Nokea
The nurse would expect to see a provision in the plan of care for a person who has had a liver transplant to prevent which complication?
- A. fluid congestion.
- B. fatigue.
- C. infection.
- D. urinary retention.
Correct Answer: C
Rationale: A critical aspect of nursing care following liver transplantation is monitoring for infection. The major postoperative complications of a liver transplant are rejection and infection.
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Which should the nurse expect of a patient with a malabsorption of vitamin K?
- A. Anemia
- B. Excess platelet production
- C. Increased coagulation time
- D. Elevated for infection due to diminished white blood cell count
Correct Answer: C
Rationale: Prothrombin times are increased because malabsorption of vitamin K or inability to produce the clotting factors VII, IX, and X cause the patient to have bleeding tendencies.
The nurse is aware that an elevated serum amylase is diagnostic of pancreatitis at an early stage as an elevation can be assessed as early as how many hours after the onset of pancreatic disease?
- A. 2 hours
- B. 8 hours
- C. 24 hours
- D. 36 hours
Correct Answer: A
Rationale: An increase in the serum amylase can be detected as early as 2 hours after the onset of pancreatic disease. In simple acute pancreatitis, the level returns to normal in about 36 hours. In chronic disease, it remains elevated.
The patient's cirrhosis of the liver has also caused a dilation of the veins of the lower esophagus secondary to portal hypertension, resulting in the development of which complication?
- A. esophageal varices.
- B. diverticulosis.
- C. Crohn disease.
- D. esophageal reflux (GERD).
Correct Answer: A
Rationale: Esophageal varices (a complex of longitudinal, tortuous veins at the lower end of the esophagus) enlarge and become edematous as the result of portal hypertension.
Which is a by-product of protein metabolism?
- A. Urine
- B. Protease
- C. Amylase
- D. Ammonia
Correct Answer: D
Rationale: Protein products enter the bloodstream and are changed in the bowel to ammonia; the products then pass through the portal vein to the liver where the ammonia is converted to urea, which is then excreted by the kidneys.
Which is an indication for a liver transplant?
- A. Congenital biliary abnormalities
- B. Hepatic malignancy
- C. Chronic hepatitis
- D. Cirrhosis due to alcoholism
- E. Gallbladder disease
Correct Answer: A,B,C
Rationale: Indications for liver transplantation include congenital biliary abnormalities, inborn errors of metabolism, hepatic malignancy (confined to the liver), sclerosing cholangitis, and chronic end-stage liver disease.