A patient is scheduled for a liver biopsy.
Which laboratory result would be of most concern to the nurse?

Serum ammonia level of 56 mcg N/dL

Hemoglobin of 11 g/dL

White blood cell count of 14.2 x 103/uL

Prothrombin time of 32 seconds

Answer and Explanation

The Correct Answer is D

Choice A rationale

While an elevated serum ammonia level can indicate liver dysfunction, it is not typically a contraindication for liver biopsy. Ammonia is a byproduct of protein metabolism and is normally converted into urea by the liver, which is then excreted in the urine. Elevated levels can occur in liver disease, but they are not typically a direct concern in the context of a liver biopsy.
Choice B rationale
A hemoglobin level of 11 g/dL is slightly low, but it is not typically a contraindication for a liver biopsy. Hemoglobin is the protein in red blood cells that carries oxygen. While a low hemoglobin level can indicate anemia, it would not typically prevent a patient from undergoing a liver biopsy.
Choice C rationale
A white blood cell count of 14.2 x 103/uL is slightly elevated, indicating a possible infection or inflammation. However, this would not typically be a contraindication for a liver biopsy.
Choice D rationale
A prothrombin time of 32 seconds is significantly prolonged, indicating a potential problem with blood clotting. This would be a major concern for a nurse caring for a patient scheduled for a liver biopsy, as the procedure involves inserting a needle into the liver and could lead to bleeding. Patients with a prolonged prothrombin time are at an increased risk of bleeding complications.

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Correct Answer is D

Explanation

Choice A rationale
Documenting the bowel sounds as hypoactive is not the most appropriate action. Hypoactive bowel sounds are fewer than three bowel sound events in a minute or none at all. However, the absence of bowel sounds does not necessarily mean they are hypoactive. It could be due to other reasons such as ileus.
Choice B rationale
Administering prescribed drugs for constipation is not the immediate course of action when the nurse doesn’t hear any gurgling while listening to bowel sounds. Constipation is a condition that can cause hypoactive bowel sounds, but it’s not the only reason for the absence of bowel sounds. The nurse should first confirm the absence of bowel sounds before considering this action.
Choice C rationale

Reviewing dietary intake for the past 24 hours is not the immediate course of action. While diet can affect bowel sounds, it’s not the first step when bowel sounds are not heard. The nurse should first confirm the absence of bowel sounds before considering this action.
Choice D rationale
The correct action when the nurse doesn’t hear any gurgling while listening to bowel sounds is to continue to listen for at least another 60 seconds. Bowel sounds are produced by the movement of fluid, gas, and contents through the intestines. An absence of bowel sounds for greater than two minutes may indicate that there is no peristalsis—which implies an ileus.
Therefore, the nurse should continue to listen for at least another 60 seconds to confirm the absence of bowel sounds.

A. Fecal contamination of food or water B. Sexual intercourse C. Kissing mouth-to-mouth D. Contact with infected blood .

Correct Answer is A

Explanation

Choice A rationale
Hepatitis A is primarily transmitted through fecal contamination of food or water. This can occur when an infected person does not wash their hands properly after going to the bathroom and then touches food or other objects that others then put in their mouths.
Choice B rationale
While sexual intercourse can potentially transmit Hepatitis A, it is not the primary mode of transmission. The risk is higher if the sexual activity involves oral-anal contact.
Choice C rationale
Kissing mouth-to-mouth is not typically a primary mode of Hepatitis A transmission unless fecal particles are somehow involved.
Choice D rationale
Contact with infected blood is not the primary mode of Hepatitis A transmission. Hepatitis A is primarily spread through the fecal-oral route, not through blood.

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A patient is scheduled for a liver biopsy. Which laboratory result would be of most concern to the nurse?

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Naxlex Comprehensive Predictor Exams

The nurse doesn’t hear any gurgling while listening to bowel sounds. What should be the nurse’s next course of action?

Correct Answer is D

Explanation

A patient diagnosed with Hepatitis A is concerned about the risk of transmission to other family members. What is the primary mode of Hepatitis A transmission that the nurse should mention in the response?

Correct Answer is A

Explanation

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A patient is scheduled for a liver biopsy.
Which laboratory result would be of most concern to the nurse?