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 ["B","C","D"]
Explanation
Choice A reason: Anorexia, nausea, and vomiting are not typical findings associated with Cushing syndrome. These symptoms can be related to other medical conditions but do not specifically indicate Cushing syndrome.
Choice B reason: Truncal obesity, thin extremities, and rounding of the face (moon face) are classic signs of Cushing syndrome. This condition leads to fat redistribution, resulting in increased fat around the trunk and face while the extremities appear thinner. The distinctive appearance of moon face is due to fat accumulation.
Choice C reason: Purplish streaks on the abdomen, also known as striae, are a common feature of Cushing syndrome. These stretch marks occur due to the excessive production of cortisol, which weakens the connective tissue, leading to skin changes.
Choice D reason: Hyperglycemia, or high blood sugar, is frequently seen in patients with Cushing syndrome. The excess cortisol increases glucose production and decreases insulin sensitivity, leading to elevated blood sugar levels.
Choice E reason: A bronzed appearance of the skin is not a typical finding of Cushing syndrome. This symptom is more commonly associated with Addison's disease, which involves adrenal insufficiency rather than excess cortisol production seen in Cushing syndrome.
Correct Answer is D
Explanation
Choice A reason: Administering antibiotics is essential for treating cellulitis to eliminate the infection. However, it is not the immediate priority over maintaining oxygenation, especially in a patient with sickle cell disease.
Choice B reason: Starting IV fluids is crucial for preventing dehydration and helping to reduce the sickling of red blood cells. Nevertheless, while important, it is not the most urgent action compared to maintaining adequate oxygen levels.
Choice C reason: Assessing pain every 4 hours is necessary for managing the patient's comfort and monitoring the progression of the disease. Although pain management is a significant aspect of care, it is not the top priority in this scenario.
Choice D reason: Maintaining oxygenation is the highest priority for a patient with sickle cell disease. These patients are at increased risk for hypoxia, which can exacerbate the sickling of red blood cells, leading to severe complications such as acute chest syndrome or stroke. Ensuring adequate oxygenation helps to prevent these complications and stabilizes the patient's condition.
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