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Free Practice Quiz Question List

6 Hepatic Encephalopathy Online Quiz Questions

Use this free practice quiz with 20 questions to review 6 Hepatic Encephalopathy, test your knowledge, and prepare for your next test or exam.

20 questions
01
True or false
1 point

Asterixis is specific to hepatic encephalopathy (HE).

  1. A

    True

  2. B

    False

02
Written response
1 point

Which criteria are used to describe the severity of hepatic encephalopathy?

03
Fill in the blank
1 point

Under the West Haven criteria, grade or higher is generally considered overt hepatic encephalopathy.

04
True or false
1 point

Lactulose for overt hepatic encephalopathy should be titrated to produce uncontrolled diarrhea.

  1. A

    True

  2. B

    False

05
Choose one
1 point

A patient with cirrhosis is lethargic, disoriented to time, and has a flapping tremor when holding out their hands. Which West Haven grade best fits?

  1. A

    Grade I

  2. B

    Grade II

  3. C

    Grade III

  4. D

    Grade IV

06
Written response
1 point

For a patient taking lactulose for overt hepatic encephalopathy, what is the upper end of the usual daily stool goal? Enter a whole-number count of soft bowel movements.

07
Fill in the blank
1 point

A patient with cirrhosis and ascites develops fever and new confusion. Prompt evaluation for infection should include to assess for spontaneous bacterial peritonitis.

08
Choose one
1 point

A patient with cirrhosis is confused and has an elevated serum ammonia level. Which interpretation is most appropriate?

  1. A

    An elevated result confirms HE, although it cannot indicate severity.

  2. B

    An elevated result determines the West Haven grade but not the diagnosis.

  3. C

    The result alone should not establish HE, grade its severity, or guide treatment.

  4. D

    A normal result confirms that HE is the cause of confusion.

09
Choose all
1 point

Which factors can precipitate or worsen overt hepatic encephalopathy? Select all that apply.

  1. A

    Infection

  2. B

    Gastrointestinal bleeding

  3. C

    Constipation

  4. D

    Dehydration or excessive diuresis

  5. E

    Electrolyte or renal abnormalities

  6. F

    Sedating medications such as opioids or benzodiazepines

  7. G

    Asterixis by itself

10
Choose one
1 point

A patient with cirrhosis develops altered mental status. Which approach best reflects how hepatic encephalopathy should be evaluated?

  1. A

    Diagnose HE from cirrhosis alone without assessing the mental-status change.

  2. B

    Assess for HE while also considering other causes of altered mental status.

  3. C

    Use the ammonia level as the sole diagnostic test.

  4. D

    Wait for asterixis to appear before considering HE.

11
Choose all
1 point

A patient has recurrent overt hepatic encephalopathy despite maintenance lactulose. Which actions are appropriate? Select all that apply.

  1. A

    Reassess adherence to maintenance treatment.

  2. B

    Search again for precipitating factors.

  3. C

    Consider adding rifaximin.

  4. D

    Stop looking for precipitants once lactulose has been prescribed.

  5. E

    Use ammonia alone to decide the treatment plan.

12
Choose one
1 point

A patient with hepatic encephalopathy has marked confusion and somnolence with gross disorientation, but is not comatose. Which West Haven grade best fits?

  1. A

    Grade I

  2. B

    Grade II

  3. C

    Grade III

  4. D

    Grade IV

13
Choose one
1 point

A patient with cirrhosis is difficult to arouse and responds only to strong stimulation. What is the immediate management priority?

  1. A

    Continue routine outpatient observation because the patient still responds to stimulation.

  2. B

    Urgently assess airway protection and level of care, while evaluating for other urgent causes.

  3. C

    Use the ammonia level to determine whether airway assessment is necessary.

  4. D

    Treat with lactulose alone before assessing the patient's level of care.

14
Open ended
1 point

A patient with cirrhosis becomes acutely confused, then becomes difficult to arouse and responds only to strong stimulation. Outline the immediate management priorities, including triage and evaluation.

15
Choose one
1 point

Which description best defines hepatic encephalopathy?

  1. A

    Brain dysfunction associated with liver impairment or portosystemic shunting

  2. B

    A liver infection that always causes coma

  3. C

    A movement disorder caused only by electrolyte abnormalities

  4. D

    A diagnosis established solely by an elevated ammonia level

16
True or false
1 point

A normal ammonia result in a confused patient should prompt consideration of alternative or additional causes of altered mental status.

  1. A

    True

  2. B

    False

17
Choose one
1 point

A confused patient with cirrhosis has an elevated serum ammonia level. What conclusion is justified by this result alone?

  1. A

    It confirms hepatic encephalopathy and determines its grade.

  2. B

    It rules out other causes of altered mental status.

  3. C

    It does not by itself confirm hepatic encephalopathy or determine its severity.

  4. D

    It should be used alone to decide whether to give treatment.

18
Choose one
1 point

A patient with cirrhosis and overt hepatic encephalopathy has recently started an opioid. Which action best applies the guidance on potentially reversible contributors?

  1. A

    Treat the medication as unrelated to mental status and make no medication review.

  2. B

    Review the opioid as a possible precipitating or worsening factor.

  3. C

    Increase the opioid dose to treat the confusion.

  4. D

    Use the medication exposure to diagnose hepatic encephalopathy without further assessment.

19
Written response
1 point

Lactulose is usually titrated to about 2–3 soft bowel movements daily. What is the lower end of this target? Enter a number of soft bowel movements per day.

20
Written response
1 point

Which medication may be added when hepatic encephalopathy recurs despite maintenance treatment with lactulose?