A registered nurse (RN) assesses a patient with cirrhosis and finds ascites with pitting edema of the feet and legs. Which factor contributes to edema and ascites in patients with cirrhosis?
Diminished serum albumin levels causes water to shift from blood to tissue.
Portal hypotension causes a fluid shift from the abdominal cavity into the portal veins.
Hypoaldosteronism causes a fluid volume deficit: shifting water from blood into tissue.
Aberrations of the portal system cause a back-up of blood that leads to hydronephrosis.
The Correct Answer is A
A. Diminished serum albumin levels cause water to shift from blood to tissue: In cirrhosis, liver dysfunction leads to decreased production of albumin, a protein that helps maintain oncotic pressure. Low albumin levels cause fluid to shift from the vascular space into the tissues, resulting in ascites and peripheral edema.
B. Portal hypotension causes a fluid shift from the abdominal cavity into the portal veins: Portal hypertension, not hypotension, is a common feature of cirrhosis, but it leads to ascites by increasing pressure in the portal venous system, not by shifting fluid into the portal veins.
C. Hypoaldosteronism causes a fluid volume deficit: shifting water from blood into tissue: Cirrhosis often leads to hyperaldosteronism, not hypoaldosteronism, resulting in sodium and water retention, which contributes to edema.
D. Aberrations of the portal system cause a back-up of blood that leads to hydronephrosis: Hydronephrosis is related to obstruction of the urinary tract, not a complication of portal hypertension or cirrhosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Esophageal varices: Coffee-ground emesis suggests upper gastrointestinal bleeding, which is often due to ruptured esophageal varices in patients with cirrhosis.
B. Colorectal cancer: This condition typically presents with lower gastrointestinal symptoms such as changes in bowel habits or blood in the stool, not coffee-ground emesis.
C. Inflammatory bowel disease: This condition can cause gastrointestinal bleeding but is more commonly associated with symptoms like diarrhea and abdominal pain rather than coffee-ground emesis.
D. Appendicitis: This condition typically presents with right lower quadrant pain, not upper GI bleeding.
Correct Answer is A
Explanation
A. Positive Brudzinski's sign: A positive Brudzinski's sign, which involves involuntary flexion of the hips and knees when the neck is flexed, is a common finding in meningitis (both viral and bacterial).
B. Dysarthria and double vision: These symptoms are not typical of viral meningitis; they are more often associated with neurological disorders such as multiple sclerosis.
C. Petechiae and purpura: These are more commonly associated with bacterial meningitis, particularly meningococcal meningitis, rather than viral meningitis.
D. Positive Babinski's reflex: A positive Babinski’s reflex indicates an upper motor neuron lesion and is not specific to meningitis.
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