1.
A female client who has just been diagnosed with hepatitis A asks, “How could I have gotten this disease?” What is the nurse’s best response?
Correct Answer
A. “You may have eaten contaminated restaurant food.”
Explanation
Hepatitis A virus typically is transmitted by the oral-fecal route — commonly by consuming food contaminated by infected food handlers. The virus isn’t transmitted by the I.V. route, blood transfusions, or unprotected sex. Hepatitis B can be transmitted by I.V. drug use or blood transfusion. Hepatitis C can be transmitted by unprotected sex.
2.
A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are:
Correct Answer
D. Cryoprecipitate and fresh frozen plasma.
Explanation
The liver is vital in the synthesis of clotting factors, so when it’s diseased or dysfunctional, as in hepatitis C, bleeding occurs. Treatment consists of administering blood products that aid clotting. These include fresh frozen plasma containing fibrinogen and cryoprecipitate, which have most of the clotting factors. Although administering whole blood, albumin, and packed cells will contribute to hemostasis, those products aren’t specifically used to treat hemostasis. Platelets are helpful, but the best answer is cryoprecipitate and fresh frozen plasma.
3.
A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note:
Correct Answer
B. Anorexia, nausea, and vomiting.
Explanation
Hallmark signs and symptoms of hepatitis A include anorexia, nausea, vomiting, fatigue, and weakness. Abdominal pain may occur but doesn’t radiate to the shoulder. Eructation and constipation are common in gallbladder disease, not hepatitis A. Abdominal ascites is a sign of advanced hepatic disease, not an early sign of hepatitis A.
4.
A female client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should:
Correct Answer
C. Wash the hands after touching the client.
Explanation
To maintain enteric precautions, the nurse must wash the hands after touching the client or potentially contaminated articles and before caring for another client. A private room is warranted only if the client has poor hygiene — for instance, if the client is unlikely to wash the hands after touching infective material or is likely to share contaminated articles with other clients. For enteric precautions, the nurse need not wear a mask and must wear a gown only if soiling from fecal matter is likely.
5.
Which of the following factors can cause hepatitis A?
Correct Answer
C. Eating contaminated shellfish
Explanation
Hepatitis A can be caused by consuming contaminated water, milk, or food — especially shellfish from contaminated water. Hepatitis B is caused by blood and sexual contact with an infected person. Hepatitis C is usually caused by contact with infected blood, including receiving blood transfusions.
6.
Dr. Smith has determined that the client with hepatitis has contracted the infection form contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis?
Correct Answer
A. Hepatitis A
Explanation
Hepatitis A is transmitted by the fecal-oral route via contaminated food or infected food handlers. Hepatitis B, C, and D are transmitted most commonly via infected blood or body fluids.
7.
A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis?
Correct Answer
B. Elevated serum bilirubin level
Explanation
Laboratory indicators of hepatitis include elevated liver enzyme levels, elevated serum bilirubin levels, elevated erythrocyte sedimentation rates, and leukopenia. An elevated blood urea nitrogen level may indicate renal dysfunction. A hemoglobin level is unrelated to this diagnosis.
8.
Nurse Rachel teaches a client who has been recently diagnosed with hepatitis A about untoward signs and symptoms related to Hepatitis that may develop. The one that should be reported immediately to the physician is:
Correct Answer
D. Clay- colored stools
Explanation
Clay colored stools are indicative of hepatic obstruction
9.
Which of the following symptoms during the icteric phase of viral hepatitis should the nurse expect the client to inhibit?
Correct Answer
B. Yellow sclera
Explanation
Liver inflammation and obstruction block the normal flow of bile. Excess bilirubin turns the skin and sclera yellow and the urine dark and frothy.
10.
For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?
Correct Answer
A. Use of sterile syringes and needles
Explanation
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.
11.
A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?
Correct Answer
D. Lipitor (atorvastatin)
Explanation
Lipid-lowering agents are contraindicated in the client with active liver disease. Answers A, B, and C are incorrect because they are not contraindicated in the client with active liver disease.
12.
In caring for a client with acute viral hepatitis, which task should be delegated to the nursing assistant?
