👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: LFTs · liver panel · liver enzymes · AST ALT · hepatic panel
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Use this quick-reference guide to spot, treat, and prevent Liver Function Tests on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Enzymes
ALT 7-56 U/L (liver specific)
AST 10-40 U/L
↑ = hepatocellular injury
📌 Bili
Total bilirubin 0.3-1.0 mg/dL
↑ = jaundice, biliary obstruction
📌 Other
Albumin 3.5-5.0 g/dL
↓Albumin → edema, ascites
ALP 44-147; ↑bone/biliary
🚩 Report
↑Ammonia → encephalopathy
↑PT/INR → bleeding risk
📚 Liver Function Tests — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Liver function tests assess hepatocellular injury, bile flow, and the liver's synthetic ability. AST and ALT rise with liver cell damage, bilirubin and alkaline phosphatase rise with biliary obstruction, and albumin and PT/INR reflect how well the liver is making proteins and clotting factors. They guide monitoring of hepatotoxic drugs and chronic liver disease.
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Key points
Understand these first
ALT is more specific to the liver than AST, which also appears in muscle and other tissues.
Elevated bilirubin causes jaundice and signals impaired bile processing or biliary obstruction.
Low albumin reflects poor liver synthetic function and contributes to edema and ascites.
A prolonged PT/INR in liver disease reflects reduced production of clotting factors.
A rising ammonia level in liver failure can produce confusion and hepatic encephalopathy.
Many medications, including acetaminophen and statins, require LFT monitoring for hepatotoxicity.
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Nursing priorities
What to do, in order
Assess for jaundice, ascites, easy bruising, bleeding, and changes in mental status.
Monitor for bleeding risk given impaired clotting factor production in liver disease.
Review and question hepatotoxic medications and limit acetaminophen dosing.
Implement bleeding and fall precautions in patients with significant liver dysfunction.
Trend LFTs and coagulation values to evaluate progression or drug toxicity.
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Red flags — report now
Escalate immediately
New confusion, asterixis, or rising ammonia signals hepatic encephalopathy and needs prompt reporting.
Signs of GI bleeding such as hematemesis or melena are emergencies in liver disease.
Never exceed maximum acetaminophen dosing, especially with existing liver impairment.
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Labs & values
Numbers to know
ALT 7-56 units/L
AST 10-40 units/L
Total bilirubin 0.1-1.2 mg/dL
Alkaline phosphatase 44-147 units/L
Albumin 3.5-5.0 g/dL
Ammonia 15-45 mcg/dL
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Patient teaching
What patients must know
Avoid alcohol and limit acetaminophen, and tell providers about all medications and supplements.
Report yellowing of the skin or eyes, increasing abdominal swelling, or confusion.
❓ Liver Function Tests: NCLEX FAQs
What are the priority nursing interventions for Liver Function Tests?
Assess for jaundice, ascites, easy bruising, bleeding, and changes in mental status. Monitor for bleeding risk given impaired clotting factor production in liver disease. Review and question hepatotoxic medications and limit acetaminophen dosing. Implement bleeding and fall precautions in patients with significant liver dysfunction.
What are the warning signs of Liver Function Tests a nurse must report?
New confusion, asterixis, or rising ammonia signals hepatic encephalopathy and needs prompt reporting. Signs of GI bleeding such as hematemesis or melena are emergencies in liver disease. Never exceed maximum acetaminophen dosing, especially with existing liver impairment.
What do I need to know about Liver Function Tests for the NCLEX?
ALT is more specific to the liver than AST, which also appears in muscle and other tissues. Elevated bilirubin causes jaundice and signals impaired bile processing or biliary obstruction. Low albumin reflects poor liver synthetic function and contributes to edema and ascites. A prolonged PT/INR in liver disease reflects reduced production of clotting factors.
What patient teaching is important for Liver Function Tests?
Avoid alcohol and limit acetaminophen, and tell providers about all medications and supplements. Report yellowing of the skin or eyes, increasing abdominal swelling, or confusion.
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Quick Tip
ALT is more specific to the liver than AST, which also appears in muscle and other tissues.