Medical-Surgical Nursing, 10th Edition TEST BANK – Real Exam Questions
with 100% Verified Answers – LATEST UPDATED MAY 2025
Contents
Chapter 53: Concepts of Care for Patients With Liver Problems Ignatavicius....................................................... 2
Chapter 19: Concepts of Cancer Development Ignatavicius ................................................................................ 10
Chapter 12: Concepts of Disaster Preparedness Ignatavicius ............................................................................... 17
Chapter 10: Concepts of Emergency and Trauma Nursing Ignatavicius .............................................................. 24
Chapter 41: Critical Care of Patients With Neurologic Emergencies Ignatavicius .............................................. 32
Chapter 20: Concepts of Care for Patients With Cancer Ignatavicius .................................................................. 43
,Chapter 53: Concepts of Care for Patients With Liver Problems Ignatavicius
1. The nurse is caring for a client who has cirrhosis of the liver. Which risk factor is the leading
cause of cirrhosis?
a. Metabolic syndrome
b. Liver cancer
c. Nonalcoholic fatty liver disease
d. Hepatitis C-
ANS: D
Hepatitis C is the leading cause of cirrhosis and an also cause liver cancer. Clients with
nonalcoholic fatty liver disease often have metabolic syndrome and can also develop cirrhosis
2. The nurse is caring for a client who has cirrhosis of the liver. What nursing action is appropriate to help
control ascites?
a. Monitor intake and output.
b. Provide a low-sodium diet.
c. Increase oral fluid intake.
d. Weigh the patient daily-
ANS: B
A low-sodium diet is one means of controlling abdominal fluid collection. Monitoring intake
and output does not control fluid accumulation, nor does weighing the client. These interventions merely assess
or monitor the situation. Increasing fluid intake would not be helpful
3. The nurse assesses a client who is recovering from a paracentesis 1 hour ago. Which assessment finding
would require immediate action by the nurse?
a. Urine output via indwelling urinary catheter is 20 mL/hr
b. Blood pressure increases from 110/58 to 120/62 mm Hg
c. Respiratory rate decreases from 22 to 16 breaths/min
d. A decrease in the client's weight by 3 lb (1.4 kg-
ANS: A
,decreased abdominal pressure, which can contribute to hypovolemia. This can be manifested by a decrease in
urine output to below 30 mL/hr. A slight increase in systolic blood pressure is insignificant. A decrease in
respiratory rate indicates that breathing has been made easier by the procedure. The nurse would expect the
client's weight to drop as fluid is removed. To prevent hypovolemic shock, no more than 2000 mL are usually
removed from the abdomen at one time. The patient's weight typically only decreases by less than 2 kg or 4.4
lb.
4. The nurse is caring for a client who has a risk gene for developing cirrhosis. Which racial/ethnic group has
this gene most often?
a. Blacks
b. Asian/Pacific Islanders
c. Latinos
d. French-
ANS: C
The Patatin-like phospholipase domain containing 3 gene (PNPLA3) has been identified as a risk gene for
cirrhosis, which occurs most often in Latinos when compared to other populations
5. The nurse is caring for a client with hepatic portal-systemic encephalopathy (PSE). The client
is thin and cachectic, and the family expresses distress that the patient is receiving little
dietary protein. How would the nurse respond?
a. "A low-protein diet will help the liver rest and will restore liver function."
b. "Less protein in the diet will help prevent confusion associated with liver failure."
c. "Increasing dietary protein will help the patient gain weight and muscle mass."
d. "Low dietary protein is needed to prevent fluid from leaking into the abdomen."-
ANS: B
A low-protein diet is prescribed when serum ammonia levels increase and/or the client shows signs of PSE. A
low-protein diet helps reduce excessive breakdown of protein into ammonia by intestinal bacteria.
