A nurse is caring for an older adult patient who has just been admitted to the intensive care unit with a diagnosis of confusion/delirium.The patient has an end-stage liver failure diagnosis with increasing ascites.
Their spouse Questions the nurse about the patient’s mental status because they state that the patient is usually lucid. Which of the following is likely the contributing factor for the admitting diagnosis?

This is likely related to new-onset dementia.

This is likely related to new-onset schizophrenia.

This is likely related to new-onset hepatic encephalopathy.

This is likely related to a new-onset UTI.

Answer and Explanation

The Correct Answer is C

Choice C rationale
Hepatic encephalopathy is a condition that can cause confusion or delirium in patients with end-stage liver disease and increasing ascites. It occurs when the liver is unable to remove toxins from the blood, such as ammonia, which can then accumulate in the brain and affect mental function. This condition is common in patients with cirrhosis or end-stage liver disease, and can manifest as confusion, changes in sleep patterns, mood alterations, and, in severe cases, coma.
Choice A rationale
While dementia can cause confusion and changes in mental status, it is typically a progressive condition that develops over time. In the context of a patient with end-stage liver failure and

increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice B rationale
Schizophrenia is a chronic mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. It is not typically associated with end-stage liver disease or ascites. In the context of a patient with end-stage liver failure and increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice D rationale
While a urinary tract infection (UTI) can cause confusion, especially in older adults, it would not typically be the primary suspect in a patient with end-stage liver failure and increasing ascites. In such a patient, hepatic encephalopathy is a more likely cause of confusion or delirium.

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Correct Answer is A

Explanation

Choice A rationale
Patients with a nasogastric (NG) tube to suction are at risk for hypokalemia. Hypokalemia, or low potassium levels, can occur due to increased losses from the gastrointestinal tract, which can occur with NG tube suction. Potassium is an essential electrolyte that plays a vital role in many bodily functions, particularly in the heart and cardiovascular system. Therefore, any condition or intervention that leads to a significant loss of potassium, such as NG tube suction, can potentially lead to hypokalemia.
Choice B rationale

A tracheostomy tube attached to humidified oxygen is primarily used to help a patient breathe. It does not typically contribute to potassium loss or imbalance. Therefore, it is not likely to increase the risk of hypokalemia.
Choice C rationale
An indwelling urinary catheter to gravity drainage is used to drain urine from the bladder. While the kidneys do play a role in maintaining potassium balance, the use of a urinary catheter itself does not typically lead to significant potassium loss or increase the risk of hypokalemia.
Choice D rationale
A chest tube to water seal is used to remove air, fluid, or pus from the pleural space to help the lungs expand properly. It does not typically contribute to potassium loss or imbalance.
Therefore, it is not likely to increase the risk of hypokalemia.

A. Why do you think the copper helps with your arthritis? B. Yes, I understand that you feel better wearing your bracelet. C. I think you should rely more on your medication therapy than on your bracelet. D. Believing objects have powers to make you feel better has no scientific basis.

Correct Answer is B

Explanation

Choice A rationale
Asking why the patient thinks the copper helps with their arthritis might seem like a good way to understand their beliefs, but it could come off as challenging or dismissive.
Choice B rationale
Acknowledging that the patient feels better wearing the bracelet is a respectful response. It validates the patient’s experience without endorsing the effectiveness of copper bracelets, which lack scientific evidence for treating arthritis.
Choice C rationale

This response could be seen as dismissive of the patient’s beliefs and experiences. It’s important to respect patients’ choices in managing their symptoms, as long as those choices aren’t harmful.
Choice D rationale
While it’s true that there’s no scientific basis for believing objects have powers to make you feel better, saying this could come off as dismissive or disrespectful.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for four clients who have drainage tubes. Which of the following clients should the nurse recognize as being at risk for hypokalemia?

Correct Answer is A

Explanation

A nurse is caring for a patient who has rheumatoid arthritis and tells the nurse that she wears a copper bracelet to help her feel better. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

A nurse is assisting a patient with hypothyroidism in meal planning. Which foods should the nurse suggest the patient add to their diet?

The nurse doesn’t hear any gurgling while listening to bowel sounds. What should be the nurse’s next course of action?

After thyroid surgery, the nurse suspects damage to the parathyroid glands when the patient develops which of the following?

A nurse is caring for a client diagnosed with systemic scleroderma five years ago. The nurse plans to assess the client to document the disease’s progression. In addition to skin changes, which of the following findings should the nurse expect?

A nurse is educating a client who has hepatitis A on how to prevent the spread of the virus. Which of the following strategies should the nurse include in the teaching?

What effect does chronic exposure to ultraviolet (UV) rays have on the skin that increases the risk for skin cancer?

Which body substance should the nurse observe to evaluate the effectiveness of pancreatic enzyme replacement for a patient with chronic pancreatitis?