EAQ Liver Diseases Questions and Answers 2023
A client is admitted to the hospital with Laënnec cirrhosis and chronic pancreatitis. Bile
salts (bile acid factor) are prescribed, and the client asks why they are needed. What is
the nurse's best response?
1 "They stimulate prothrombin production."
2 "They aid absorption of fat-soluble vitamins."
3 "They promote bilirubin secretion in the urine."
4 "They help the common bile duct contract stronger."
Ans: 2
Bile salts are used to aid digestion of fats and absorption of the fat-soluble vitamins A,
D, E, and K. Bile salts are not involved in stimulating prothrombin production, in
promoting bilirubin secretion in the urine, or in stimulating contraction of the common
bile duct.
A client with a long history of alcohol abuse develops cirrhosis of the liver. The client
exhibits the presence of ascites. What does the nurse conclude is the most likely cause
of this client's ascites?
1 Impaired portal venous return
2 Impaired thoracic lymph channels
3 Excess production of serum albumin
4 Enhanced hepatic deactivation of aldosterone secretion
Ans: 1
The congested liver impairs venous return, leading to increased portal vein hydrostatic
pressure and an accumulation of fluid in the abdominal cavity. Although lymph channels
in the abdomen become congested, facilitating the leakage of plasma into the peritoneal
cavity, it is primarily the increased portal vein hydrostatic pressure that causes the
accumulation of fluid in the abdominal cavity. Increased serum albumin causes
hypervolemia, not ascites. As fluid is trapped in the peritoneal cavity, circulating blood
volume drops and aldosterone secretion increases, not decreases; aldosterone
secretion is related to the renin-angiotensin system.
A nurse is caring for a client who is admitted to the hospital with ascites and a diagnosis
of cirrhosis of the liver. What does the nurse conclude is the probable cause of ascites?
1 Impaired portal venous return
2 Inadequate secretion of bile salts
3 Excess production of serum albumin
4 Decreased interstitial osmotic pressure
Ans: 1
An enlarged liver impairs venous return, leading to an increased portal vein hydrostatic
pressure and a fluid shift into the abdominal cavity. Bile plays an important role in
digestion of fats, but it is not a major factor in fluid balance. Increased serum albumin
causes hypervolemia, not ascites. Ascites is not associated with the interstitial fluid
compartment.
, A client is admitted to the hospital with a diagnosis of cirrhosis of the liver. For which
assessment signs of hepatic encephalopathy should the nurse assess this client?
Select all that apply.
1 Mental confusion
2 Increased cholesterol
3 Brown-colored stools
4 Flapping hand tremors
5 Musty, sweet breath odor
Ans: 1,4,5
An accumulation of nitrogenous wastes affects the central nervous system, causing
mental confusion. An accumulation of nitrogenous wastes in hepatic encephalopathy
affects the nervous system. Flapping tremors and generalized twitching occur in the
second and third stages, respectively. Fetor hepaticus is the musty, sweet odor of the
client's breath. Increased cholesterol levels are not necessarily present. Stool is often
clay-colored because of lack of bile caused by biliary obstruction.
A nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations
should the nurse assess in the client? Select all that apply.
1 Ascites
2 Hunger
3 Pruritus
4 Jaundice
5 Headache
Ans: 1,3,4
Ascites is a result of portal hypertension that occurs with cirrhosis. Pruritus is common
because bile pigments seep into the skin from the bloodstream. Jaundice occurs
because the bile duct becomes obstructed and bile enters the bloodstream. The
appetite decreases because of the pressure on the abdominal organs from the ascites
and the liver's decreased ability to metabolize food. Headache is not a common
manifestation of cirrhosis of the liver.
A client is diagnosed as having the hepatitis B virus (HBV). The nurse reviews the
client's health history for possible situations in which exposure may have occurred.
Which event does the nurse determine is most likely the source of this infection?
1 Had a small tattoo on the arm three months ago
2 Assisted in the emergency birth of a baby two weeks ago
3 Worked for a month in an undeveloped area in Mexico four months ago
4 Attended an ecologic conference in a large urban center two months ago
Ans: 1
Any situation in which a needle is inserted under the skin is a potential source of
hepatitis; according to the Centers for Disease Control and Prevention, the range for the
incubation period is 45 to 180 days; however, the average incubation period is 60 to 90
days. The range for the incubation period is 45 to 180 days. Hepatitis B is not
transmitted via inadequate sanitation or a contaminated water supply. Hepatitis B is not
transmitted by casual proximity to others.