Correct Answer
A. Empty the bedpan while wearing gloves.
Explanation
The nursing assistant should use infection control precautions for the protection of self, employees, and other clients. Planning and monitoring are RN responsibilities. While the nursing assistants can report valuable information, they should not be responsible for signs and symptoms that can be subtle or hard to detect, such as skin changes. Focus: Delegation
13.
Tony has diagnosed with hepatitis A. The information from the health history that is most likely linked to hepatitis A is:
Correct Answer
B. Working as local plumber
Explanation
Hepatitis A is primarily spread via fecal-oral route. Sewage polluted water may harbor the virus.
14.
A mother brought her child in the health center for hepatitis B vaccination in a series. The mother informs the nurse that the child missed an appointment last month to have the third hepatitis B vaccination. Which of the following statements is the appropriate nursing response to the mother?
Correct Answer
C. “Your child will get the next dose as soon as possible”
Explanation
Continuity is essential to promote active immunity and give hepatitis B lifelong prophylaxis. Optimally, the third vaccination is given 6 months after the first.
15.
In the United States, nurses performing invasive procedures need to be up-to-date with their immunizations, particularly
Correct Answer
A. hepatitis B.
Explanation
Hepatitis B is transmitted through contact with infected blood or plasma.
16.
Which of the following is not a specific element of Hepatitis C?
Correct Answer
A. Vaccine available
Explanation
The correct answer is "Vaccine available." This means that there is no specific vaccine available for Hepatitis C. While the other options mention possible characteristics or symptoms of Hepatitis C, the absence of a vaccine is what sets this answer apart.
17.
Which of the following Vitamins is not stored in the Liver?
Correct Answer
C. Vitamin C
Explanation
Vitamin C is not stored in the liver. Unlike other vitamins, which can be stored in the body for later use, vitamin C is water-soluble and is not stored in significant amounts. This means that the body does not have a large reserve of vitamin C and it needs to be consumed regularly through diet or supplements.
18.
Tiffany Black is diagnosed with type A hepatitis. What special precautions should the nurse take when caring for this patient?
Correct Answer
B. Wear gloves and a gown when removing the patient’s bedpan.
Explanation
The nurse should wear gloves and a gown when removing the patient’s bedpan because the type A hepatitis virus occurs in stools. It may also occur in blood, nasotracheal secretions, and urine. Type A hepatitis isn’t transmitted through the air by way of droplets. Special precautions aren’t needed when feeding the patient, but disposable utensils should be used.
19.
A patient with chronic hepatitis C has been receiving interferon alfa-2a (Roferon-A) injections for the last month. Which information gathered during a visit in the home to conduct an interview and physical assessment is most important to communicate to the physician?
Correct Answer
A. The patient has chronic nausea and vomiting
Explanation
Nausea and vomiting are common adverse effects of interferon alfa-2a, but continued vomiting should be reported to the physician because dehydration may occur. The medication may be given by either the subcutaneous or intramuscular route. Flu-like symptoms such as a mild temperature elevation, headache, muscle aches, and anorexia are common after initiating therapy but tend to decrease over time.
20.
You obtain these assessment data while completing as admission for a patient with a history of a liver transplant who is receiving cyclosporine (Sandimmune), prednisone (Deltasone), and mycophenolate (CellCept) to suppress immune function. Which one will be of most concern?
Correct Answer
C. The patient has a non-tender swelling above the clavicle.
Explanation
Patients taking immunosuppressive medications are at increased risk for development of cancer. A non-tender swelling or lump may indicate the patient has lymphoma. The other data indicate that the patient is experiencing common side effects of the immunosuppressive medications.
21.
Van Fajardo is a 55 year old who was admitted to the hospital with newly diagnosed hepatitis. The nurse is doing a patient teaching with Mr. Fajardo. What kind of role does the nurse assume?
Correct Answer
B. Teacher
Explanation
The nurse will assume the role of a teacher in this therapeutic relationship. The other roles are inappropriate in this situation.
22.
An infant is brought to the health care clinic for three immunizations at the same time. The nurse knows that hepatitis B, DPT, and Haemophilus influenzae type B immunizations should:
Correct Answer
C. Not be mixed and the nurse must give three injections in three sites.
Explanation
Immunization should never be mixed together in a syringe, thus necessitating three separate injections in three sites. Note: some manufacturers make a premixed combination of immunization that is safe and effective.