Exam (elaborations)
Capstone: Liver (NCLEX) Questions & Detailed Answers
- Course
- Capstone Liver
- Institution
- University Of California - San Francisco
Capstone: Liver (NCLEX) Questions & Detailed Answers
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Capstone: Liver (NCLEX) Questions &Detailed Answers
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
Hepatitis A is transmitted through the oral-fecal route, and antibody to HAV IgM
appears during the acute phase of hepatitis A. The patient would not have antigen
for hepatitis B or antibody for hepatitis D. Anti-HAV IgG would indicate past
infection and lifelong immunity.
Administration of hepatitis B vaccine to a healthy 18-year-old patient has been
effective when a specimen of the patient's blood reveals
a. HBsAg.
b. anti-HBs.
c. anti-HBc IgG.
d. anti-HBc IgM. - ANS B
,The presence of surface antibody to HBV (anti-HBs) is a marker of a positive
response to the vaccine. The other laboratory values indicate current infection
with HBV
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
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
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
,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
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.
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
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
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
c. Activity level
d. Albumin level - ANS D
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