A nurse is admitting a middle adult client who has cirrhosis. Findings upon admission:

Exhibits

The nurse is assessing the client 24 hr later. How should the nurse interpret the findings?

For each finding, click to specify whether the finding is unrelated to the diagnosis, a sign of potential improvement, or a sign of potential worsening condition.

Spontaneous bruising

Ascites

Increased albumin level

Hematemesis

Elevated iron levels

Answer and Explanation

The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"C"},"C":{"answers":"B"},"D":{"answers":"C"},"E":{"answers":"C"}}

Liver cirrhosis interferes with the synthesis of clotting factors in the liver leading to bleeding as evidence by the spontaneous bruises

The development of ascites occurs as the cirrhotic process progresses leading to increased extravasation of fluid in the splanchnic circulation.

Increased albumin indicates that the synthetic role of the liver is improving. Albumin is synthesized in the liver parenchyma.

Hematemesis occurs due to the presence of esophageal varices as a complication of advanced liver cirrhosis

The liver plays a key role in formation of ferritin which binds iron. Decreased levels of ferritin may lead to increased levels of free iron in the blood

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Correct Answer is D

Explanation

D. Hanging a monthly calendar in the client's bedroom provides a visual aid for tracking important dates and events, which can help maintain their sense of routine and structure.
A. Keeping the client's bedroom dark at night may increase confusion and disorientation, especially if the client wakes up during the night.
B. Placing a large-face clock in the client's bedroom allows them to easily see and understand the time, which can help orient them to the day and reduce confusion. However, it may become monotonous for the client.
C. While it's essential to childproof the home to prevent accidents, covering electrical outlets with tape may not effectively prevent access to them and can pose a fire hazard.

A. "These discomforts should decrease with time." B. "Women your age experience thickening of the vaginal tissue." C. "Your symptoms are likely due to decreasing estrogen levels." D. "You should avoid intercourse to prevent injury to your vagina."

Correct Answer is C

Explanation

C. It acknowledges the client's symptoms and provides a likely explanation related to hormonal changes associated with aging. It opens the door for further discussion and potential interventions to address the underlying cause.
A. This response dismisses the client's symptoms without addressing the underlying cause or providing potential solutions.
B. The opposite tends to occur with age – vaginal tissue can become thinner and drier due to decreasing estrogen levels, leading to symptoms like vaginal dryness and itching.
D. While avoiding intercourse may be recommended in certain situations, such as if there is discomfort or pain, it does not address the underlying cause of the symptoms. Additionally, it may not be necessary if appropriate treatments are pursued to alleviate vaginal dryness and itching.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching the family of a client who has Alzheimer's disease about caring for the client at home. Which of the following instructions should the nurse include?

Correct Answer is D

Explanation

A nurse is caring for an older adult client who reports vaginal dryness and itching. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

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