Leigh
NUR445 Exam 5 – Cirrhosis, Hepatitis, Liver Cancer & Kidney Disorders | 40+
NCLEX Questions, Answers & Full Rationales
1. Which clinical manifestations are MOST consistent with cirrhosis?
A. Hypertension, polyuria, dry skin
B. Petechiae, jaundice, asterixis, ascites
C. Bradycardia, warm flushed skin
D. Hyperactivity, increased appetite
Answer: B
Rationale: Cirrhosis results in impaired liver function → decreased clotting →
petechiae/bleeding, inability to clear bilirubin → jaundice, increased ammonia →
asterixis, portal hypertension → ascites.
Other options are inconsistent with liver failure.
2. Which treatment is appropriate for managing ammonia levels in cirrhosis?
A. Ibuprofen
B. Omeprazole
C. Lactulose
D. Aluminum hydroxide
Answer: C
Rationale: Lactulose traps ammonia in stool → promotes excretion → prevents
encephalopathy.
NSAIDs and acetaminophen must be avoided due to hepatotoxicity.
3. Why is promoting rest essential for clients with cirrhosis?
A. Prevents aspiration
B. Prevents bleeding
C. Helps metabolize medications
D. Decreases metabolic and oxygen demands on the liver
,Leigh
Answer: D
Rationale: Rest reduces body demands, allowing the failing liver to function
without excessive stress.
4. Which medication is contraindicated in cirrhosis?
A. Furosemide
B. Acetaminophen
C. Lactulose
D. Spironolactone
Answer: B
Rationale: Acetaminophen and aspirin cannot be metabolized well by a damaged
liver → risk of toxicity & bleeding.
5. Asterixis is best described as which clinical finding?
A. Tremor when initiating movement
B. Flapping hand tremor when extending the wrist
C. Twitching of facial muscles
D. Repetitive jerking of extremities
Answer: B
Rationale: Asterixis = hallmark sign of hepatic encephalopathy due to elevated
ammonia.
6. Which lab findings indicate cirrhosis progression?
A. Decreased bilirubin, increased albumin
B. Elevated bilirubin, ALT, AST, ammonia
C. Increased platelets
D. Low INR
, Leigh
Answer: B
Rationale: Liver failure → cell death → release of enzymes → ↑ ALT/AST; ↓
bilirubin clearance; ↑ ammonia.
7. Which lab finding is expected to DECREASE in cirrhosis?
A. Bilirubin
B. AST
C. Albumin
D. Ammonia
Answer: C
Rationale: Impaired synthetic function of the liver → ↓ albumin →
ascites/edema.
8. Appropriate diet for cirrhosis with ascites and hepatic encephalopathy
includes:
A. High protein, high sodium
B. High protein, low calorie
C. Low sodium, low protein
D. Low carb, high potassium
Answer: C
Rationale:
Low sodium → reduces fluid retention
Low protein → reduces ammonia production
9. Early sign that ammonia levels are increasing in a cirrhosis patient:
NUR445 Exam 5 – Cirrhosis, Hepatitis, Liver Cancer & Kidney Disorders | 40+
NCLEX Questions, Answers & Full Rationales
1. Which clinical manifestations are MOST consistent with cirrhosis?
A. Hypertension, polyuria, dry skin
B. Petechiae, jaundice, asterixis, ascites
C. Bradycardia, warm flushed skin
D. Hyperactivity, increased appetite
Answer: B
Rationale: Cirrhosis results in impaired liver function → decreased clotting →
petechiae/bleeding, inability to clear bilirubin → jaundice, increased ammonia →
asterixis, portal hypertension → ascites.
Other options are inconsistent with liver failure.
2. Which treatment is appropriate for managing ammonia levels in cirrhosis?
A. Ibuprofen
B. Omeprazole
C. Lactulose
D. Aluminum hydroxide
Answer: C
Rationale: Lactulose traps ammonia in stool → promotes excretion → prevents
encephalopathy.
NSAIDs and acetaminophen must be avoided due to hepatotoxicity.
3. Why is promoting rest essential for clients with cirrhosis?
A. Prevents aspiration
B. Prevents bleeding
C. Helps metabolize medications
D. Decreases metabolic and oxygen demands on the liver
,Leigh
Answer: D
Rationale: Rest reduces body demands, allowing the failing liver to function
without excessive stress.
4. Which medication is contraindicated in cirrhosis?
A. Furosemide
B. Acetaminophen
C. Lactulose
D. Spironolactone
Answer: B
Rationale: Acetaminophen and aspirin cannot be metabolized well by a damaged
liver → risk of toxicity & bleeding.
5. Asterixis is best described as which clinical finding?
A. Tremor when initiating movement
B. Flapping hand tremor when extending the wrist
C. Twitching of facial muscles
D. Repetitive jerking of extremities
Answer: B
Rationale: Asterixis = hallmark sign of hepatic encephalopathy due to elevated
ammonia.
6. Which lab findings indicate cirrhosis progression?
A. Decreased bilirubin, increased albumin
B. Elevated bilirubin, ALT, AST, ammonia
C. Increased platelets
D. Low INR
, Leigh
Answer: B
Rationale: Liver failure → cell death → release of enzymes → ↑ ALT/AST; ↓
bilirubin clearance; ↑ ammonia.
7. Which lab finding is expected to DECREASE in cirrhosis?
A. Bilirubin
B. AST
C. Albumin
D. Ammonia
Answer: C
Rationale: Impaired synthetic function of the liver → ↓ albumin →
ascites/edema.
8. Appropriate diet for cirrhosis with ascites and hepatic encephalopathy
includes:
A. High protein, high sodium
B. High protein, low calorie
C. Low sodium, low protein
D. Low carb, high potassium
Answer: C
Rationale:
Low sodium → reduces fluid retention
Low protein → reduces ammonia production
9. Early sign that ammonia levels are increasing in a cirrhosis patient:
