Liver Quiz: Cirrhosis Or Hepatitis?

1. A client receives hepatitis B vaccine. Which response indicates successful immunization?

Negative HBsAg

Positive anti-HBs (hepatitis B surface antibody)

Positive HBeAg

Negative anti-HBc

2. A patient with decompensated cirrhosis is at high risk for renal dysfunction. Which syndrome characterizes this complication?

Hepatorenal syndrome

Acute tubular necrosis

Chronic glomerulonephritis

Diabetic nephropathy

3. Which antiviral medication is commonly used for hepatitis B to suppress viral replication?

Ribavirin alone

Tenofovir or entecavir

Interferon alpha only

Corticosteroids

4. A nurse educates a patient newly diagnosed with cirrhosis on alcohol abstinence. Which outcome would best demonstrate effective teaching?

Patient states alcohol worsens portal hypertension and liver damage

Patient agrees to reduce alcohol to weekends only

Patient reports decreased jaundice after one week

Patient's albumin level normalizes

5. Hepatitis D (delta virus) requires which condition to establish infection?

Concurrent hepatitis B infection

Prior hepatitis C exposure

Immunosuppression

Cirrhosis

6. A patient with cirrhosis presents with ascites. Which mechanism best explains fluid accumulation in the peritoneal cavity?

Decreased colloid osmotic pressure from low albumin and portal hypertension

Acute viral infection destroying hepatocytes

Elevated bilirubin causing fluid transudation

Hepatitis B surface antigen triggering inflammation

7. Which finding on liver biopsy would confirm a diagnosis of cirrhosis rather than acute hepatitis?

Hepatocyte ballooning and Kupffer cell activation

Diffuse fibrosis with bridging and architectural distortion

Portal inflammation with lymphocyte infiltration

Fatty infiltration of hepatocytes

8. Variceal bleeding is a medical emergency in cirrhosis. What is the immediate nursing priority?

Administer beta-blockers

Establish two large-bore IVs and prepare for volume resuscitation

Elevate the head of bed

Administer antibiotics

9. A patient with hepatitis C has genotype 1. Which statement about treatment is most accurate?

Direct-acting antivirals offer high cure rates regardless of genotype

Genotype 1 requires longer treatment duration than genotypes 2–3

Interferon monotherapy is the gold standard

No effective treatment exists for genotype 1

10. Which dietary modification is most important for a patient with cirrhosis and hepatic encephalopathy?

High-protein diet to rebuild liver cells

Protein restriction to reduce ammonia production

High-fat diet for caloric density

Unrestricted sodium intake

11. Which pathophysiologic change is characteristic of cirrhosis but NOT typical of acute viral hepatitis?

Hepatocyte inflammation and necrosis

Fibrosis and permanent architectural distortion

Elevated transaminase levels

Jaundice from hyperbilirubinemia

12. Cirrhosis impairs the liver's synthetic function. Which lab value best reflects this decline?

Increased albumin

Decreased prothrombin time

Prolonged PT/INR with low albumin

Elevated alkaline phosphatase

13. A patient with decompensated cirrhosis develops spontaneous bacterial peritonitis. Which antibiotic class is typically initiated empirically?

Aminoglycosides

Third-generation cephalosporins

Fluoroquinolones

Macrolides

14. Hepatitis A differs from hepatitis B and C primarily in its:

Acute presentation and fecal-oral transmission

Chronic progression and cirrhosis risk

Blood-borne transmission only

Requirement for HDV co-infection

15. A nurse administers lactulose to a patient with cirrhosis. What is the primary therapeutic goal?

Reduce ammonia levels and prevent encephalopathy

Increase bile production

Improve platelet count

Enhance protein synthesis

16. Which clinical sign suggests hepatic encephalopathy rather than simple jaundice in a cirrhotic patient?

Yellow discoloration of skin and sclera

Asterixis and altered mental status

Dark urine and pale stools

Pruritus and spider angiomas

17. A client with chronic hepatitis B is asymptomatic but has detectable HBeAg and HBV DNA. What does this indicate?

Resolved infection with immunity

Active viral replication and infectivity

Chronic carrier state with low infectivity

Fulminant hepatic failure

18. Portal hypertension develops as a direct result of cirrhosis. Which complication would the nurse anticipate first?

Esophageal varices

Ascites

Hepatic encephalopathy

Spontaneous bacterial peritonitis

19. A patient with hepatitis C presents with fatigue and right upper quadrant tenderness. Which lab finding would most likely differentiate acute hepatitis from cirrhosis?

Markedly elevated ALT/AST with normal albumin

Low albumin with elevated PT/INR

Elevated bilirubin alone

Positive HCV antibody

Liver Quiz: Cirrhosis or Hepatitis?