NR 464 - Exam 1 questions with complete
solutions 2024
A j24-year-old jfemale jcontracts jhepatitis jfrom jcontaminated jfood. jDuring jthe
jacute j(icteric) jphase jof jthe jpatient's jillness, jthe jnurse jwould jexpect jserologic
jtesting jto jreveal
a. jantibody jto jhepatitis jD j(anti-HDV).
b. jhepatitis jB jsurface jantigen j(HBsAg).
c. janti-hepatitis jA jvirus jimmunoglobulin jG j(anti-HAV jIgG).
d. janti-hepatitis jA jvirus jimmunoglobulin jM j(anti-HAV jIgM). j- jANS✓✓-d. janti-
hepatitis jA jvirus jimmunoglobulin jM j(anti-HAV jIgM).
Hepatitis jA jis jtransmitted jthrough jthe joral-fecal jroute, jand jantibody jto jHAV jIgM
jappears jduring jthe jacute jphase jof jhepatitis jA
A j36-year-old jmale jpatient jin jthe joutpatient jclinic jis jdiagnosed jwith jacute
jhepatitis jC j(HCV) jinfection. jWhich jaction jby jthe jnurse jis jappropriate?
a. jSchedule jthe jpatient jfor jHCV jgenotype jtesting.
b. jAdminister jthe jHCV jvaccine jand jimmune jglobulin.
c. jTeach jthe jpatient jabout jribavirin j(Rebetol) jtreatment.
d. jExplain jthat jthe jinfection jwill jresolve jover ja jfew jmonths. j- jANS✓✓-a.
jSchedule jthe jpatient jfor jHCV jgenotype jtesting.
Genotyping jof jHCV jhas jan jimportant jrole jin jmanaging jtreatment jand jis jdone
jbefore jdrug jtherapy jis jinitiated. jBecause jmost jpatients jwith jacute jHCV
jinfection jconvert jto jthe jchronic jstate, jthe jnurse jshould jnot jteach jthe jpatient
jthat jthe jHCV jwill jresolve jin ja jfew jmonths. jImmune jglobulin jor jvaccine jis jnot
javailable jfor jHCV. jRibavirin jis jused jfor jchronic jHCV jinfection.
The jnurse jwill jplan jto jteach jthe jpatient jdiagnosed jwith jacute jhepatitis jB jabout
a. jside jeffects jof jnucleotide janalogs.
b. jmeasures jfor jimproving jthe jappetite
c. jways jto jincrease jactivity jand jexercise.
d. jadministering ja-interferon j(Intron jA). j- jANS✓✓-b. jmeasures jfor jimproving jthe
jappetite.
,Maintaining jadequate jnutritional jintake jis jimportant jfor jregeneration jof
jhepatocytes. jInterferon jand jantivirals jmay jbe jused jfor jchronic jhepatitis jB, jbut
jthey jare jnot jprescribed jfor jacute jhepatitis jB jinfection. jRest jis jrecommended.
The jnurse jadministering ja-interferon jand jribavirin j(Rebetol) jto ja jpatient jwith
jchronic jhepatitis jC jwill jplan jto jmonitor jfor
a. jleukopenia.
b. jhypokalemia.
c. jpolycythemia.
d. jhypoglycemia. j- jANS✓✓-a. jleukopenia.
Therapy jwith jribavirin jand ja-interferon jmay jcause jleukopenia. jThe jother
jproblems jare jnot jassociated jwith jthis jdrug jtherapy.
Which jinformation jgiven jby ja j70-year-old jpatient jduring ja jhealth jhistory
jindicates jto jthe jnurse jthat jthe jpatient jshould jbe jscreened jfor jhepatitis jC?
a. jThe jpatient jhad ja jblood jtransfusion jin j2005.
b. jThe jpatient jused jIV jdrugs jabout j20 jyears jago.
c. jThe jpatient jfrequently jeats jin jfast-food jrestaurants.
d. jThe jpatient jtraveled jto ja jcountry jwith jpoor jsanitation. j- jANS✓✓-b. jThe
jpatient jused jIV jdrugs jabout j20 jyears jago.
