NURS 241 Exam 4- Cirrhosis, Liver
Cancer, Drug & Alcohol Abuse Exam
Questions With Correct Answers
Put the following pathophysiological conditions in order from least severe to most
| | | | | | | | | | |
severe:
|
____ Cirrhosis
|
____ Hepatitis
|
____ Liver cancer
| |
____ NAFLD/FLD - CORRECT ANSWER✔✔-__3__ Cirrhosis
| | | | |
__2__ Hepatitis |
__4__ Liver cancer
| |
__1__ NAFLD/FLD |
1) Fatty liver condition, either alcoholic or not are common and not life
| | | | | | | | | | | | |
threatening. Fatty liver can also be related to diet and obesity and can be
| | | | | | | | | | | | | |
reversed by controlling their cause. They have no symptoms and cannot be
| | | | | | | | | | | |
detected by labs or physical assessment
| | | | |
2) Hepatitis is an inflammatory condition that irritates the liver. Hepatitis can be
| | | | | | | | | | | | |
caused by food/water/feces (A & E), by a virus ( B, C & D) or can be autoimmune
| | | | | | | | | | | | | | | | | |
(body turning on itself) can be caused by medications such as
| | | | | | | | | | |
minocycline,nitrofurantoin, hydralazine, methyldopa, statins, fenofibrate, alpha | | | | | |
and betainterferon, infliximab and etanercept.
| | | | |
3) Cirrhosis is the progressive scarring and fibrosis after chronic irritation. The
| | | | | | | | | | | |
number one cause of cirrhosis is alcoholism. It is largely irreversible.
| | | | | | | | | | |
,4) Liver cancer is the progressive degeneration of the liver cells that lose shape,
| | | | | | | | | | | | | |
organization, and function. Such cells, lacking differentiation, tend to go 'rogue'
| | | | | | | | | | |
and become cancerous. It is hard to treat. Transplantation may help to restore
| | | | | | | | | | | | |
function.
Match the liver malfunction with its assessment finding:
| | | | | | |
____ Hepatic encephalopathy
| |
____ Medication toxicity
| |
____ Jaundice
|
____ PT 6, INR 15
| | | |
____ Folic acid deficiency
| | |
____ Central obesity and round face
| | | | |
1. Hormonal dysregulation
| |
2.Clotting dysfunction |
3.Lack of vitamin storage
| | |
4.Lack of processing and excreting of ammonia
| | | | | |
5.Inability to conjugate/excrete bilirubin
| | |
6.Inability to reduce drug levels - CORRECT ANSWER✔✔-__4__ Hepatic
| | | | | | | | |
encephalopathy
__6__ Medication toxicity
| |
__5__ Jaundice|
__2__ PT 6, INR 15
| | | |
__3__ Folic acid deficiency
| | |
,__1__ Central obesity and round face
| | | | |
The nurse knows that which of the following is the most likely presentation of
| | | | | | | | | | | | | |
Grade II hepatic encepalopathy?
| | |
a) Tremor and dyscoordination
| | |
b) Somnolence and/or aggression
| | |
c) Gross personality changes
| | |
d) Euphoria or anxiety
| | |
e) Abnormal changes in neuropsychological tests - CORRECT ANSWER✔✔-c)
| | | | | | | | |
Gross personality changes
| |
*This is a reminder to review the Bager article! In general I want you to know
| | | | | | | | | | | | | | | |
what there are different grades of encephalopathy, and in what direction does 0-
| | | | | | | | | | | |
4 go. There is a danger with organic cognitive changes that nurses could think
| | | | | | | | | | | | | |
their patient is just being a jerk, when actually their body chemistry could be
| | | | | | | | | | | | | |
subtly changing. Also read about lactulose use and administration in this article
| | | | | | | | | | | |
and know what a TIPS procedure is (also detailed in Iggy, use both sources).
| | | | | | | | | | | | |
The nurse assesses the following stool for a patient. Charting this finding
| | | | | | | | | | | |
accurately in the electronic medical record may include which of the following
| | | | | | | | | | | |
terminology choices? |
A) Melena, hematuria, hemorrhage
| | |
B) Hyperviscosity, hemmorrhage, black, tarry
| | | |
C) Melena, asterixis, hemmorrhage
| | |
D) Melena, black, tarry, sticky, hematochezia - CORRECT ANSWER✔✔-D) Melena,
| | | | | | | | | |
black, tarry, sticky, hematochezia
| | | |
, *This contains the best choices to describe this stool. Tarry and sticky are correct
| | | | | | | | | | | | | |
and refer to the consistency, which the nurse can check with a tongue blade.
