A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect to find?

Weak pulse

Dark colored stools

Spider angioma

Increased body hair

Answer and Explanation

The Correct Answer is C

Choice A: Weak pulse. This is not a manifestation that the nurse should expect to find in a client who has advanced cirrhosis. A weak pulse may indicate hypovolemia, shock, or cardiac dysfunction, but it is not directly related to liver disease.

Choice B: Dark colored stools. This is not a manifestation that the nurse should expect to find in a client who has advanced cirrhosis. Dark colored stools may indicate bleeding in the upper gastrointestinal tract, such as from esophageal varices or peptic ulcers, but they are not specific to liver disease.

Choice C: Spider angioma. This is a manifestation that the nurse should expect to find in a client who has advanced cirrhosis, which is a chronic liver disease that causes scarring and impaired liver function. Spider angioma is a type of vascular lesion that appears as a red spot with radiating branches on the skin, usually on the face, neck, chest, or upper arms. It is caused by increased estrogen levels due to reduced liver metabolism of hormones.

Choice D: Increased body hair. This is not a manifestation that the nurse should expect to find in a client who has advanced cirrhosis. Increased body hair may indicate hypertrichosis, which is excessive hair growth due to genetic, hormonal, or metabolic factors, but it is not related to liver disease.

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Correct Answer is B

Explanation

Choice A: Palpitations. This is not a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, but rather a sign of hyperthyroidism, which is a condition that occurs when the thyroid gland produces too much thyroid hormone. Hyperthyroidism can cause palpitations due to increased cardiac output and heart rate.

Choice B: Weight gain. This is a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, which is a condition that occurs when the thyroid gland does not produce enough thyroid hormone. The thyroid hormone regulates the metabolism of carbohydrates, proteins, and fats, and aﬀects energy expenditure and body temperature. Hypothyroidism can cause weight gain due to decreased metabolic rate and increased ﬂuid retention.

Choice C: Diaphoresis. This is not a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, but rather a sign of hyperthyroidism. Hyperthyroidism can cause diaphoresis due to increased heat production and vasodilation.

Choice D: Protruding eyeballs. This is not a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, but rather a sign of Graves’ disease, which is an autoimmune disorder that causes hyperthyroidism. Graves’ disease can cause protruding eyeballs due to inﬂammation and edema of the orbital tissues and muscles.

A. Drinking orange juice regularly B. Eating dinner early in the evening C. Consuming low-fat meats D. Sleeping on a large wedge-style pillow

Correct Answer is A

Explanation

Choice A: Drinking orange juice regularly. This is a contributing factor to the client’s heartburn because orange juice is acidic and can irritate the esophageal mucosa and lower esophageal sphincter, causing reﬂux of gastric contents into the esophagus.

Choice B: Eating dinner early in the evening. This is not a contributing factor to the client’s heartburn, but rather a recommended action for the client to prevent heartburn. The client should avoid eating within 3 hours of bedtime to allow for gastric emptying and reduce the risk of reﬂux.

Choice C: Consuming low-fat meats. This is not a contributing factor to the client’s heartburn, but rather a recommended action for the client to prevent heartburn. The client should avoid high-fat foods, which can delay gastric emptying and increase intra-abdominal pressure, leading to reﬂux.

Choice D: Sleeping on a large wedge-style pillow. This is not a contributing factor to the client’s heartburn, but rather a recommended action for the client to prevent heartburn. The client should elevate the head of their bed or use a wedge pillow to create an incline that prevents gastric contents from ﬂowing back into the esophagus.

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A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect to find?

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Naxlex Comprehensive Predictor Exams

A nurse in a clinic is caring for a client who has a new diagnosis of hypothyroidism. Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

A nurse is collecting data from a client who has gastroesophageal reﬂux disease (GERD) and reports having heartburn every night. Which of the following actions should the nurse identify as a contributing factor to the client’s heartburn?

Correct Answer is A

Explanation

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