Any jpatient jwith ja jhistory jof jIV jdrug juse jshould jbe jtested jfor jhepatitis jC.
jBlood jtransfusions jgiven jafter j1992 j(when jan jantibody jtest jfor jhepatitis jC
jbecame javailable) jdo jnot jpose ja jrisk jfor jhepatitis jC. jHepatitis jC jis jnot jspread
jby jthe joral-fecal jroute jand jtherefore jis jnot jcaused jby jcontaminated jfood jor jby
jtraveling jin junderdeveloped jcountries.
A j55-year-old jpatient jadmitted jwith jan jabrupt jonset jof jjaundice jand jnausea jhas
jabnormal jliver jfunction jstudies jbut jserologic jtesting jis jnegative jfor jviral
jcauses jof jhepatitis. jWhich jquestion jby jthe jnurse jis jmost jappropriate?
a. j"Is jthere jany jhistory jof jIV jdrug juse?"
b. j"Do jyou juse jany jover-the-counter jdrugs?"
c. j"Are jyou jtaking jcorticosteroids jfor jany jreason?"
d. j"Have jyou jrecently jtraveled jto ja jforeign jcountry?" j- jANS✓✓-b. j"Do jyou juse
jany jover-the-counter jdrugs?"
The jpatient's jsymptoms, jlack jof jantibodies jfor jhepatitis, jand jthe jabrupt jonset
jof jsymptoms jsuggest jtoxic jhepatitis, jwhich jcan jbe jcaused jby jcommonly jused
jover-the-counter jdrugs jsuch jas jacetaminophen j(Tylenol). jTravel jto ja jforeign
jcountry jand ja jhistory jof jIV jdrug juse jare jrisk jfactors jfor jviral jhepatitis.
jCorticosteroid juse jdoes jnot jcause jthe jsymptoms jlisted.
,Which jdata jwill jthe jnurse jmonitor jin jrelation jto jthe j4+ jpitting jedema jassessed
jin ja jpatient jwith jcirrhosis?
a. jHemoglobin
b. jTemperature
c. jActivity jlevel
d. jAlbumin jlevel j- jANS✓✓-d. jAlbumin jlevel
The jlow joncotic jpressure jcaused jby jhypoalbuminemia jis ja jmajor
jpathophysiologic jfactor jin jthe jdevelopment jof jedema.
Which jtopic jis jmost jimportant jto jinclude jin jpatient jteaching jfor ja j41-year-old
jpatient jdiagnosed jwith jearly jalcoholic jcirrhosis?
a. jMaintaining jgood jnutrition
b. jAvoiding jalcohol jingestion
c. jTaking jlactulose j(Cephulac)
d. jUsing jvitamin jB jsupplements j- jANS✓✓-b. jAvoiding jalcohol jingestion
The jdisease jprogression jcan jbe jstopped jor jreversed jby jalcohol jabstinence.
A jserum jpotassium jlevel jof j3.2 jmEq/L j(3.2 jmmol/L) jis jreported jfor ja jpatient
jwith jcirrhosis jwho jhas jscheduled jdoses jof jspironolactone j(Aldactone) jand
jfurosemide j(Lasix). jdue. jWhich jaction jshould jthe jnurse jtake?
a. jAdminister jboth jdrugs.
b. jAdminister jthe jspironolactone.
c. jWithhold jthe jspironolactone jand jadminister jthe jfurosemide.
d. jWithhold jboth jdrugs juntil jdiscussed jwith jthe jhealth jcare jprovider. j- jANS✓✓-
b. jAdminister jthe jspironolactone.
