A nurse is reinforcing home safety information with an older adult client.
Which of the following statements indicates that the client needs further instruction?

Choice A rationale
Aspartate aminotransferase (AST) is an enzyme that is found in various tissues, including the liver. Elevated levels of AST can indicate liver damage or disease.
Choice B rationale
Albumin is a protein that is made by the liver. It helps keep fluid in the bloodstream so it doesn’t leak into other tissues. Low levels of albumin can indicate liver disease.
Choice C rationale
Lipase is an enzyme that is produced by the pancreas and used in the digestion of fats. It is not a marker of liver function.
Choice D rationale

Alanine transaminase (ALT) is an enzyme found mostly in the cells of the liver and kidney. Much like AST, high levels of ALT can indicate liver damage or disease.

Choice A rationale
Surgery to increase mucus will not heal the ulcerations. Peptic ulcers are caused by an imbalance between the digestive fluids hydrochloric acid and pepsin, and the body’s ability to protect itself from these substances. The stomach and the duodenum have some protection from these acids, but if this protection is decreased, or the production of acids and pepsin is increased, an ulcer can form.
Choice B rationale
A common cause of peptic ulcer disease is an infection from Helicobacter pylori (H. pylori).
H. pylori is a bacterium that can damage the protective lining of your stomach and small intestine. This can lead to inflammation and ulcers.

Choice C rationale
Gastric ulcers do not occur more frequently than peptic ulcers. In fact, peptic ulcers include both gastric ulcers, which form on the lining of the stomach, and duodenal ulcers, which form on the lining of the upper part of the small intestine.
Choice D rationale
Erosion is not confined to the stomach and esophagus in peptic ulcer disease. Peptic ulcers can occur in the stomach and the duodenum, and less commonly, the lower esophagus.