A nurse is caring for a patient who has recently been diagnosed with liver disease.
Which laboratory values should the nurse anticipate the healthcare provider will order to confirm this diagnosis?
Erythrocyte sedimentation rate (ESR)
D-dimer
C-reactive protein (CRP)
Albumin .
The Correct Answer is D
Choice A rationale
An erythrocyte sedimentation rate (ESR) is a blood test that can detect and monitor inflammation in the body. It measures the rate at which red blood cells (erythrocytes) in a test tube separate from blood serum over time, with the rate being faster in people with inflammatory diseases. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice B rationale
D-dimer is a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is typically used to rule out thrombosis (blood clots), not to diagnose liver disease.
Choice C rationale
C-reactive protein (CRP) is a protein made by the liver and sent into the bloodstream in response to inflammation. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice D rationale
Albumin is a protein made by the liver, and measuring its levels can help diagnose liver disease. When the liver is damaged, it can’t make enough albumin, so the level of albumin in the blood gets lower. This is why albumin is often used as a marker of liver function, and why it would be anticipated in the laboratory values ordered to confirm a diagnosis of liver disease.
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Correct Answer is C
Explanation
Choice A rationale
Peptic ulcer disease is not a common complication of difficulty swallowing after a stroke. It is typically caused by an infection with the bacterium Helicobacter pylori or long-term use of nonsteroidal anti-inflammatory drugs.
Choice B rationale
Dumping syndrome is not a common complication of difficulty swallowing after a stroke. It is a condition that can occur after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight.
Choice C rationale
Aspiration is a common problem for people with dysphagia, a condition that can occur after a stroke. It occurs when something you’ve swallowed enters the airway and lungs. Normally, aspiration causes a violent cough, but a stroke can reduce sensation. In this case, you may not know you’re aspirating (silent aspiration)5.
Choice D rationale
Gastroesophageal reflux disease (GERD) is not a common complication of difficulty swallowing after a stroke. GERD is a chronic disease that occurs when stomach acid or bile flows into the food pipe and irritates the lining.
Correct Answer is B
Explanation
Choice A rationale
While dietary iron restrictions can contribute to iron-deficiency anemia, they are not typically a symptom of ulcerative colitis. Ulcerative colitis is an inflammatory bowel disease that primarily affects the colon and rectum, and its symptoms are generally related to inflammation and damage in these areas.
Choice B rationale
Chronic blood loss is a common symptom of ulcerative colitis and a major contributing factor to the development of anemia in these patients. This is because the inflammation and ulceration in the colon and rectum can lead to bleeding, which over time can result in a significant loss of red blood cells.
Choice C rationale
Frequent diarrhea is a common symptom of ulcerative colitis, but it does not directly contribute to the development of anemia. However, severe or prolonged diarrhea can lead to malnutrition and malabsorption of nutrients, including iron, which could indirectly contribute to anemia.
Choice D rationale
Abdominal pain is a common symptom of ulcerative colitis, but it does not directly contribute to the development of anemia. The pain is typically caused by inflammation and ulceration in the colon and rectum, not by a loss of red blood cells.
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