Spironolactone jis ja jpotassium-sparing jdiuretic jand jwill jhelp jincrease jthe
jpatient's jpotassium jlevel. jThe jnurse jdoes jnot jneed jto jtalk jwith jthe jdoctor
jbefore jgiving jthe jspironolactone, jalthough jthe jhealth jcare jprovider jshould jbe
jnotified jabout jthe jlow jpotassium jvalue. jThe jfurosemide jwill jfurther jdecrease
jthe jpatient's jpotassium jlevel jand jshould jbe jheld juntil jthe jnurse jtalks jwith jthe
jhealth jcare jprovider.
Which jaction jshould jthe jnurse jtake jto jevaluate jtreatment jeffectiveness jfor ja
jpatient jwho jhas jhepatic jencephalopathy?
a. jRequest jthat jthe jpatient jstand jon jone jfoot.
b. jAsk jthe jpatient jto jextend jboth jarms jforward.
c. jRequest jthat jthe jpatient jwalk jwith jeyes jclosed.
, d. jAsk jthe jpatient jto jperform jthe jValsalva jmaneuver. j- jANS✓✓-b. jAsk jthe
jpatient jto jextend jboth jarms jforward.
Extending jthe jarms jallows jthe jnurse jto jcheck jfor jasterixis, ja jclassic jsign jof
jhepatic jencephalopathy. jThe jother jtests jmight jalso jbe jdone jas jpart jof jthe
jneurologic jassessment jbut jwould jnot jbe jdiagnostic jfor jhepatic
jencephalopathy.
Which jfinding jindicates jto jthe jnurse jthat jlactulose j(Cephulac) jis jeffective jfor ja
j72-year-old jman jwho jhas jadvanced jcirrhosis?
a. jThe jpatient jis jalert jand joriented.
b. jThe jpatient jdenies jnausea jor janorexia.
c. jThe jpatient's jbilirubin jlevel jdecreases.
d. jThe jpatient jhas jat jleast jone jstool jdaily. j- jANS✓✓-a. jThe jpatient jis jalert jand
joriented.
The jpurpose jof jlactulose jin jthe jpatient jwith jcirrhosis jis jto jlower jammonia
jlevels jand jprevent jencephalopathy. jAlthough jlactulose jmay jbe jused jto jtreat
jconstipation, jthat jis jnot jthe jpurpose jfor jthis jpatient. jLactulose jwill jnot
jdecrease jnausea jand jvomiting jor jlower jbilirubin jlevels.
A j53-year-old jpatient jis jbeing jtreated jfor jbleeding jesophageal jvarices jwith
jballoon jtamponade. jWhich jnursing jaction jwill jbe jincluded jin jthe jplan jof jcare?
a. jInstruct jthe jpatient jto jcough jevery jhour.
b. jMonitor jthe jpatient jfor jshortness jof jbreath.
c. jVerify jthe jposition jof jthe jballoon jevery j4 jhours.
d. jDeflate jthe jgastric jballoon jif jthe jpatient jreports jnausea. j- jANS✓✓-b. jMonitor
jthe jpatient jfor jshortness jof jbreath.
The jmost jcommon jcomplication jof jballoon jtamponade jis jaspiration jpneumonia.
jIn jaddition, jif jthe jgastric jballoon jruptures, jthe jesophageal jballoon jmay jslip
jupward jand jocclude jthe jairway. jCoughing jincreases jthe jpressure jon jthe
jvarices jand jincreases jthe jrisk jfor jbleeding. jBalloon jposition jis jverified jafter
jinsertion jand jdoes jnot jrequire jfurther jverification. jThe jesophageal jballoon jis
jdeflated jevery j8 jto j12 jhours jto javoid jnecrosis, jbut jif jthe jgastric jballoon jis
jdeflated, jthe jesophageal jballoon jmay jocclude jthe jairway.
