Nokea
A client is about to undergo a liver biopsy. Which should the nurse administer to the client before the procedure?
- A. Potassium
- B. Vitamin K
- C. Vitamin B
- D. Oral bile acids
Correct Answer: B
Rationale: Clients about to undergo a liver biopsy may require vitamin K before the procedure to reduce the risk of bleeding. Potassium would be given only if the client's serum potassium levels were low. Oral bile acids are not prescribed for a client about to undergo a liver biopsy, they are given to dissolve gallstones. Vitamin B has no implications in the procedure.
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The nurse is assessing a client with suspected cholelithiasis. What can the nurse expect to observe?
- A. Stools that contain blood and mucus
- B. Bowel sounds that are absent
- C. Stools that appear small and dry
- D. Urine that appears dark brown
Correct Answer: D
Rationale: When a client is being assessed for cholelithiasis, the urine appears dark brown, whereas the stools may be light-colored. Bowel sounds are present because cholelithiasis does not cause lack of bowel motility. The stool does not contain blood or mucus.
A nurse is preparing a presentation for a local community group about hepatitis. Which information would the nurse include?
- A. Hepatitis B is transmitted primarily by the oral-fecal route.
- B. Hepatitis A is frequently spread by sexual contact.
- C. Hepatitis C increases a person's risk for liver cancer.
- D. Infection with hepatitis G is similar to hepatitis A.
Correct Answer: C
Rationale: Infection with hepatitis C increases the risk of a person developing hepatic (liver) cancer. Hepatitis A is transmitted primarily by the oral-fecal route, hepatitis B is frequently spread by sexual contact and infected blood. Hepatitis E is similar to hepatitis A whereas hepatitis G is similar to hepatitis C.
A client with cirrhosis is complaining to the nurse of itching. The client asks the nurse if the itching is from taking warm baths. What is the best response by the nurse?
- A. The itching is caused by the accumulation of bile salts.
- B. The itching is related to dry skin from the warm baths.
- C. The itching is most likely a side effect from some of the medications used in treatment.
- D. The itching is related to a psychological response from the illness.
Correct Answer: A
Rationale: Skin may itch (pruritus) from accumulated bile salts related to the diseased liver. It is not related to the baths or a psychological response from the illness. Medication side effect may cause itching, but the most likely cause is the accumulation of bile salts.
A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis?
- A. A liver biopsy
- B. A CT scan
- C. A prothrombin time
- D. Platelet count
Correct Answer: A
Rationale: A liver biopsy, which reveals hepatic fibrosis, is the most conclusive diagnostic procedure. It can be performed in the radiology department with ultrasound or CT to identify appropriate placement of the trocar or biopsy needle. A prothrombin time and platelet count will assist with determining if the client is at increased risk for bleeding.
A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide?
- A. Cure the cirrhosis.
- B. Treat the esophageal varices.
- C. Reduce fluid accumulation and venous pressure.
- D. Promote optimal neurologic function.
Correct Answer: C
Rationale: Methods of treating portal hypertension aim to reduce fluid accumulation and venous pressure. There is no cure for cirrhosis; treating the esophageal varices is only a small portion of the overall objective. Promoting optimal neurologic function will not reduce portal hypertension.