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Quizzes > Health & Medicine

Cirrhosis NCLEX Questions: Brush Up on GI Nursing Care

Quick, free cirrhosis practice test. Instant results.

Editorial: Review CompletedCreated By: Rockey CulleyUpdated Aug 25, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
paper art liver cross section free NCLEX cirrhosis quiz test digestive and GI disorders on dark blue background

This quiz helps you review cirrhosis nursing care for the NCLEX, including assessment, labs, complications, safety, and medications. Use your results to spot weak areas and focus your next study session. For broader GI prep, try our gastrointestinal nclex quiz, and round out med-surg practice with ckd nclex questions.

What is the most common cause of cirrhosis in the United States?
Alcoholic liver disease
Nonalcoholic fatty liver disease
Autoimmune hepatitis
Chronic hepatitis B infection
Alcoholic liver disease accounts for the majority of cirrhosis cases in the US. Chronic alcohol consumption leads to hepatocyte injury, fibrosis, and regenerative nodules characteristic of cirrhosis. Other causes include viral hepatitis and nonalcoholic fatty liver disease but are less prevalent.
Ascites is defined as:
Swelling of the lower extremities
Inflammation of the gallbladder
Obstruction of the bile duct
Accumulation of fluid in the peritoneal cavity
Ascites is the accumulation of fluid in the peritoneal cavity due to increased hydrostatic pressure and decreased oncotic pressure in cirrhosis. This results from portal hypertension and hypoalbuminemia. It presents clinically as abdominal distension and shifting dullness on examination.
Which skin finding is most characteristic of cirrhosis?
Spider angiomas
Livedo reticularis
Seborrheic keratosis
Cafe-au-lait spots
Spider angiomas are vascular lesions with a central arteriole and radiating capillaries seen in cirrhosis due to hyperestrogenism and vascular changes. They are most commonly located on the chest, face, and arms. They help in assessing the severity of liver dysfunction.
Which laboratory finding is expected in a patient with cirrhosis?
Increased clotting factors
Hypernatremia
Hypoalbuminemia
Elevated albumin
Cirrhosis leads to decreased albumin synthesis by the damaged liver, resulting in hypoalbuminemia. Low albumin contributes to decreased oncotic pressure and complications like ascites. Other lab abnormalities include elevated liver enzymes and prolonged prothrombin time.
Portal hypertension in cirrhosis primarily results from which of the following?
Fibrosis and nodular regeneration increasing vascular resistance
Immune-mediated vasculitis
Systemic vasoconstriction
Increased cardiac output
Portal hypertension in cirrhosis arises from increased resistance to portal blood flow due to fibrosis and nodule formation. This elevated pressure leads to the formation of varices and ascites. The structural changes in the liver architecture are the primary drivers of resistance.
What is the first-line pharmacologic treatment for ascites in a patient with cirrhosis?
Furosemide
Mannitol
Spironolactone
Hydrochlorothiazide
Spironolactone is the first-line diuretic for cirrhotic ascites because it antagonizes aldosterone, reducing sodium retention and preventing potassium loss. Loop diuretics like furosemide can be added but carry a higher risk of hypokalemia. Combining agents may be necessary for refractory cases.
Which event most commonly precipitates hepatic encephalopathy in cirrhotic patients?
Viral infection
Gastrointestinal bleeding
Hyperglycemia
Hypothyroidism
Gastrointestinal bleeding is a common precipitant of hepatic encephalopathy as it increases nitrogen load in the gut, leading to elevated ammonia levels. Other triggers include infections, dehydration, and electrolyte imbalances. Prompt control of bleeding and encephalopathy is essential.
Before performing a paracentesis, the nurse should ensure the patient does which of the following?
Takes an antihypertensive
Eats a meal
Lies supine for two hours
Empties the bladder
An empty bladder before paracentesis reduces the risk of accidental bladder puncture during the procedure. Ensuring the patient voids also improves comfort and safety. Other preparatory steps include proper positioning and monitoring vital signs.
An AST to ALT ratio greater than 2:1 is most suggestive of which type of cirrhosis?
Cholestatic cirrhosis
Alcoholic cirrhosis
Cryptogenic cirrhosis
Viral cirrhosis
An AST to ALT ratio greater than 2:1 is characteristic of alcoholic liver disease due to mitochondrial damage and pyridoxine deficiency in alcoholics. Viral hepatitis typically shows higher ALT than AST. This ratio helps distinguish alcohol-related injury.
A patient with cirrhosis develops oliguria, rising serum creatinine, and no improvement after diuretic withdrawal. This constellation is most consistent with:
Post-renal obstruction
Pre-renal azotemia
Hepatorenal syndrome
Acute tubular necrosis
Hepatorenal syndrome is a functional renal failure in advanced liver disease marked by oliguria, rising creatinine, and lack of improvement with fluid management or diuretic withdrawal. It results from severe vasoconstriction of renal circulation. Early recognition is critical for management.
Lactulose treats hepatic encephalopathy by which primary mechanism?
Acidifying the colon to convert ammonia to ammonium
Binding ammonia in the bloodstream
Stimulating renal ammonia excretion
Inhibiting ammonia production in the liver
Lactulose acidifies the colon lumen, converting ammonia (NH3) into ammonium (NH4+), which is less absorbable and promotes ammonia excretion. This reduces systemic ammonia levels and improves encephalopathy. It also has an osmotic laxative effect.
The Model for End-Stage Liver Disease (MELD) score includes which three laboratory values?
AST, ALT, and alkaline phosphatase
Gamma-glutamyl transferase, bilirubin, and lipase
Serum bilirubin, serum creatinine, and INR
Albumin, total protein, and platelet count
The MELD score uses serum bilirubin, serum creatinine, and INR to predict mortality in end-stage liver disease and prioritize transplant allocation. It has replaced older systems like the Child-Pugh score for organ allocation. Higher scores indicate greater urgency.
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Study Outcomes