A client is admitted to the hospital with Laënnec cirrhosis and chronic pancreatitis. Bile
salts (bile acid factor) are prescribed, and the client asks why they are needed. What is
the nurse's best response?
1 "They stimulate prothrombin production."
2 "They aid absorption of fat-soluble vitamins."
3 "They promote bilirubin secretion in the urine."
4 "They help the common bile duct contract stronger."
Ans: 2
Bile salts are used to aid digestion of fats and absorption of the fat-soluble vitamins A,
D, E, and K. Bile salts are not involved in stimulating prothrombin production, in
promoting bilirubin secretion in the urine, or in stimulating contraction of the common
bile duct.
A client with a long history of alcohol abuse develops cirrhosis of the liver. The client
exhibits the presence of ascites. What does the nurse conclude is the most likely cause
of this client's ascites?
1 Impaired portal venous return
2 Impaired thoracic lymph channels
3 Excess production of serum albumin
4 Enhanced hepatic deactivation of aldosterone secretion
Ans: 1
The congested liver impairs venous return, leading to increased portal vein hydrostatic
pressure and an accumulation of fluid in the abdominal cavity. Although lymph channels
in the abdomen become congested, facilitating the leakage of plasma into the peritoneal
cavity, it is primarily the increased portal vein hydrostatic pressure that causes the
accumulation of fluid in the abdominal cavity. Increased serum albumin causes
hypervolemia, not ascites. As fluid is trapped in the peritoneal cavity, circulating blood
volume drops and aldosterone secretion increases, not decreases; aldosterone
secretion is related to the renin-angiotensin system.
A nurse is caring for a client who is admitted to the hospital with ascites and a diagnosis
of cirrhosis of the liver. What does the nurse conclude is the probable cause of ascites?
1 Impaired portal venous return
2 Inadequate secretion of bile salts
3 Excess production of serum albumin
4 Decreased interstitial osmotic pressure
Ans: 1
An enlarged liver impairs venous return, leading to an increased portal vein hydrostatic
pressure and a fluid shift into the abdominal cavity. Bile plays an important role in
digestion of fats, but it is not a major factor in fluid balance. Increased serum albumin
causes hypervolemia, not ascites. Ascites is not associated with the interstitial fluid
compartment.
, A client is admitted to the hospital with a diagnosis of cirrhosis of the liver. For which
assessment signs of hepatic encephalopathy should the nurse assess this client?
Select all that apply.
1 Mental confusion
2 Increased cholesterol
3 Brown-colored stools
4 Flapping hand tremors
5 Musty, sweet breath odor
Ans: 1,4,5
An accumulation of nitrogenous wastes affects the central nervous system, causing
mental confusion. An accumulation of nitrogenous wastes in hepatic encephalopathy
affects the nervous system. Flapping tremors and generalized twitching occur in the
second and third stages, respectively. Fetor hepaticus is the musty, sweet odor of the
client's breath. Increased cholesterol levels are not necessarily present. Stool is often
clay-colored because of lack of bile caused by biliary obstruction.
A nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations
should the nurse assess in the client? Select all that apply.
1 Ascites
2 Hunger
3 Pruritus
4 Jaundice
5 Headache
Ans: 1,3,4
Ascites is a result of portal hypertension that occurs with cirrhosis. Pruritus is common
because bile pigments seep into the skin from the bloodstream. Jaundice occurs
because the bile duct becomes obstructed and bile enters the bloodstream. The
appetite decreases because of the pressure on the abdominal organs from the ascites
and the liver's decreased ability to metabolize food. Headache is not a common
manifestation of cirrhosis of the liver.
A client is diagnosed as having the hepatitis B virus (HBV). The nurse reviews the
client's health history for possible situations in which exposure may have occurred.
Which event does the nurse determine is most likely the source of this infection?
1 Had a small tattoo on the arm three months ago
2 Assisted in the emergency birth of a baby two weeks ago
3 Worked for a month in an undeveloped area in Mexico four months ago
4 Attended an ecologic conference in a large urban center two months ago
Ans: 1
Any situation in which a needle is inserted under the skin is a potential source of
hepatitis; according to the Centers for Disease Control and Prevention, the range for the
incubation period is 45 to 180 days; however, the average incubation period is 60 to 90
days. The range for the incubation period is 45 to 180 days. Hepatitis B is not
transmitted via inadequate sanitation or a contaminated water supply. Hepatitis B is not
transmitted by casual proximity to others.