To jdetect jpossible jcomplications jin ja jpatient jwith jsevere jcirrhosis jwho jhas
jbleeding jesophageal jvarices, jit jis jmost jimportant jfor jthe jnurse jto jmonitor
a. jbilirubin jlevels.
b. jammonia jlevels.
c. jpotassium jlevels.
d. jprothrombin jtime. j- jANS✓✓-b. jammonia jlevels.
solutions 2024
A j24-year-old jfemale jcontracts jhepatitis jfrom jcontaminated jfood. jDuring jthe
jacute j(icteric) jphase jof jthe jpatient's jillness, jthe jnurse jwould jexpect jserologic
jtesting jto jreveal
a. jantibody jto jhepatitis jD j(anti-HDV).
b. jhepatitis jB jsurface jantigen j(HBsAg).
c. janti-hepatitis jA jvirus jimmunoglobulin jG j(anti-HAV jIgG).
d. janti-hepatitis jA jvirus jimmunoglobulin jM j(anti-HAV jIgM). j- jANS✓✓-d. janti-
hepatitis jA jvirus jimmunoglobulin jM j(anti-HAV jIgM).
Hepatitis jA jis jtransmitted jthrough jthe joral-fecal jroute, jand jantibody jto jHAV jIgM
jappears jduring jthe jacute jphase jof jhepatitis jA
A j36-year-old jmale jpatient jin jthe joutpatient jclinic jis jdiagnosed jwith jacute
jhepatitis jC j(HCV) jinfection. jWhich jaction jby jthe jnurse jis jappropriate?
a. jSchedule jthe jpatient jfor jHCV jgenotype jtesting.
b. jAdminister jthe jHCV jvaccine jand jimmune jglobulin.
c. jTeach jthe jpatient jabout jribavirin j(Rebetol) jtreatment.
d. jExplain jthat jthe jinfection jwill jresolve jover ja jfew jmonths. j- jANS✓✓-a.
jSchedule jthe jpatient jfor jHCV jgenotype jtesting.
Genotyping jof jHCV jhas jan jimportant jrole jin jmanaging jtreatment jand jis jdone
jbefore jdrug jtherapy jis jinitiated. jBecause jmost jpatients jwith jacute jHCV
jinfection jconvert jto jthe jchronic jstate, jthe jnurse jshould jnot jteach jthe jpatient
jthat jthe jHCV jwill jresolve jin ja jfew jmonths. jImmune jglobulin jor jvaccine jis jnot
javailable jfor jHCV. jRibavirin jis jused jfor jchronic jHCV jinfection.
The jnurse jwill jplan jto jteach jthe jpatient jdiagnosed jwith jacute jhepatitis jB jabout
a. jside jeffects jof jnucleotide janalogs.
b. jmeasures jfor jimproving jthe jappetite
c. jways jto jincrease jactivity jand jexercise.
d. jadministering ja-interferon j(Intron jA). j- jANS✓✓-b. jmeasures jfor jimproving jthe
jappetite.
,Maintaining jadequate jnutritional jintake jis jimportant jfor jregeneration jof
jhepatocytes. jInterferon jand jantivirals jmay jbe jused jfor jchronic jhepatitis jB, jbut
jthey jare jnot jprescribed jfor jacute jhepatitis jB jinfection. jRest jis jrecommended.
The jnurse jadministering ja-interferon jand jribavirin j(Rebetol) jto ja jpatient jwith
jchronic jhepatitis jC jwill jplan jto jmonitor jfor
a. jleukopenia.
b. jhypokalemia.
c. jpolycythemia.
d. jhypoglycemia. j- jANS✓✓-a. jleukopenia.
Therapy jwith jribavirin jand ja-interferon jmay jcause jleukopenia. jThe jother
jproblems jare jnot jassociated jwith jthis jdrug jtherapy.
Which jinformation jgiven jby ja j70-year-old jpatient jduring ja jhealth jhistory
jindicates jto jthe jnurse jthat jthe jpatient jshould jbe jscreened jfor jhepatitis jC?
a. jThe jpatient jhad ja jblood jtransfusion jin j2005.
b. jThe jpatient jused jIV jdrugs jabout j20 jyears jago.
c. jThe jpatient jfrequently jeats jin jfast-food jrestaurants.
d. jThe jpatient jtraveled jto ja jcountry jwith jpoor jsanitation. j- jANS✓✓-b. jThe
jpatient jused jIV jdrugs jabout j20 jyears jago.