  1. Understand Cirrhosis Pathophysiology -

    Identify the underlying mechanisms of liver scarring and portal hypertension associated with cirrhosis to strengthen your foundation in gastrointestinal system disorders.

  2. Analyze Clinical and Laboratory Findings -

    Interpret key lab values and physical assessment signs to recognize complications such as ascites, encephalopathy, and variceal bleeding in cirrhosis management questions.

  3. Apply Nursing Interventions -

    Demonstrate appropriate nursing actions for fluid management, dietary modifications, and monitoring in patients with digestive disorders, reinforcing practical skills for NCLEX digestive system disorders.

  4. Evaluate Medication Regimens -

    Assess pharmacologic treatments commonly used in cirrhosis and related GI conditions to ensure safe and effective patient care during your NCLEX prep.

  5. Differentiate GI Disorders -

    Distinguish cirrhosis from other gastrointestinal system disorders nclex quiz scenarios to enhance your diagnostic reasoning and clinical decision-making.

  6. Reinforce NCLEX Test-Taking Strategies -

    Practice critical-thinking approaches with NCLEX-style questions on cirrhosis management and digestive disorders to boost confidence and exam readiness.

Cheat Sheet

  1. Understanding Cirrhosis Pathophysiology -

    In cirrhosis, healthy hepatic tissue is replaced by fibrotic nodules and scar tissue, leading to portal hypertension and impaired detoxification (NIH). Recall the "Scar Highway" mnemonic to visualize how blood flow reroutes through collateral vessels. Mastering this core concept is crucial for nclex cirrhosis questions and broader nclex digestive system disorders practice.

  2. Key Clinical Manifestations -

    Common signs include jaundice, ascites, peripheral edema, and hepatic encephalopathy; use the mnemonic "JADE" (Jaundice, Ascites, Delirium, Edema) to remember them in a flash. For example, a positive fluid wave test confirms ascites in cirrhosis management questions (Johns Hopkins Medicine). Early recognition of these symptoms boosts success on gastrointestinal system disorders NCLEX quiz items.

  3. Laboratory and Diagnostic Markers -

    Elevated AST, ALT, ALP, and bilirubin with hypoalbuminemia and prolonged PT/INR are hallmarks (American Liver Foundation). Familiarize yourself with the MELD score formula: 0.957×ln(creatinine)+0.378×ln(bilirubin)+1.12×ln(INR)+0.643 to assess severity. Accurate interpretation of labs is a frequent focus in digestive disorders NCLEX practice.

  4. Evidence-Based Management Strategies -

    Sodium restriction (<2 g/day), spironolactone plus furosemide, and therapeutic paracentesis for refractory ascites are standard (AASLD guidelines). For hepatic encephalopathy, lactulose (20 - 30 g orally TID) acidifies the colon and traps ammonia - think "Trap the Toxin." Solid grasp of these interventions will shine in cirrhosis management questions on the NCLEX.

  5. Patient Education and Preventive Measures -

    Encourage alcohol cessation, hepatitis A and B vaccination, and small frequent meals with adequate protein to prevent muscle wasting (CDC). Teach patients the "ABC" of self-care: Abstain, Balance diet, Check labs regularly. Empowering patients builds confidence - and it mirrors the teaching components tested on gastrointestinal system disorders NCLEX quizzes.

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