Nokea
A client is seeing the physician for a suspected tumor of the liver. What laboratory study results would indicate that the client may have a primary malignant liver tumor?
- A. Elevated white blood cell count
- B. Elevated alpha-fetoprotein
- C. Decreased AST levels
- D. Decreased alkaline phosphatase levels
Correct Answer: B
Rationale: Alpha-fetoprotein, a serum protein normally produced during fetal development, is a marker that, if elevated, can induce a primary malignant liver tumor. Total bilirubin and serum enzyme levels may be elevated. White blood cell count elevation would indicate an inflammatory response.
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A client is scheduled to have a laparoscopic cholecystectomy as an outpatient. The client asks the nurse when it will be possible to resume normal activities. What information should the nurse provide?
- A. Normal activities may be resumed the day after surgery.
- B. Normal activities may be resumed in 1 week.
- C. Normal activities may be resumed in 1 weeks.
- D. Normal activities may be resumed in 1 month.
Correct Answer: B
Rationale: A prolonged recovery period usually is unnecessary. Most clients resume normal activities within 1 week.
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 hepatitis who has not responded to medical treatment is scheduled for a liver transplant. Which most likely would be ordered?
- A. Chenodiol
- B. Ursodiol
- C. Tacrolimus
- D. Interfereron alfa-2b, recombinant
Correct Answer: C
Rationale: In preparation for a liver transplant, a client receives immunosuppressants to reduce the risk for organ rejection. Tacrolimus and cyclosporine are two immunosuppressants that may be used. Chenodiol and ursodiol are agents used to dissolve gallstones. Recombinant interferon alfa-2b is used to treat chronic hepatitis B, C, and D to force the virus into remission.
The nurse is caring for a client with chronic pancreatitis. Which symptom would indicate the client has developed secondary diabetes?
- A. Increased appetite and thirst
- B. Vomiting and diarrhea
- C. Low blood pressure and pulse
- D. Decreased urination and constipation
Correct Answer: A
Rationale: When secondary diabetes develops in a client with chronic pancreatitis, the client experiences increased appetite, thirst, and urination. Vomiting, diarrhea, low blood pressure and pulse, and constipation do not indicate the development of secondary diabetes.
A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding?
- A. Vitamin K
- B. Octreotide
- C. Vasopressin
- D. Epinephrine
Correct Answer: B
Rationale: Acute hemorrhage from esophageal varices is life threatening. Resuscitative measures include administration of IV fluids and blood products. IV octreotide is started as soon as possible. Octreotide is preferred because of fewer side effects. Octreotide reduces pressure in the portal venous system and is preferred to the previously used agents, vasopressin or terlipressin. Vitamin K promotes blood coagulation in bleeding conditions, resulting from liver disease.