| | | | | | | | | | | | | |
Hematochezia usually describes frank/obvious/ red blood, and can describe stool,
| | | | | | | | |
although usually is in contrast to the blackness of melena.Stool this color and
| | | | | | | | | | | | | |
consistency should be confirmed for blood by sending a specimen to the lab.
| | | | | | | | | | | |
-ALK. PHOSPHATASE: 178 H (30-120U/L)
| | | |
-BILIRUBIN - TOTAL: 1.4 H (0.2-1.2MG/DL)
| | | | |
-Unconjugated/indirect Bilirubin: 1.2 H (0.2-0.8MG/DL) | | | |
-Conjugated/ direct Bilirubin: 0.4 H (0.1-0.3MG/DL)
| | | | |
-TOTAL PROTEIN: 8.8 H (6.0-8.0G/DL)
| | | |
-ALBUMIN: 6.6 H(3.6-5.0G/DL)| |
-GLUCOSE: 55 L (65-99MG/DL) | | |
-AST (SGOT): 107 H (10-40 U/L)
| | | | |
-ALT (SGPT): 68 H (2-45 U/L)
| | | | |
-SODIUM 143 (135-145 MEQ/L)
| | |
-POTASSIUM 3.5 (3.5-4.9 MEQ/L) | | |
-AMMONIA 105 H (15-45 MCG/DL) | | | |
-CHLORIDE 96 (96-110 MEQ/L) | | |
-LACTATE 3.5 H (0.5-1 Mmol/l)
| | | |
-PLATELETS 120 L (150K-450K /MIC.L)
| | | |
-Anti Nuclear Antibody 20:60 H (1:40 to 1:60 titer)
| | | | | | | |
-FIBRINOGEN 100 (150-400 MG/DL) | | |
Cancer, Drug & Alcohol Abuse Exam
Questions With Correct Answers
Put the following pathophysiological conditions in order from least severe to most
| | | | | | | | | | |
severe:
|
____ Cirrhosis
|
____ Hepatitis
|
____ Liver cancer
| |
____ NAFLD/FLD - CORRECT ANSWER✔✔-__3__ Cirrhosis
| | | | |
__2__ Hepatitis |
__4__ Liver cancer
| |
__1__ NAFLD/FLD |
1) Fatty liver condition, either alcoholic or not are common and not life
| | | | | | | | | | | | |
threatening. Fatty liver can also be related to diet and obesity and can be
| | | | | | | | | | | | | |
reversed by controlling their cause. They have no symptoms and cannot be
| | | | | | | | | | | |
detected by labs or physical assessment
| | | | |
2) Hepatitis is an inflammatory condition that irritates the liver. Hepatitis can be
| | | | | | | | | | | | |
caused by food/water/feces (A & E), by a virus ( B, C & D) or can be autoimmune
| | | | | | | | | | | | | | | | | |
(body turning on itself) can be caused by medications such as
| | | | | | | | | | |
minocycline,nitrofurantoin, hydralazine, methyldopa, statins, fenofibrate, alpha | | | | | |
and betainterferon, infliximab and etanercept.
| | | | |
3) Cirrhosis is the progressive scarring and fibrosis after chronic irritation. The
| | | | | | | | | | | |
number one cause of cirrhosis is alcoholism. It is largely irreversible.
| | | | | | | | | | |
,4) Liver cancer is the progressive degeneration of the liver cells that lose shape,
| | | | | | | | | | | | | |
organization, and function. Such cells, lacking differentiation, tend to go 'rogue'
| | | | | | | | | | |
and become cancerous. It is hard to treat. Transplantation may help to restore
| | | | | | | | | | | | |
function.
