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Chapter 112: Cirrhosis Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient is diagnosed with fibrotic liver disease; a liver biopsy shows micronodular cirrhosis. What is the most common cause of this form of cirrhosis?

a. Alcoholism b. Hepatitis C c. Hepatocellular carcinoma d. Right-sided heart failure

ANS: A a. Early liver cirrhosis b. Late liver cirrhosis c. Liver failure and ascites d. Probably viral hepatitis

Micronodular cirrhosis is often associated with alcoholic liver disease. Viral causes and carcinoma usually cause macronodular cirrhosis. Right-sided heart failure occurs with many other causes as part of the disease development.

2. A patient with a history of chronic alcoholism reports weight loss, pruritis, and fatigue. The patient’s urine and stools appear normal. What do these findings indicate?

ANS: A

Early symptoms of cirrhosis are characterized by this patient’s symptoms. As the condition worsens, stools and urine change color and the patient develops anorexia, nausea, and vomiting. Liver failure and ascites are late and will include abdominal pain. Viral hepatitis is a less likely diagnosis in the patient with a history of alcoholism.

NURSINGTB.COM a. Cephalosporin b. Furosemide c. Lactulose d. Spironolactone

3. A patient diagnosed with cirrhosis develops ascites. Which medication will be ordered initially to improve symptoms?

ANS: D

Spironolactone is the initial diuretic used to improve fluid diuresis in patients with ascites. Furosemide may be used as adjunctive therapy. Cephalosporin is used when infections occur. Lactulose is used to increase stools and reduce encephalopathy.

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