NCLEX Hepatic and Biliary Practice Exam

These questions are part of the practice quiz. Start practicing

• A client with cirrhosis has difficulty arousing and an elevated serum ammonia level. Which situation should the nurse suspect?
• After completing the Hepatitis B vaccine series, which blood result demonstrates immunity?
• A 45-year-old man with cirrhosis develops gynecomastia. Which explanation is correct?
• During an acute episode of cholecystitis, where is the pain most likely located and radiating?
• Which option below is a complication of portal hypertension?
• Which statement best describes the storage site of bile?
• Which phase is described as prodromal and precedes jaundice?
• In managing ascites due to liver dysfunction, which monitoring measures are essential?
• A client has a T-tube drainage of 750 mL since cholecystectomy. What is the most appropriate nursing action?
• In acute liver failure with confusion and decreased level of consciousness, which diagnostic finding best explains this behavior?
• What is the primary goal of nursing care for a client with acute pancreatitis?
• Why is a low-fat diet often recommended for patients with viral hepatitis?
• How is Hepatitis E transmitted?
• Which client statement is most consistent with vitamin C deficiency in chronic liver dysfunction?
• In acute pancreatitis, guarding and a board-like abdomen is an ominous sign and usually indicates which complication?
• Which statement best describes the storage site of bile?
• A client newly prescribed cholestyramine (Questran). Which statement indicates a need for further instruction?
• Elevated ammonia with changes in mental status indicates which condition?
• Which sign indicates jaundice in a patient with liver disease?
• What is the treatment approach for Hepatitis A?
• How should the nurse assess for the presence of asterixis in a client with cirrhosis?
• Which of the following is NOT an expected outcome of pancrelipase therapy?
• In the icteric phase, what happens to flu-like symptoms?
• During the posticteric phase, what happens to liver enzymes and bilirubin?
• Which is an age-related change of the hepatobiliary system?
• Which hepatitis is transmitted primarily through sexual contact and infected blood?
• Which statement best describes the storage site of bile?
• In advanced cirrhosis with hepatic encephalopathy, which assessment finding should the nurse report immediately?
• Which statement is true about lactulose therapy for hepatic encephalopathy?
• Deficient vitamin K absorption due to hepatic disease presents with which assessment finding?
• Which enzyme aids in the digestion of fats?
• Which statement best describes mild acute pancreatitis?
• Which phase features clay-colored stool due to bilirubin not reaching the stool?
• For a client with portal hypertension and esophageal varices, what is the goal of nursing interventions?
• During preoperative teaching, a client asks where bile is stored. The nurse knows that bile is stored in the:
• What nursing assessment should be performed when the abdomen is distended in cirrhosis?
• Which phase features a hallmark sign of hepatitis?
• Select the bilirubin level that would be considered normal in the context of hepatitis.
• Which sign is commonly associated with hepatic encephalopathy due to ammonia buildup?
• How many lobes does the liver have?
• A client with severe chronic liver disease reports difficulty seeing at night. Which vitamin deficiency is most likely responsible?
• What is the most common transmission route of Hepatitis C?
• Which type of deficiency results in macrocytic anemia?
• A physician orders for a new client with pancreatitis include bed rest, NPO, and total parenteral nutrition (TPN). What is the reason for the NPO status?
• A patient with esophageal varices is at risk for hemorrhagic shock. Which sign indicates potential hypovolemia?
• In cirrhosis, decreased metabolism of estrogen may lead to which finding?
• During assessment of a patient with cirrhosis and splenomegaly, which lab finding would you monitor most closely?
• What is the BEST preventive measure to help prevent ALL types of viral Hepatitis?
• A patient with gross ascites is positioned in high semi-Fowler’s. What is the nurse’s priority assessment for this patient?
• After cholecystectomy with a T-tube, which drainage color indicates expected progression?
• A patient with hepatitis has a bilirubin level of 6 mg/dL. Which finding would you expect?
• Which nursing intervention is most appropriate for a pancreatitis patient in the ICU?
• Which hepatitis type currently has a preventive vaccine available in the United States?
• In the setting of a balloon tamponade for variceal bleeding, which precaution is essential to ensure patient safety?
• Which statement best describes fluid management in pancreatitis?
• Which phase follows the icteric phase and indicates recovery?
• After an upper abdominal surgery for gallbladder disease, which intervention best prevents respiratory complications?
• Which finding indicates lactulose is effectively reducing ammonia in hepatic encephalopathy?
• Which statement about the liver’s role in coagulation is correct?
• After an incisional cholecystectomy for cholelithiasis, which nursing intervention is the highest priority for the client?
