A nurse is caring for a client who has hepatic encephalopathy. Which of the following laboratory values should the nurse monitor?
Calcium
Potassium
Ammonia
Glucose
The Correct Answer is C
Rationale:
A. Calcium: While calcium is important for many bodily functions, it is not a primary indicator for monitoring hepatic encephalopathy. Calcium imbalances do not directly correlate with the severity or management of this condition.
B. Potassium: Potassium levels are important for overall electrolyte balance, but they are not specific to hepatic encephalopathy. Monitoring potassium is part of routine care but does not indicate the progression or severity of encephalopathy.
C. Ammonia: Elevated ammonia levels are a key contributor to hepatic encephalopathy. The liver normally converts ammonia to urea, and when liver function is impaired, ammonia accumulates, affecting neurological function. Monitoring ammonia helps assess severity and guide treatment interventions.
D. Glucose: While glucose monitoring is important in general care, it is not specific to hepatic encephalopathy. Hyper- or hypoglycemia may occur with liver disease but does not directly reflect the presence or progression of encephalopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Place an ice pack directly on the skin of the affected joints: Ice should never be applied directly to the skin as it can cause frostbite or skin damage. It should be wrapped in a cloth or towel before use. While cold therapy can reduce inflammation and numb pain, safety precautions are essential.
B. Limit dietary intake of phosphorus: Phosphorus restriction is not relevant for osteoarthritis management. Dietary modifications for osteoarthritis focus more on maintaining a healthy weight and anti-inflammatory nutrients rather than phosphorus intake.
C. Place a large pillow under the knees when sleeping: Placing a large pillow under the knees can hyperflex the joints and increase strain on the knees and hips. Proper positioning involves keeping joints in a neutral or slightly extended position to reduce discomfort and prevent contractures.
D. Take a hot shower every day: Heat therapy helps relax muscles, relieve stiffness, and improve joint mobility in clients with osteoarthritis. Warm showers or moist heat applications are effective nonpharmacological interventions for managing pain and promoting comfort.
Correct Answer is D
Explanation
Rationale:
A. "Why did you start drinking alcohol?": This question explores motivations or personal history but is not part of the standardized Alcohol Use Disorders Identification Test (AUDIT). The AUDIT focuses on quantity, frequency, and consequences of alcohol use rather than reasons for drinking.
B. "Does anyone else in your family have a drinking problem?": Family history of alcohol use may be relevant for overall assessment but is not included in the AUDIT, which is designed to screen the client’s own drinking behaviors and risks.
C. "How old were you when you started to drink alcohol?": Age of initiation provides background information but is not a question within the AUDIT. The test is concerned with current patterns and consequences of alcohol consumption.
D. "How often do you drink alcohol?": This question is a standard component of the AUDIT and assesses the frequency of alcohol consumption. It helps identify patterns of use and potential risk for alcohol-related problems, making it appropriate for inclusion in the screening.
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