Hepatitis and cirrhosis question and answer
1. A registered nurse is planning care for a patient who has end-stage cirrhosis of the liver with encephalopathy. Which
of the following interventions should the registered nurse plan to implement to decrease the patient's ammonia level?
A. Administer diuretics.
Rationale: Diuretics do not help to decrease ammonia levels.
B. Restrict the patient's intake of fluids.
Rationale: Restricting fluid intake does not help to decrease a patient's ammonia level.
C. Reduce the patient's intake of protein.
Rationale: Ammonia is formed in the gastrointestinal tract by the action of bacteria on protein. Limiting
dietary protein intake can assist with decreasing the patient's ammonia level. Protein is
necessary for healing, so strict limitation of dietary protein is not recommended.
D. Administer vitamin K.
Rationale: Vitamin K does not help to decrease a patient's ammonia level.
2. A registered nurse is teaching a community education course about the physical complications related to substance
use disorder. Which of the following findings should the registered nurse identify as the primary cause of liver
cirrhosis?
A. Alcohol
Rationale: Chronic alcohol use disorder is one of the primary causes of cirrhosis of the liver.
B. Caffeine
Rationale: Chronic ingestion of caffeine can finding in many physical complications; however, it is not
associated with liver cirrhosis.
C. Cocaine
Rationale: Cocaine can finding in many physical complications; however, it is not associated with liver
cirrhosis.
D. Inhalants
Rationale: Inhalants can finding in many physical complications; however, they are not associated with liver
cirrhosis.
3. A registered nurse is reviewing the laboratory findings of a patient who has liver failure with ascites and is receiving
spironolactone. Which of the following findings should the registered nurse expect?
A. Decreased sodium level
Rationale: The registered nurse should expect a decreased sodium level. Spironolactone is a potassium-
sparing
Created on:03/15/2020 Page 1
, Hepatitis and cirrhosis question and answer
diuretic that inhibits the action of aldosterone, findinging in an increased excretion of sodium.
B. Decreased phosphate level
Rationale: The registered nurse should not expect a decreased phosphate level. Spironolactone inhibits the
action of aldosterone, findinging in the retention of phosphate.
C. Decreased potassium level
Rationale: The registered nurse should not expect a decreased potassium level. Spironolactone is a
potassium-sparing diuretic that inhibits the action of aldosterone, findinging in the retention of
potassium.
D. Decreased chloride level
Rationale: The registered nurse should not expect a decreased chloride level. Spironolactone is a potassium-
sparing diuretic that inhibits the action of aldosterone, findinging in the retention of chloride.
4. A registered nurse is caring for a patient who has liver cirrhosis with ascites, bleeding esophageal varices, and
portal hypertension. The registered nurse recognizes which of the following laboratory findings as indicating the
patient’s gastrointestinal (GI) tract is digesting and absorbing blood?
A. Elevated blood urea nitrogen (BUN)
Rationale: As the body digests blood, BUN rises. An elevated BUN is an indication of GI bleeding.
B. Elevated HbA1c
Rationale: Chronic blood loss can lower HbA1c and alcohol toxicity can raise it. But digestion of blood does
not elevate it.
C. Decreased chloride
Rationale: Neither liver disease nor GI bleeding affects chloride levels, although severe vomiting and GI
suction can decrease chloride levels.
D. Decreased bilirubin
Rationale: Bilirubin levels rise with cirrhosis and with hemolysis of red blood cells.
5. A registered nurse is caring for a patient who has cirrhosis and has a prescription for bumetanide. When delivering
the patient's lunch tray, which of the following items should the registered nurse identify as contraindicated for the
patient?
A. Baked potato
Rationale: The patient who has cirrhosis requires a diet that is high in carbohydrates. A baked potato
contains 33.62 g of carbohydrates.