Match the liver malfunction with its assessment finding:
| | | | | | |
____ Hepatic encephalopathy
| |
____ Medication toxicity
| |
____ Jaundice
|
____ PT 6, INR 15
| | | |
____ Folic acid deficiency
| | |
____ Central obesity and round face
| | | | |
1. Hormonal dysregulation
| |
2.Clotting dysfunction |
3.Lack of vitamin storage
| | |
4.Lack of processing and excreting of ammonia
| | | | | |
5.Inability to conjugate/excrete bilirubin
| | |
6.Inability to reduce drug levels - CORRECT ANSWER✔✔-__4__ Hepatic
| | | | | | | | |
encephalopathy
__6__ Medication toxicity
| |
__5__ Jaundice|
__2__ PT 6, INR 15
| | | |
__3__ Folic acid deficiency
| | |
,__1__ Central obesity and round face
| | | | |
The nurse knows that which of the following is the most likely presentation of
| | | | | | | | | | | | | |
Grade II hepatic encepalopathy?
| | |
a) Tremor and dyscoordination
| | |
b) Somnolence and/or aggression
| | |
c) Gross personality changes
| | |
d) Euphoria or anxiety
| | |
e) Abnormal changes in neuropsychological tests - CORRECT ANSWER✔✔-c)
| | | | | | | | |
Gross personality changes
| |
*This is a reminder to review the Bager article! In general I want you to know
| | | | | | | | | | | | | | | |
what there are different grades of encephalopathy, and in what direction does 0-
| | | | | | | | | | | |
4 go. There is a danger with organic cognitive changes that nurses could think
| | | | | | | | | | | | | |
their patient is just being a jerk, when actually their body chemistry could be
| | | | | | | | | | | | | |
subtly changing. Also read about lactulose use and administration in this article
| | | | | | | | | | | |
and know what a TIPS procedure is (also detailed in Iggy, use both sources).
| | | | | | | | | | | | |
The nurse assesses the following stool for a patient. Charting this finding
| | | | | | | | | | | |
accurately in the electronic medical record may include which of the following
| | | | | | | | | | | |
terminology choices? |
A) Melena, hematuria, hemorrhage
| | |
B) Hyperviscosity, hemmorrhage, black, tarry
| | | |
C) Melena, asterixis, hemmorrhage
| | |
D) Melena, black, tarry, sticky, hematochezia - CORRECT ANSWER✔✔-D) Melena,
| | | | | | | | | |
black, tarry, sticky, hematochezia
| | | |
, *This contains the best choices to describe this stool. Tarry and sticky are correct
| | | | | | | | | | | | | |
and refer to the consistency, which the nurse can check with a tongue blade.
| | | | | | | | | | | | | |
Hematochezia usually describes frank/obvious/ red blood, and can describe stool,
| | | | | | | | |
although usually is in contrast to the blackness of melena.Stool this color and
| | | | | | | | | | | | | |
consistency should be confirmed for blood by sending a specimen to the lab.
| | | | | | | | | | | |
-ALK. PHOSPHATASE: 178 H (30-120U/L)
| | | |
-BILIRUBIN - TOTAL: 1.4 H (0.2-1.2MG/DL)
| | | | |
-Unconjugated/indirect Bilirubin: 1.2 H (0.2-0.8MG/DL) | | | |
-Conjugated/ direct Bilirubin: 0.4 H (0.1-0.3MG/DL)
| | | | |
-TOTAL PROTEIN: 8.8 H (6.0-8.0G/DL)
| | | |
-ALBUMIN: 6.6 H(3.6-5.0G/DL)| |
-GLUCOSE: 55 L (65-99MG/DL) | | |
-AST (SGOT): 107 H (10-40 U/L)
| | | | |
-ALT (SGPT): 68 H (2-45 U/L)
| | | | |
-SODIUM 143 (135-145 MEQ/L)
| | |
-POTASSIUM 3.5 (3.5-4.9 MEQ/L) | | |
-AMMONIA 105 H (15-45 MCG/DL) | | | |
-CHLORIDE 96 (96-110 MEQ/L) | | |
-LACTATE 3.5 H (0.5-1 Mmol/l)
| | | |
-PLATELETS 120 L (150K-450K /MIC.L)
| | | |
-Anti Nuclear Antibody 20:60 H (1:40 to 1:60 titer)
| | | | | | | |
-FIBRINOGEN 100 (150-400 MG/DL) | | |
