ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 58 : Care of Patients with Liver Problems Questions
Question 1 of 5
A nurse cares for a client with hepatitis C. The client's brother states, 'I do not want to contract this infection, so I will not go into his room.' How should the nurse respond?
Correct Answer: B
Rationale: Although family members may be afraid that they will contract hepatitis C, the nurse should educate the client's family about how the virus is spread. Hepatitis C is spread via blood-to-blood transmission and is associated with illicit IV drug use, needle sharing, blood and organ transplantation, accidental needle sticks, unsanitary tattoo equipment, and sharing of intranasal cocaine paraphernalia. Wearing a gown and gloves will not decrease the transmission of this virus. Hepatitis C is not spread through casual contact or a fecal specimen. Sharing the client's status without consent would violate privacy.
Question 2 of 5
An infection control nurse develops a plan to decrease the number of health care professionals who contract viral hepatitis at work. Which ideas should the nurse include in this plan? (Select all that apply.)
Correct Answer: A,C,D,E
Rationale: Nurses should always use Standard Precautions for client care, and policies should reflect this. Needleless systems and reduction of sharps can help prevent hepatitis. Postexposure prophylaxis should be provided in a timely manner. Hepatitis B immunity in clients does not protect healthcare workers, but ensuring worker immunity through vaccination is critical.
Question 3 of 5
A nurse assesses a client who has liver disease. Which laboratory findings should the nurse recognize as potentially limiting complications of this disorder? (Select all that apply.)
Correct Answer: B,E,F
Rationale: Because INR and PT are indications of clotting disturbances and alert the nurse to the increased possibility of hemorrhage, and elevated ammonia levels increase the client's confusion, these are critical findings. The other values are abnormal and associated with liver disease but do not necessarily place the client at increased risk for complications.
Question 4 of 5
A nurse delegates hygiene care for a client who has advanced cirrhosis to an unlicensed nursing personnel (UAP). Which statements should the nurse include when delegating this task to the UAP? (Select all that apply.)
Correct Answer: A,C,D
Rationale: Clients with advanced cirrhosis often have pruritus. Lotion will help decrease itchiness from dry skin. A soft toothbrush should be used to prevent gum bleeding, and the client's nails should be trimmed short to prevent scratching. Clients should use cool, not warm, water on their skin and should not use excessive amounts of soap.
Question 5 of 5
A nurse assesses a male client who has symptoms of cirrhosis. Which questions should the nurse ask to identify potential factors contributing to this disorder? (Select all that apply.)
Correct Answer: A,B,E
Rationale: Alcohol consumption is a major cause of cirrhosis. Sexual practices, particularly unprotected sex with men, increase the risk of hepatitis B or C, which can lead to cirrhosis. Incarceration is a risk factor due to potential exposure to hepatitis C through shared needles or unsanitary conditions. Family history of cancer and working as a plumber are not directly associated with cirrhosis.