Any jpatient jwith ja jhistory jof jIV jdrug juse jshould jbe jtested jfor jhepatitis jC.
jBlood jtransfusions jgiven jafter j1992 j(when jan jantibody jtest jfor jhepatitis jC
jbecame javailable) jdo jnot jpose ja jrisk jfor jhepatitis jC. jHepatitis jC jis jnot jspread
jby jthe joral-fecal jroute jand jtherefore jis jnot jcaused jby jcontaminated jfood jor jby
jtraveling jin junderdeveloped jcountries.
A j55-year-old jpatient jadmitted jwith jan jabrupt jonset jof jjaundice jand jnausea jhas
jabnormal jliver jfunction jstudies jbut jserologic jtesting jis jnegative jfor jviral
jcauses jof jhepatitis. jWhich jquestion jby jthe jnurse jis jmost jappropriate?
a. j"Is jthere jany jhistory jof jIV jdrug juse?"
b. j"Do jyou juse jany jover-the-counter jdrugs?"
c. j"Are jyou jtaking jcorticosteroids jfor jany jreason?"
d. j"Have jyou jrecently jtraveled jto ja jforeign jcountry?" j- jANS✓✓-b. j"Do jyou juse
jany jover-the-counter jdrugs?"
The jpatient's jsymptoms, jlack jof jantibodies jfor jhepatitis, jand jthe jabrupt jonset
jof jsymptoms jsuggest jtoxic jhepatitis, jwhich jcan jbe jcaused jby jcommonly jused
jover-the-counter jdrugs jsuch jas jacetaminophen j(Tylenol). jTravel jto ja jforeign
jcountry jand ja jhistory jof jIV jdrug juse jare jrisk jfactors jfor jviral jhepatitis.
jCorticosteroid juse jdoes jnot jcause jthe jsymptoms jlisted.
,Which jdata jwill jthe jnurse jmonitor jin jrelation jto jthe j4+ jpitting jedema jassessed
jin ja jpatient jwith jcirrhosis?
a. jHemoglobin
b. jTemperature
c. jActivity jlevel
d. jAlbumin jlevel j- jANS✓✓-d. jAlbumin jlevel
The jlow joncotic jpressure jcaused jby jhypoalbuminemia jis ja jmajor
jpathophysiologic jfactor jin jthe jdevelopment jof jedema.
Which jtopic jis jmost jimportant jto jinclude jin jpatient jteaching jfor ja j41-year-old
jpatient jdiagnosed jwith jearly jalcoholic jcirrhosis?
a. jMaintaining jgood jnutrition
b. jAvoiding jalcohol jingestion
c. jTaking jlactulose j(Cephulac)
d. jUsing jvitamin jB jsupplements j- jANS✓✓-b. jAvoiding jalcohol jingestion
The jdisease jprogression jcan jbe jstopped jor jreversed jby jalcohol jabstinence.
A jserum jpotassium jlevel jof j3.2 jmEq/L j(3.2 jmmol/L) jis jreported jfor ja jpatient
jwith jcirrhosis jwho jhas jscheduled jdoses jof jspironolactone j(Aldactone) jand
jfurosemide j(Lasix). jdue. jWhich jaction jshould jthe jnurse jtake?
a. jAdminister jboth jdrugs.
b. jAdminister jthe jspironolactone.
c. jWithhold jthe jspironolactone jand jadminister jthe jfurosemide.
d. jWithhold jboth jdrugs juntil jdiscussed jwith jthe jhealth jcare jprovider. j- jANS✓✓-
b. jAdminister jthe jspironolactone.