• A patient with severe chronic liver dysfunction presents with gingival bleeding and blood in the stool. Which vitamin deficiency is most likely?
• Regarding the Hepatitis A vaccine, which statement is accurate?
• Kupffer cells reside in the liver and perform which function?
• For a patient evaluated with acute cholecystitis and biliary colic, which nursing diagnosis takes top priority?
• Which laboratory pattern is most typical of hepatocellular injury in hepatitis?
• When should the second and third doses of the hepatitis B vaccine be administered?
• Which neurological sign is most commonly associated with hepatic encephalopathy?
• For Hepatitis A, contagiousness occurs before symptoms and continues after symptoms.
• A client with massive esophageal variceal hemorrhage requires balloon tamponade. What is the highest-priority goal in planning care?
• Which type of hepatitis is transmitted by fecal-oral exposure, often from contaminated food?
• A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct?
• Which statement correctly describes a total pancreatectomy?
• A postoperative client has a PRN order for ondansetron (Zofran). For which condition is this medication prescribed?
• What does ERCP stand for?
• Which position is most helpful to ease abdominal pain in a patient with acute pancreatitis?
• The pungent, musty breath characteristic of advanced liver disease is called?
• In acute liver failure, which lab finding best explains the decreased level of consciousness?
• Hepatitis D infection occurs only in conjunction with infection by which virus?
• In common bile duct obstruction, which change occurs in urine coloration?
• Hepatitis B immune globulin (HBIG) provides what type of protection?
• In chronic pancreatitis, secondary diabetes results from dysfunction of which pancreatic cells?
• A patient with acute pancreatitis has an order for an anticholinergic medication. This medication is given to which purpose?
• Clinical manifestations of common bile duct obstruction include all of the following except?
• In which phase would you expect bilirubin and liver enzymes to normalize after the acute illness?
• Lactulose reduces ammonia by which mechanism?
• A critical care nurse is caring for a client with acute pancreatitis. Which of the following would be an appropriate intervention to prevent respiratory complications?
• Hepatitis B exposure postexposure prophylaxis (HBIG) should be given as soon as possible, preferably within how long after exposure?
• Which patient below is at MOST risk for developing a complication related to a Hepatitis E infection?
• To prevent hypokalemia in a patient with ascites, which diuretic is potassium-sparing and may be ordered?
• What is the most common reason for inserting a nasogastric tube after abdominal surgery?
• The liver receives two blood supplies; which vessel delivers oxygen-rich arterial blood to the liver?
• A patient has a positive HBsAg. What education will you provide?
• A client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
• A lab shows positive HBsAg. Which education would be appropriate?
• A client being treated for pancreatitis faces the risk of atelectasis. Which intervention would be important to minimize this risk?
• In acute pancreatitis pain management, which intervention takes priority?
• A patient with high bilirubin may present with which assessment finding?
• A client has hepatitis A after eating contaminated oysters. Which assessment finding would you expect?
• A patient with cirrhosis is at risk for esophageal variceal bleeding. Which finding would be most concerning?
• What initial measure can the nurse implement to reduce risk of injury for a client with liver disease?
• Which of the following is a function of the liver?
• Which enzyme primarily digests carbohydrates and is secreted by the exocrine pancreas?
• A client is scheduled for a cholecystogram. What is the diagnostic use of this exam?
• A patient with esophageal varices is at risk for hemorrhagic shock. Which sign indicates hypovolemia?
• Which laboratory finding is most consistent with hyperammonemia-related encephalopathy?
• An older client with cirrhosis on diuretic therapy shows a steady weight loss. Which of the following findings most likely indicates effective diuresis?
• In what location would the nurse palpate for the liver?
• When assessing a client with cirrhosis, which stool color is typically reported due to lack of bile in the GI tract?
• Upon receiving a dinner tray for a patient admitted with acute gallbladder inflammation, which item should be questioned?
• A client is undergoing removal of the head of the pancreas, resection of the duodenum and stomach, with redirecting the flow of secretions from the stomach, gallbladder, and pancreas into the jejunum. What procedure is this client undergoing?
• In a client with cirrhosis and elevated ammonia, which diet is anticipated?
• Which sign indicates hepatic encephalopathy?
• Lactulose is used in cirrhosis to detoxify ammonium and act as an osmotic laxative. Which statement best describes its action?
• Which dietary consideration is appropriate for pancreatitis to minimize pancreatic stimulation?
• Which phase is also called the posticteric phase?
• A patient with continued variceal bleeding after pharmacologic and endoscopic therapy requires a procedure that lowers portal pressure. Which procedure is indicated?
