Certified Hospice and Palliative Assistant (CHPNA) Practice Test

Which terminal event is commonly associated with end stage liver disease?

1. Kidney failure

2. Respiratory failure

3. Bleeding from gastrointestinal or esophageal varices

4. Heart failure

The correct answer is: Bleeding from gastrointestinal or esophageal varices

In end-stage liver disease, one of the critical complications that can arise is bleeding from gastrointestinal or esophageal varices. This is primarily due to the buildup of pressure in the veins that supply the liver, leading to a condition known as portal hypertension. As liver disease progresses, the liver's ability to function declines, which can cause the veins in the esophagus and stomach to become engorged and fragile. These varices can rupture, resulting in significant and potentially life-threatening bleeding. This event is common in patients with end-stage liver disease and often requires urgent medical intervention. While kidney failure, respiratory failure, and heart failure can all occur in patients with multiple comorbidities, they are not as specific and directly related to the terminal event of end-stage liver disease as are the complications associated with variceal bleeding. Thus, bleeding from gastrointestinal or esophageal varices is the most characteristic terminal event linked directly with end-stage liver disease.