Encephalopathy is caused by excess ammonia. A low-protein diet has
no impact on restoring liver function. Increasing the patient's dietary protein will cause complications of liver
failure and would not be suggested. Increased intravascular protein will help prevent ascites, but clients with
liver failure are not able to effectively synthesize dietary protein
6. The nurse is caring for a client who is prescribed lactulose. The client states, "I do not want to take this
medication because it causes diarrhea." How would the nurse respond?
, a. "Diarrhea is expected; that's how your body gets rid of ammonia."
b. "You may take antidiarrheal medication to prevent loose stools."
c. "Do not take any more of the medication until your stools firm up."
d. "We will need to send a stool specimen to the laboratory as soon as possible."-
ANS: A
The purpose of administering lactulose to this patient is to help ammonia leave the circulatory system through
the colon. Lactulose draws water into the bowel with its high osmotic gradient, thereby producing a laxative
effect and subsequently evacuating ammonia from the bowel. The patient must understand that this is an
expected and therapeutic effect for him or her to remain compliant. The nurse would not suggest administering
anything that would decrease the excretion of ammonia or holding the medication. There is no need to send a
stool
specimen to the laboratory because diarrhea is the therapeutic response to this medication.
7. After teaching a client who has been diagnosed with hepatitis A, the nurse assesses the client's understanding.
Which statement by the client indicates correct understanding of the teaching?
a. "Some medications have been known to cause hepatitis A."
b. "I may have been exposed when we ate shrimp last weekend."
c. "I was infected with hepatitis A through a recent blood transfusion."
d. "My infection with Epstein-Barr virus can co-infect me with hepatitis A."-
ANS: B
The route of transmission for hepatitis A infection is through close personal contact or ingestion of
contaminated water or shellfish. Hepatitis A is not transmitted through medications, blood transfusions, or
Epstein-Barr virus. Toxic and drug-induced hepatitis is caused from exposure to hepatotoxins, but this is not a
form of hepatitis A. Hepatitis B can be
spread through blood transfusions. Epstein-Barr virus causes a secondary infection that is not associated with
hepatitis A.
8. 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
with 100% Verified Answers – LATEST UPDATED MAY 2025
Contents
Chapter 53: Concepts of Care for Patients With Liver Problems Ignatavicius....................................................... 2
Chapter 19: Concepts of Cancer Development Ignatavicius ................................................................................ 10
Chapter 12: Concepts of Disaster Preparedness Ignatavicius ............................................................................... 17
Chapter 10: Concepts of Emergency and Trauma Nursing Ignatavicius .............................................................. 24
Chapter 41: Critical Care of Patients With Neurologic Emergencies Ignatavicius .............................................. 32
Chapter 20: Concepts of Care for Patients With Cancer Ignatavicius .................................................................. 43
,Chapter 53: Concepts of Care for Patients With Liver Problems Ignatavicius
1. The nurse is caring for a client who has cirrhosis of the liver. Which risk factor is the leading
cause of cirrhosis?
a. Metabolic syndrome
b. Liver cancer
c. Nonalcoholic fatty liver disease
d. Hepatitis C-
ANS: D
Hepatitis C is the leading cause of cirrhosis and an also cause liver cancer. Clients with
nonalcoholic fatty liver disease often have metabolic syndrome and can also develop cirrhosis
2. The nurse is caring for a client who has cirrhosis of the liver. What nursing action is appropriate to help
control ascites?
a. Monitor intake and output.
b. Provide a low-sodium diet.
c. Increase oral fluid intake.
d. Weigh the patient daily-
ANS: B
A low-sodium diet is one means of controlling abdominal fluid collection. Monitoring intake
and output does not control fluid accumulation, nor does weighing the client. These interventions merely assess
or monitor the situation. Increasing fluid intake would not be helpful
3. The nurse assesses a client who is recovering from a paracentesis 1 hour ago. Which assessment finding
would require immediate action by the nurse?
