A high blood level of which substance causes hepatic coma?
Bilirubin
Calcium
Ammonia
Sodium
The Correct Answer is C
Choice A reason: While elevated bilirubin levels can indicate liver dysfunction and lead to jaundice, they are not the primary cause of hepatic coma. Bilirubin is a byproduct of red blood cell breakdown and its accumulation can cause yellowing of the skin and eyes.
Choice B reason: Calcium levels, whether high or low, can affect neuromuscular function and cardiac health, but they are not directly associated with causing hepatic coma. Hypercalcemia or hypocalcemia can present with various symptoms, but not typically with hepatic coma.
Choice C reason: Elevated ammonia levels are directly associated with hepatic coma. In patients with severe liver dysfunction, the liver cannot efficiently convert ammonia (a byproduct of protein metabolism) into urea for excretion. The accumulation of ammonia in the blood can cross the blood-brain barrier and lead to encephalopathy, resulting in confusion, altered mental status, and potentially hepatic coma.
Choice D reason: Sodium levels can affect neurological function, particularly with conditions like hypernatremia or hyponatremia. However, these imbalances are not the primary cause of hepatic coma. The direct link to hepatic coma is through elevated ammonia levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: A hemoglobin level of 12.0 g/dL is slightly below the normal range for men but is not the most critical concern preoperatively. It indicates mild anemia, which should be monitored but does not present an immediate high risk.
Choice B reason: A serum creatinine level of 1.3 mg/dL is slightly elevated and indicates mild renal impairment. While this should be considered, it is not as immediately concerning as a significantly abnormal coagulation value.
Choice C reason: A Blood Urea Nitrogen (BUN) level of 24 mg/dL is slightly above normal, indicating some renal function impairment or dehydration. However, it does not pose the most significant immediate risk compared to a high INR value.
Choice D reason: An INR of 3.5 is significantly elevated and indicates a high risk of bleeding. For a surgical patient, this is the most concerning pre-op lab value because it suggests that the patient's blood is not clotting properly. This increases the risk of excessive bleeding during and after surgery, making it a priority to address before proceeding with the operation.
Correct Answer is B
Explanation
Choice A reason: Kidney failure is not a common immediate complication related to the patient's presentation of sudden right-sided weakness and difficulty speaking, which are indicative of a stroke. Although diabetes and hypertension can eventually lead to kidney issues, this is not an acute complication.
Choice B reason: Aspiration pneumonia is a potential complication of the patient's condition, especially given the presence of expressive aphasia. Patients with neurological deficits, particularly those affecting speech and swallowing, are at higher risk of aspirating food or liquids into the lungs, leading to pneumonia.
Choice C reason: Hypotension is not commonly a direct complication of a stroke, especially considering the patient's elevated blood pressure. Stroke patients often present with hypertension rather than hypotension.
Choice D reason: Heart failure, while related to the patient's underlying conditions like hypertension and possibly diabetes, is not an immediate complication of the acute neurological event described. The focus should be more on the neurological and respiratory complications.
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