Administer 1 unit of albumin 90 minutes before the procedure as ordered.
C) Administer at least 1 unit of packed red blood cells as ordered the day before the
scheduled procedure.
D) Confirm that the patient's electrolyte levels have been assessed prior to the
procedure.
Ans: A
Feedback:
Immediately after a percutaneous liver biopsy, assist the patient to turn onto the right
side and place a pillow under the costal margin. Prior administration of albumin or
PRBCs is unnecessary. Coagulation tests should be performed, but electrolyte analysis
is not necessary.
17. A patient has developed hepatic encephalopathy secondary to cirrhosis and is
receiving care on the medical unit. The patient's current medication regimen
includes lactulose (Cephulac) four times daily. What desired outcome should the
nurse relate to this pharmacologic intervention?
A) Two to 3 soft bowel movements daily
B) Significant increase in appetite and food intake
C) Absence of nausea and vomiting
D) Absence of blood or mucus in stool
Ans: A
2022
A nurse is performing an admission assessment of a patient with a diagnosis of
cirrhosis. What technique should the nurse use to palpate the patient's liver?
A) Place hand under the right lower abdominal quadrant 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 right side of the abdomen and push down
firmly. Ans: C
Feedback:
To palpate the liver, the examiner places one hand under the right lower rib cage
and presses downward with light pressure with the other hand. The liver is not on
the left side or in the right lower abdominal quadrant.
7. A triage nurse in the emergency department is assessing a patient who presented
with complaints of general malaise. Assessment reveals the presence of jaundice
and increased abdominal girth. What assessment question best addresses the
possible etiology of this patient's presentation?
A) “How many alcoholic drinks do you typically consume in a week?”
B) “To the best of your knowledge, are your immunizations up to date?”
C) “Have you ever worked in an occupation where you might have been exposed
to toxins?”
D) “Has anyone in your family ever experienced symptoms similar to yours?”
Ans: A
Feedback:
Signs or symptoms of hepatic dysfunction indicate a need to assess for alcohol use.
Immunization status, occupational risks, and family history are also relevant
,RNSG-233 Adult Health exam questions with answers
2022
considerations, but alcohol use is a more common etiologic factor in liver disease.
8. A nurse is participating in the emergency care of a patient who has just developed
variceal bleeding. What intervention should the nurse anticipate?
A) Infusion of intravenous heparin
B) IV administration of albumin
C) STAT administration of vitamin K by the intramuscular route
D) IV administration of octreotide (Sandostatin)
Ans: D
Feedback:
Octreotide (Sandostatin)—a synthetic analog of the hormone somatostatin—is
effective in decreasing bleeding from esophageal varices, and lacks the
vasoconstrictive effects of vasopressin. Because of this safety and efficacy profile,
octreotide is considered the preferred treatment regimen for immediate control of
variceal bleeding. Vitamin K and albumin are not administered and heparin would
exacerbate, not alleviate, bleeding.
Page 2
11. A participant in a health fair has asked the nurse about the role of drugs in liver
disease. What health promotion teaching has the most potential to prevent drug-
induced hepatitis?
A) Finish all prescribed courses of antibiotics, regardless of symptom resolution.
B) Adhere to dosing recommendations of OTC analgesics.
,RNSG-233 Adult Health exam questions with answers
2022
C) Ensure that expired medications are disposed of safely.
D) Ensure that pharmacists regularly review drug regimens for potential interactions.
Ans: B
Feedback:
Although any medication can affect liver function, use of acetaminophen (found in
many over-the-counter medications used to treat fever and pain) has been identified as
the leading cause of acute liver failure. Finishing prescribed antibiotics and avoiding
expired medications are unrelated to this disease. Drug interactions are rarely the cause
of drug-induced hepatitis.
14. A patient is being discharged after a liver transplant and the nurse is performing
discharge education. When planning this patient's continuing care, the nurse
should prioritize which of the following risk diagnoses?
A) Risk for Infection Related to Immunosuppressant Use
B) Risk for Injury Related to Decreased Hemostasis
C) Risk for Unstable Blood Glucose Related to Impaired Gluconeogenesis
D) Risk for Contamination Related to Accumulation of Ammonia
Ans: A
Feedback:
Infection is the leading cause of death after liver transplantation. Pulmonary and
fungal infections are common; susceptibility to infection is increased by the
immunosuppressive therapy that is needed to prevent rejection. This risk exceeds the
threats of injury and unstable blood glucose. The diagnosis of Risk for Contamination
relates to environmental toxin exposure.
Page 3
, RNSG-233 Adult Health exam questions with answers
2022
15. A patient with a liver mass is undergoing a percutaneous liver biopsy. What action
should the nurse perform when assisting with this procedure?
A) Position the patient on the right side with a pillow under the costal margin after
the procedure.
B) Administer 1 unit of albumin 90 minutes before the procedure as ordered.
C) Administer at least 1 unit of packed red blood cells as ordered the day before the
scheduled procedure.
D) Confirm that the patient's electrolyte levels have been assessed prior to the
procedure.
Ans: A
Feedback:
Immediately after a percutaneous liver biopsy, assist the patient to turn onto the right
side and place a pillow under the costal margin. Prior administration of albumin or
PRBCs is unnecessary. Coagulation tests should be performed, but electrolyte analysis
is not necessary.
17. A patient has developed hepatic encephalopathy secondary to cirrhosis and is
receiving care on the medical unit. The patient's current medication regimen
includes lactulose (Cephulac) four times daily. What desired outcome should the
nurse relate to this pharmacologic intervention?
A) Two to 3 soft bowel movements daily
B) Significant increase in appetite and food intake
C) Absence of nausea and vomiting
D) Absence of blood or mucus in stool
Ans: A