a. Urine output via indwelling urinary catheter is 20 mL/hr
b. Blood pressure increases from 110/58 to 120/62 mm Hg
c. Respiratory rate decreases from 22 to 16 breaths/min
d. A decrease in the client's weight by 3 lb (1.4 kg-
ANS: A
,decreased abdominal pressure, which can contribute to hypovolemia. This can be manifested by a decrease in
urine output to below 30 mL/hr. A slight increase in systolic blood pressure is insignificant. A decrease in
respiratory rate indicates that breathing has been made easier by the procedure. The nurse would expect the
client's weight to drop as fluid is removed. To prevent hypovolemic shock, no more than 2000 mL are usually
removed from the abdomen at one time. The patient's weight typically only decreases by less than 2 kg or 4.4
lb.
4. The nurse is caring for a client who has a risk gene for developing cirrhosis. Which racial/ethnic group has
this gene most often?
a. Blacks
b. Asian/Pacific Islanders
c. Latinos
d. French-
ANS: C
The Patatin-like phospholipase domain containing 3 gene (PNPLA3) has been identified as a risk gene for
cirrhosis, which occurs most often in Latinos when compared to other populations
5. The nurse is caring for a client with hepatic portal-systemic encephalopathy (PSE). The client
is thin and cachectic, and the family expresses distress that the patient is receiving little
dietary protein. How would the nurse respond?
a. "A low-protein diet will help the liver rest and will restore liver function."
b. "Less protein in the diet will help prevent confusion associated with liver failure."
c. "Increasing dietary protein will help the patient gain weight and muscle mass."
d. "Low dietary protein is needed to prevent fluid from leaking into the abdomen."-
ANS: B
A low-protein diet is prescribed when serum ammonia levels increase and/or the client shows signs of PSE. A
low-protein diet helps reduce excessive breakdown of protein into ammonia by intestinal bacteria.
Encephalopathy is caused by excess ammonia. A low-protein diet has
no impact on restoring liver function. Increasing the patient's dietary protein will cause complications of liver
failure and would not be suggested. Increased intravascular protein will help prevent ascites, but clients with
liver failure are not able to effectively synthesize dietary protein
6. The nurse is caring for a client who is prescribed lactulose. The client states, "I do not want to take this
medication because it causes diarrhea." How would the nurse respond?
, a. "Diarrhea is expected; that's how your body gets rid of ammonia."
b. "You may take antidiarrheal medication to prevent loose stools."
c. "Do not take any more of the medication until your stools firm up."
d. "We will need to send a stool specimen to the laboratory as soon as possible."-
ANS: A
The purpose of administering lactulose to this patient is to help ammonia leave the circulatory system through
the colon. Lactulose draws water into the bowel with its high osmotic gradient, thereby producing a laxative
effect and subsequently evacuating ammonia from the bowel. The patient must understand that this is an
expected and therapeutic effect for him or her to remain compliant. The nurse would not suggest administering
anything that would decrease the excretion of ammonia or holding the medication. There is no need to send a
stool
specimen to the laboratory because diarrhea is the therapeutic response to this medication.
7. After teaching a client who has been diagnosed with hepatitis A, the nurse assesses the client's understanding.
Which statement by the client indicates correct understanding of the teaching?
a. "Some medications have been known to cause hepatitis A."
b. "I may have been exposed when we ate shrimp last weekend."
c. "I was infected with hepatitis A through a recent blood transfusion."
d. "My infection with Epstein-Barr virus can co-infect me with hepatitis A."-
ANS: B
The route of transmission for hepatitis A infection is through close personal contact or ingestion of
contaminated water or shellfish. Hepatitis A is not transmitted through medications, blood transfusions, or
Epstein-Barr virus. Toxic and drug-induced hepatitis is caused from exposure to hepatotoxins, but this is not a
form of hepatitis A. Hepatitis B can be
spread through blood transfusions. Epstein-Barr virus causes a secondary infection that is not associated with
hepatitis A.
8. 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