• A patient with hepatitis develops hepatic encephalopathy. Which lab result best correlates with this mental status change?
• Which description best characterizes the pain in acute pancreatitis?
• Which symptom will a nurse observe most commonly in clients with pancreatitis?
• Which sign indicates hepatic encephalopathy due to ammonia buildup?
• Hepatitis G is most similar to which hepatitis?
• If a patient has positive anti-HBs, what can be inferred?
• If a patient tests positive for anti-HAV and IgG, what is the appropriate interpretation?
• Which of the following statements is a sign of jaundice?
• A client scheduled for an endoscopic retrograde cholangiopancreatography (ERCP) asks what to expect. The nurse identifies the need for further information if the client says which statement?
• Which is NOT a function of the liver?
• What test should the nurse prepare the client for that will locate stones in the common bile duct?
• Which of the following is a sign commonly associated with hepatitis?
• A patient with cirrhosis shows hand-flapping tremors. How is this finding documented?
• What is the predominant clinical feature of acute pancreatitis?
• If anti-HAV and IgM are detected, what does that indicate?
• In cirrhosis, collateral vessels reflect GI circulation changes. Which finding reflects this process?
• Which lab result would best explain hepatic encephalopathy signs such as disorientation and asterixis?
• In a client with pancreatitis, which condition necessitates close monitoring of fluid intake and output and electrolytes?
• A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect?
• What is the purpose of balloon tamponade in esophageal variceal bleeding?
• Which laboratory test is elevated to help confirm suspected pancreatitis?
• Lactulose is prescribed to treat hepatic encephalopathy. Which lab result would indicate the medication was effective?
• Which pancreatic enzyme primarily digests fats?
• Which statement is true about acute vs chronic hepatitis infections?
• In the icteric phase, which symptom is commonly present?
• A patient with cirrhosis is admitted; which vessel delivers blood high in nutrients to the liver?
• Which instruction should the nurse give a client with viral hepatitis to provide adequate nutrition?
• Drug-induced hepatitis is a major cause of acute liver failure. Which medication is the leading cause?
• A patient is prescribed Peginterferon alfa-2a. What route is appropriate for administration?
• Which phase is associated with prodromal signs before jaundice appears?
• What is the most common route of transmission for Hepatitis A?
• Which statement about the liver’s production is true?
• In the posticteric phase, which statement best describes jaundice and stool color?
• Which condition is a consequence of portal hypertension that leads to fluid accumulation in the abdomen?
• Which statement about esophageal varices is true?
• Which procedure removes the bottom half of the pancreas?
• Asterixis is associated with hepatic encephalopathy. Which stage is typically linked to this finding?
• Which dietary instruction is appropriate for a patient with active Hepatitis B?
• A client with suspected biliary obstruction reports changes in stool color. Which stool color is common with biliary obstruction?
• Which phase of hepatitis is characterized by jaundice and dark urine?
• The liver receives blood from two sources. Which vessel delivers blood high in nutrients but low in oxygen to the liver?
• Esophageal varices are almost always caused by which hepatobiliary condition?
• Which intervention would you expect to be prescribed for a client with acute pancreatitis to support pancreatic rest?
• Prevention of Hepatitis D includes vaccination against which virus?
• Which vessel carries nutrient-rich blood to the liver?
• Which type of hepatitis is transmitted by blood or body fluids?
• Which statement about hepatitis is correct?
• Which statement is correct about hepatitis vaccines options in the United States?
• A patient exposed to Hepatitis A at a restaurant one week ago: what education is important?
• Cholecystojejunostomy is performed to relieve obstructive jaundice and is generally considered a palliative procedure. Which choice best reflects this statement?
• Is a patient with Hepatitis A contagious before and after signs and symptoms?
• For a client with viral hepatitis, what is the recommended daily fluid intake to support nutrition?
• Infants who contract Hepatitis B at birth are at high risk for chronic infection. Which option reflects this scenario?
• A client with cirrhosis has elevated ammonia. Which medication will the nurse administer to detoxify ammonium and act as an osmotic agent?
• Chronic pancreatitis with increased appetite and thirst may indicate secondary diabetes. What explains the cause?
• Which intervention helps prevent atelectasis and pooling of respiratory secretions in acute pancreatitis?
• Which phase is prodromal with flu-like symptoms such as fatigue and nausea?
• A patient with hepatic encephalopathy should avoid which meal option?
• Which statement about amylase in acute pancreatitis is correct?
• A client reports severe right shoulder pain 24 hours after laparoscopic cholecystectomy. Which statement provides correct information for the nurse to convey?