A nurse is reviewing the laboratory reports for a client who has cirrhosis. Which of the following results should the nurse expect for this client?

Decreased liver enzymes

Decreased platelets

Elevated sodium levels

Elevated albumin level

Answer and Explanation

The Correct Answer is B

A. Decreased liver enzymes: Liver enzymes may initially be elevated due to liver inflammation, but in end-stage cirrhosis they may appear normal or even low due to massive hepatocyte loss. A decreased enzyme level does not reliably indicate improved liver function.

B. Decreased platelets: Thrombocytopenia occurs because portal hypertension causes splenic enlargement, leading to platelet sequestration. In addition, reduced hepatic production of thrombopoietin further lowers platelet count, making this a common finding.

C. Elevated sodium levels: Cirrhosis commonly leads to low sodium (hyponatremia) due to fluid retention, activation of antidiuretic hormone, and impaired renal function. Elevated sodium would not typically be expected in advanced liver disease.

D. Elevated albumin level: Because the liver synthesizes albumin, cirrhosis results in decreased production. This leads to low albumin levels, contributing to edema and ascites due to reduced oncotic pressure. Elevated albumin is not consistent with cirrhosis.

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Correct Answer is D

Explanation

A. "The pain radiates down to my lower back.":Pain radiating to the back is more characteristic of pancreatitis or peptic ulcer perforation into posterior structures, not the typical description for uncomplicated peptic ulcer disease.

B. "My pain is relieved by having a bowel movement.":Pain relief with defecation is more consistent with irritable bowel syndrome or lower GI functional disorders, not peptic ulcer disease.

C. "The pain is worse after I eat a meal high in fat.":Pain worse after fatty meals suggests biliary (gallbladder) disease rather than classic peptic ulcer disease.

D. "I feel so much better after eating.":Pain that improves after eating is a classic presentation for a duodenal ulcer (a type of peptic ulcer) - food buffers gastric acid and may relieve the pain temporarily.

A. "Do you take any recreational drugs?" B. "Have you eaten any shellfish lately?" C. "Have you traveled to a third world country in the past two months?" D. "Did you have a blood transfusion recently?"

Correct Answer is C

Explanation

A. "Do you take any recreational drugs?":Recreational drug use is not a major transmission route for Hepatitis A (unless hygiene is poor in communal drug use).

B. "Have you eaten any shellfish lately?":Shellfish from contaminated waters can carry Hepatitis A - important, but not the first question.

C. "Have you traveled to a third world country in the past two months?":Hepatitis A is transmitted via fecal-oral route, and travel to areas with poor sanitation is the most common risk, so this is the priority question.

D. "Did you have a blood transfusion recently?":Hepatitis A is not bloodborne (that applies to Hep B and C), so this question is not relevant.

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A nurse is reviewing the laboratory reports for a client who has cirrhosis. Which of the following results should the nurse expect for this client?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

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