CMSRN Gastrointestinal and Hepatic Care 2

Question 1

Which clinical manifestation most specifically differentiates hepatic encephalopathy from other causes of altered mental status?

Accepted Answer

Asterixis (liver flap tremor)

Answer

Asterixis, a flapping tremor of the outstretched hands, is the hallmark neurological sign of hepatic encephalopathy caused by ammonia's toxic effect on the brain.

Question 2

A patient with liver cirrhosis develops ascites. The nurse understands the primary pathophysiology involves:

Accepted Answer

Decreased serum albumin and increased portal hypertension

Answer

Decreased albumin reduces plasma oncotic pressure while portal hypertension increases hydrostatic pressure, together forcing fluid from the vasculature into the peritoneal cavity.

Question 3

Following a large-volume paracentesis, which finding requires the nurse's most immediate assessment?

Accepted Answer

Hypotension and tachycardia

Answer

Hypotension and tachycardia following paracentesis signal hypovolemia from rapid fluid shifts or hemorrhage, which requires immediate hemodynamic intervention.

Question 4

A patient diagnosed with hepatitis B asks how the virus is transmitted. The nurse correctly responds that it spreads through:

Accepted Answer

Blood, sexual contact, and perinatal transmission

Answer

Hepatitis B is a bloodborne pathogen transmitted via blood and blood products, sexual contact with an infected person, and vertically from infected mother to newborn.

Question 5

A patient with ulcerative colitis is in a severe flare. Which finding most indicates the need for emergency surgical intervention?

Accepted Answer

Toxic megacolon with high fever and massive abdominal distension

Answer

Toxic megacolon is a life-threatening complication requiring emergency colectomy to prevent bowel perforation, peritonitis, and sepsis.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Gastrointestinal and Hepatic Care 2