Chapter 53: Concepts of Care for Patients
with Liver Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is caring for a client scheduled to have a transjugular intrahepatic portal-
systemic shunt (TIPS) procedure. What client assessment would the nurse perform
prior to this procedure?
a. Musculoskeletal assessment
b. Neurologic assessment
c. Mental health assessment
d. Cardiovascular assessment
ANS: D
A postprocedure complication of a TIPS procedure is right-sided heart failure.
Therefore, the nurse would perform a cardiovascular assessment before the procedure
to determine if the client has signs and symptoms of heart failure.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: TIPS, Complications MSC: Client Needs Category:
Physiological Integrity: Physiological Adaptation
2. The nurse is preparing to teach a client with chronic hepatitis B about lamivudine
therapy. What health teaching would the nurse include?
a. “Follow up on all appointments to monitor your lab values.”
b. “Do not take amiodorone at any time while on this drug.”
c. “Monitor for jaundice, rash, and itchy skin while on this drug.”
, d. “Report any changes in urinary elimination while on this drug.”
ANS: D
Lamivudine can cause renal impairment and the nurse would remind the client of
changes that may indicate kidney damage.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Hepatitis, Drug therapy MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse is teaching a client a client about taking elbasvir for hepatitis C. What
information in the client’s history would the nurse need prior to drug administration?
a. History of hepatitis B
b. History of kidney disease
c. History of cardiac disease
d. History of rectal bleeding
ANS: A
Elbasvir can cause liver toxicity and therefore the nurse would assess for a history of
or current hepatitis B.
DIF: Remembering TOP: Integrated Process: Teaching/Learning
KEY: Hepatitis, Drug therapy MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
4. A telehealth nurse speaks with a client who is recovering from a liver transplant 2
weeks ago. The client states, “I’m having right belly pain and have a temperature of
101° F (38.3° C).” How would the nurse respond?
a. “The anti-rejection drugs you are taking make you susceptible to infection.”
b. “You should go to the hospital immediately to get checked out.”
c. “You should take an additional dose of cyclosporine today.”
d. “Take acetaminophen every 4 hours until you feel better soon.”
with Liver Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is caring for a client scheduled to have a transjugular intrahepatic portal-
systemic shunt (TIPS) procedure. What client assessment would the nurse perform
prior to this procedure?
a. Musculoskeletal assessment
b. Neurologic assessment
c. Mental health assessment
d. Cardiovascular assessment
ANS: D
A postprocedure complication of a TIPS procedure is right-sided heart failure.
Therefore, the nurse would perform a cardiovascular assessment before the procedure
to determine if the client has signs and symptoms of heart failure.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: TIPS, Complications MSC: Client Needs Category:
Physiological Integrity: Physiological Adaptation
2. The nurse is preparing to teach a client with chronic hepatitis B about lamivudine
therapy. What health teaching would the nurse include?
a. “Follow up on all appointments to monitor your lab values.”
b. “Do not take amiodorone at any time while on this drug.”
c. “Monitor for jaundice, rash, and itchy skin while on this drug.”
, d. “Report any changes in urinary elimination while on this drug.”
ANS: D
Lamivudine can cause renal impairment and the nurse would remind the client of
changes that may indicate kidney damage.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Hepatitis, Drug therapy MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse is teaching a client a client about taking elbasvir for hepatitis C. What
information in the client’s history would the nurse need prior to drug administration?
a. History of hepatitis B
b. History of kidney disease
c. History of cardiac disease
d. History of rectal bleeding
ANS: A
Elbasvir can cause liver toxicity and therefore the nurse would assess for a history of
or current hepatitis B.
DIF: Remembering TOP: Integrated Process: Teaching/Learning
KEY: Hepatitis, Drug therapy MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
4. A telehealth nurse speaks with a client who is recovering from a liver transplant 2
weeks ago. The client states, “I’m having right belly pain and have a temperature of
101° F (38.3° C).” How would the nurse respond?
a. “The anti-rejection drugs you are taking make you susceptible to infection.”
b. “You should go to the hospital immediately to get checked out.”
c. “You should take an additional dose of cyclosporine today.”
d. “Take acetaminophen every 4 hours until you feel better soon.”
