Hepatitis Review for the REx-PN®
There’s a lot to do to prepare for your REx-PN®, but don’t get overwhelmed! Here’s a bite-sized lesson to help you remember your concept of hepatitis. Let’s start with a question: 

Hepatitis Review for the REx-PN®

Q: A client who is an intravenous drug abuser (IVDA) is receiving tests to confirm hepatitis. Which type(s) of hepatitis is this client at greatest risk for? 

A. Hepatitis A 

B. Hepatitis B

C. Hepatitis C 

D. Both Hepatitis B and C  

There are five main types of hepatitis: A, B, C, D, and E. A different virus is responsible for each type of hepatitis, so let’s dive into each type to answer this REx-PN®- style question!

What is Hepatitis?  

Hepatitis means inflammation of the liver. Hepa-: liver, -itis: inflammation. So, hepatitis is the inflammation of the liver. Although hepatitis is not always caused by a virus, certain viruses can cause hepatitis, which is a great concern for public health. The inflammatory process causes hepatic cell degeneration and necrosis (death), eventually leading to human death.  

How is Hepatitis Transmitted?  

Hepatitis A, B, and C transmission routes

Hepatitis A virus (HAV): spread via feces and contaminated foods. Infection is generally mild, and vaccines are recommended for protection from this virus.  


Hepatitis B virus (HBV): transmitted through bodily fluids (blood, semen, etc.). This virus can lead to chronic disease and is (with HCV) the most common cause of liver cirrhosis and cancer. Vaccines are available for the prevention of this virus.  


Hepatitis C virus (HCV): mostly transmitted through the exchange of bodily fluids and blood products. This virus can lead to chronic disease and is (with HBV) the most common cause of liver cirrhosis and cancer. Unfortunately, there is no vaccine for HCV.  


Hepatitis A and E are typically caused by consuming contaminated food and water.  


Hepatitis B, C, and D are generally spread through contact with bodily fluids. These diseases spread by sharing contaminated blood products (needles) and sexual contact. They can also be transmitted from mother to child at birth.  

Note: This content is from CleverOrcaPN.ca REx-PN® review. If you want to grab similar content, click here for the details.  

What Does Hepatitis Look Like?  

Regardless of the type of hepatitis, the clinical picture is similar. Patients enter three phases:  

  • Anicteric phase: nausea, anorexia, headache, upper right quadrant discomfort, low-grade fever. 

  • Icteric phase (jaundice phase): dark urine, pruritus, light-clay-colored stools.  

  • Post-icteric phase (after jaundice phase): the return of fatigue and malaise.  

There are vaccines available to prevent Hepatitis A & B, but not Hepatitis C. Therefore, health promotion and infection control are crucial in preventing transmission. It’s important to understand the sources of infection and disease transmission for each type as well as the diagnostic tests the client will need.  


Review the table below. When studying for the test, creating a similar visual material for each type of hepatitis, source of infection, mode of transmission, and the availability of a preventive vaccine is a great idea. 


Virus Sources of Infection  Spread of Infection  Drug therapy etc. 
Hepatitis A (HAV)  Contaminated food, food handlers, daycare  Fecal-oral contamination  Vaccination available 
Hepatitis B (HBV)  Contaminated needles, blood products  Percutaneous - blood and blood products  Vaccination available 
Hepatitis C (HCV)  Contaminated needles, blood products  Percutaneous - blood and blood products  No vaccination available 

Now that we have reviewed the different types of hepatitis, you can figure out which form of hepatitis poses the most significant risk to intravenous drug users. Go ahead and answer the REx-PN® practice question above!

Answer: D. Both Hepatitis B and C

There’s more of this type of question in our test bank. Move forward in your REx-PN® journey by trying our mock exams. Check them out here: REx-PN® Mock Exam 

Study Tips for Hepatitis

REMEMBER the following mnemonic-  


“IF IT BEGINS WITH A VOWEL, IT COMES FROM THE BOWEL.”  

You have what it takes to be successful. Keep going! 


CleverOrcaPN Team