B. Stewed tomatoes
Rationale: Patients who are prescribed loop diuretics such as bumetanide are at risk for potassium
Created on:03/15/2020 Page 2
1. A registered nurse is planning care for a patient who has end-stage cirrhosis of the liver with encephalopathy. Which
of the following interventions should the registered nurse plan to implement to decrease the patient's ammonia level?
A. Administer diuretics.
Rationale: Diuretics do not help to decrease ammonia levels.
B. Restrict the patient's intake of fluids.
Rationale: Restricting fluid intake does not help to decrease a patient's ammonia level.
C. Reduce the patient's intake of protein.
Rationale: Ammonia is formed in the gastrointestinal tract by the action of bacteria on protein. Limiting
dietary protein intake can assist with decreasing the patient's ammonia level. Protein is
necessary for healing, so strict limitation of dietary protein is not recommended.
D. Administer vitamin K.
Rationale: Vitamin K does not help to decrease a patient's ammonia level.
2. A registered nurse is teaching a community education course about the physical complications related to substance
use disorder. Which of the following findings should the registered nurse identify as the primary cause of liver
cirrhosis?
A. Alcohol
Rationale: Chronic alcohol use disorder is one of the primary causes of cirrhosis of the liver.
B. Caffeine
Rationale: Chronic ingestion of caffeine can finding in many physical complications; however, it is not
associated with liver cirrhosis.
C. Cocaine
Rationale: Cocaine can finding in many physical complications; however, it is not associated with liver
cirrhosis.
D. Inhalants
Rationale: Inhalants can finding in many physical complications; however, they are not associated with liver
cirrhosis.
3. A registered nurse is reviewing the laboratory findings of a patient who has liver failure with ascites and is receiving
spironolactone. Which of the following findings should the registered nurse expect?
A. Decreased sodium level
Rationale: The registered nurse should expect a decreased sodium level. Spironolactone is a potassium-
sparing
Created on:03/15/2020 Page 1
, Hepatitis and cirrhosis question and answer
diuretic that inhibits the action of aldosterone, findinging in an increased excretion of sodium.
B. Decreased phosphate level
Rationale: The registered nurse should not expect a decreased phosphate level. Spironolactone inhibits the
action of aldosterone, findinging in the retention of phosphate.
C. Decreased potassium level
Rationale: The registered nurse should not expect a decreased potassium level. Spironolactone is a
potassium-sparing diuretic that inhibits the action of aldosterone, findinging in the retention of
potassium.
D. Decreased chloride level
Rationale: The registered nurse should not expect a decreased chloride level. Spironolactone is a potassium-
sparing diuretic that inhibits the action of aldosterone, findinging in the retention of chloride.
4. A registered nurse is caring for a patient who has liver cirrhosis with ascites, bleeding esophageal varices, and
portal hypertension. The registered nurse recognizes which of the following laboratory findings as indicating the
patient’s gastrointestinal (GI) tract is digesting and absorbing blood?
A. Elevated blood urea nitrogen (BUN)
Rationale: As the body digests blood, BUN rises. An elevated BUN is an indication of GI bleeding.
B. Elevated HbA1c
Rationale: Chronic blood loss can lower HbA1c and alcohol toxicity can raise it. But digestion of blood does
not elevate it.
C. Decreased chloride
Rationale: Neither liver disease nor GI bleeding affects chloride levels, although severe vomiting and GI
suction can decrease chloride levels.
D. Decreased bilirubin
Rationale: Bilirubin levels rise with cirrhosis and with hemolysis of red blood cells.
5. A registered nurse is caring for a patient who has cirrhosis and has a prescription for bumetanide. When delivering
the patient's lunch tray, which of the following items should the registered nurse identify as contraindicated for the
patient?
A. Baked potato
Rationale: The patient who has cirrhosis requires a diet that is high in carbohydrates. A baked potato
contains 33.62 g of carbohydrates.
B. Stewed tomatoes
Rationale: Patients who are prescribed loop diuretics such as bumetanide are at risk for potassium
Created on:03/15/2020 Page 2
