A nurse is caring for a patient with hepatic encephalopathy. The nurse's assessment reveals that the patient exhibits episodes of confusion, is difficult to arouse from sleep and has rigid extremities.

Based on these clinical findings, the nurse should document what stage of hepatic encephalopathy?

Stage 4

Stage 3

Stage 1

Stage 2

Answer and Explanation

The Correct Answer is A

Choice A reason:

This presentation of hepatic encephalopathy includes severe manifestations, such as profound confusion, difficulty in arousal, and the presence of rigidity, indicating advanced neurological impairment. This places the patient in Stage 4, which is the most severe stage of hepatic encephalopathy.

Choice B reason:

Stage 3 is characterized by severe symptoms, such as drowsiness, anxiety, seizures, severe personality changes, confused speech, and shaky hands.

Choice C reason:

Stage 1 is characterized by mild symptoms, such as difficulty thinking, personality changes, poor concentration, and problems with handwriting.

Choice D reason

Stage 2 is characterized moderate symptoms, such as confusion, forgetfulness, poor judgment, and a musty or sweet breath odor.

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Correct Answer is A

Explanation

Choice A reason:

Chronic blood loss is a common complication of ulcerative colitis. Inflammation and ulcers in the colon can lead to ongoing bleeding, resulting in iron deficiency anemia.

Choice B reason:

While intestinal malabsorption can occur in some gastrointestinal disorders, it is not a primary mechanism in ulcerative colitis. In ulcerative colitis, the main factor leading to anemia is chronic blood loss.

Choice C reason:

Dietary iron restrictions may exacerbate anemia in individuals with ulcerative colitis, but the primary cause of anemia in this condition is chronic blood loss.

Choice D reason:

Intestinal parasites are not a common factor in ulcerative colitis and are not a primary cause of anemia in this condition. Chronic blood loss is the main contributing factor.

A. Gallstones B. Diabetes mellitus C. COPD D. Hypolipidemia

Correct Answer is A

Explanation

Choice A reason:

Gallstones are a common cause of acute pancreatitis, as they can obstruct the pancreatic duct and lead to inflammation.

Choice B reason:

While diabetes mellitus can be a risk factor for pancreatitis, it is not specific to acute pancreatitis.

Choice C reason:

Chronic obstructive pulmonary disease (COPD) is not directly related to acute pancreatitis.

Choice D reason:

Hypolipidemia (low blood lipid levels) is not a common risk factor for acute pancreatitis.

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A nurse is caring for a patient with hepatic encephalopathy. The nurse's assessment reveals that the patient exhibits episodes of confusion, is difficult to arouse from sleep and has rigid extremities. Based on these clinical findings, the nurse should document what stage of hepatic encephalopathy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia?

Correct Answer is A

Explanation

A nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history?

Correct Answer is A

Explanation

A patient who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the patient's condition is now stable. For the next several hours, the nurse caring for this patient should assess for what signs and symptoms of recurrence?

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A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

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A patient's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather than ulcerative colitis, as the cause of the patient's signs and symptoms?

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A nurse is caring for a patient with hepatic encephalopathy. The nurse's assessment reveals that the patient exhibits episodes of confusion, is difficult to arouse from sleep and has rigid extremities. Based on these clinical findings, the nurse should document what stage of hepatic encephalopathy?