Spironolactone jis ja jpotassium-sparing jdiuretic jand jwill jhelp jincrease jthe
jpatient's jpotassium jlevel. jThe jnurse jdoes jnot jneed jto jtalk jwith jthe jdoctor
jbefore jgiving jthe jspironolactone, jalthough jthe jhealth jcare jprovider jshould jbe
jnotified jabout jthe jlow jpotassium jvalue. jThe jfurosemide jwill jfurther jdecrease
jthe jpatient's jpotassium jlevel jand jshould jbe jheld juntil jthe jnurse jtalks jwith jthe
jhealth jcare jprovider.
Which jaction jshould jthe jnurse jtake jto jevaluate jtreatment jeffectiveness jfor ja
jpatient jwho jhas jhepatic jencephalopathy?
a. jRequest jthat jthe jpatient jstand jon jone jfoot.
b. jAsk jthe jpatient jto jextend jboth jarms jforward.
c. jRequest jthat jthe jpatient jwalk jwith jeyes jclosed.
, d. jAsk jthe jpatient jto jperform jthe jValsalva jmaneuver. j- jANS✓✓-b. jAsk jthe
jpatient jto jextend jboth jarms jforward.
Extending jthe jarms jallows jthe jnurse jto jcheck jfor jasterixis, ja jclassic jsign jof
jhepatic jencephalopathy. jThe jother jtests jmight jalso jbe jdone jas jpart jof jthe
jneurologic jassessment jbut jwould jnot jbe jdiagnostic jfor jhepatic
jencephalopathy.
Which jfinding jindicates jto jthe jnurse jthat jlactulose j(Cephulac) jis jeffective jfor ja
j72-year-old jman jwho jhas jadvanced jcirrhosis?
a. jThe jpatient jis jalert jand joriented.
b. jThe jpatient jdenies jnausea jor janorexia.
c. jThe jpatient's jbilirubin jlevel jdecreases.
d. jThe jpatient jhas jat jleast jone jstool jdaily. j- jANS✓✓-a. jThe jpatient jis jalert jand
joriented.
The jpurpose jof jlactulose jin jthe jpatient jwith jcirrhosis jis jto jlower jammonia
jlevels jand jprevent jencephalopathy. jAlthough jlactulose jmay jbe jused jto jtreat
jconstipation, jthat jis jnot jthe jpurpose jfor jthis jpatient. jLactulose jwill jnot
jdecrease jnausea jand jvomiting jor jlower jbilirubin jlevels.
A j53-year-old jpatient jis jbeing jtreated jfor jbleeding jesophageal jvarices jwith
jballoon jtamponade. jWhich jnursing jaction jwill jbe jincluded jin jthe jplan jof jcare?
a. jInstruct jthe jpatient jto jcough jevery jhour.
b. jMonitor jthe jpatient jfor jshortness jof jbreath.
c. jVerify jthe jposition jof jthe jballoon jevery j4 jhours.
d. jDeflate jthe jgastric jballoon jif jthe jpatient jreports jnausea. j- jANS✓✓-b. jMonitor
jthe jpatient jfor jshortness jof jbreath.
The jmost jcommon jcomplication jof jballoon jtamponade jis jaspiration jpneumonia.
jIn jaddition, jif jthe jgastric jballoon jruptures, jthe jesophageal jballoon jmay jslip
jupward jand jocclude jthe jairway. jCoughing jincreases jthe jpressure jon jthe
jvarices jand jincreases jthe jrisk jfor jbleeding. jBalloon jposition jis jverified jafter
jinsertion jand jdoes jnot jrequire jfurther jverification. jThe jesophageal jballoon jis
jdeflated jevery j8 jto j12 jhours jto javoid jnecrosis, jbut jif jthe jgastric jballoon jis
jdeflated, jthe jesophageal jballoon jmay jocclude jthe jairway.
To jdetect jpossible jcomplications jin ja jpatient jwith jsevere jcirrhosis jwho jhas
jbleeding jesophageal jvarices, jit jis jmost jimportant jfor jthe jnurse jto jmonitor
a. jbilirubin jlevels.
b. jammonia jlevels.
c. jpotassium jlevels.
d. jprothrombin jtime. j- jANS✓✓-b. jammonia jlevels.
