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NR 464 - Exam 1 Questions And Answers Latest Updated
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NR 464 - Exam 1 Questions And Answers Latest Updated
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NR 464 - Exam 1 Questions And AnswersLatest Updated
A 24-year-old female contracts hepatitis from contaminated food. During the acute (icteric) phase of the
patient's illness, the nurse would expect serologic testing to reveal
a. antibody to hepatitis D (anti-HDV).
b. hepatitis B surface antigen (HBsAg).
c. anti-hepatitis A virus immunoglobulin G (anti-HAV IgG).
d. anti-hepatitis A virus immunoglobulin M (anti-HAV IgM). ANS✔✔ d. anti-hepatitis A virus
immunoglobulin M (anti-HAV IgM).
Hepatitis A is transmitted through the oral-fecal route, and antibody to HAV IgM appears during the
acute phase of hepatitis A
A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection.
Which action by the nurse is appropriate?
a. Schedule the patient for HCV genotype testing.
b. Administer the HCV vaccine and immune globulin.
c. Teach the patient about ribavirin (Rebetol) treatment.
d. Explain that the infection will resolve over a few months. ANS✔✔ a. Schedule the patient for HCV
genotype testing.
Genotyping of HCV has an important role in managing treatment and is done before drug therapy is
initiated. Because most patients with acute HCV infection convert to the chronic state, the nurse should
not teach the patient that the HCV will resolve in a few months. Immune globulin or vaccine is not
available for HCV. Ribavirin is used for chronic HCV infection.
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,The nurse will plan to teach the patient diagnosed with acute hepatitis B about
a. side effects of nucleotide analogs.
b. measures for improving the appetite
c. ways to increase activity and exercise.
d. administering a-interferon (Intron A). ANS✔✔ b. measures for improving the appetite.
Maintaining adequate nutritional intake is important for regeneration of hepatocytes. Interferon and
antivirals may be used for chronic hepatitis B, but they are not prescribed for acute hepatitis B infection.
Rest is recommended.
The nurse administering a-interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C will
plan to monitor for
a. leukopenia.
b. hypokalemia.
c. polycythemia.
d. hypoglycemia. ANS✔✔ a. leukopenia.
Therapy with ribavirin and a-interferon may cause leukopenia. The other problems are not associated
with this drug therapy.
Which information given by a 70-year-old patient during a health history indicates to the nurse that the
patient should be screened for hepatitis C?
a. The patient had a blood transfusion in 2005.
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,b. The patient used IV drugs about 20 years ago.
c. The patient frequently eats in fast-food restaurants.
d. The patient traveled to a country with poor sanitation. ANS✔✔ b. The patient used IV drugs about 20
years ago.
Any patient with a history of IV drug use should be tested for hepatitis C. Blood transfusions given after
1992 (when an antibody test for hepatitis C became available) do not pose a risk for hepatitis C.
Hepatitis C is not spread by the oral-fecal route and therefore is not caused by contaminated food or by
traveling in underdeveloped countries.
A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function
studies but serologic testing is negative for viral causes of hepatitis. Which question by the nurse is most
appropriate?
a. "Is there any history of IV drug use?"
b. "Do you use any over-the-counter drugs?"
c. "Are you taking corticosteroids for any reason?"
d. "Have you recently traveled to a foreign country?" ANS✔✔ b. "Do you use any over-the-counter
drugs?"
The patient's symptoms, lack of antibodies for hepatitis, and the abrupt onset of symptoms suggest toxic
hepatitis, which can be caused by commonly used over-the-counter drugs such as acetaminophen
(Tylenol). Travel to a foreign country and a history of IV drug use are risk factors for viral hepatitis.
Corticosteroid use does not cause the symptoms listed.
Which data will the nurse monitor in relation to the 4+ pitting edema assessed in a patient with
cirrhosis?
a. Hemoglobin
b. Temperature
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, c. Activity level
d. Albumin level ANS✔✔ d. Albumin level
The low oncotic pressure caused by hypoalbuminemia is a major pathophysiologic factor in the
development of edema.
Which topic is most important to include in patient teaching for a 41-year-old patient diagnosed with
early alcoholic cirrhosis?
a. Maintaining good nutrition
b. Avoiding alcohol ingestion
c. Taking lactulose (Cephulac)
d. Using vitamin B supplements ANS✔✔ b. Avoiding alcohol ingestion
The disease progression can be stopped or reversed by alcohol abstinence.
A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has
scheduled doses of spironolactone (Aldactone) and furosemide (Lasix). due. Which action should the
nurse take?
a. Administer both drugs.
b. Administer the spironolactone.
c. Withhold the spironolactone and administer the furosemide.
d. Withhold both drugs until discussed with the health care provider. ANS✔✔ b. Administer the
spironolactone.
Spironolactone is a potassium-sparing diuretic and will help increase the patient's potassium level. The
nurse does not need to talk with the doctor before giving the spironolactone, although the health care
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