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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. His body does not produce any insulin so he must receive insulin injections: Type I diabetes is characterized by the destruction of pancreatic beta cells, resulting in little to no insulin production. Therefore, insulin must be administered via injection to replace the insulin the body cannot produce.

B. The pills are not as effective as the insulin injections: While this might be partially true for Type I diabetes, it is not the complete answer. Oral medications are generally not effective in Type I diabetes because they stimulate the pancreas to produce insulin, which is not possible in these patients.

C. He will only be on insulin injections for a short while, then he can take a pill: This is incorrect. Type I diabetes requires lifelong insulin therapy.

D. He can stop the insulin injections once his body begins to make insulin again: This is incorrect as Type I diabetes is a permanent condition where the body cannot produce insulin.

A. low T4, High TSH. B. low T4, high calcitonin C. high PSA and estrogen levels. D. HighT4, low TSH.

Correct Answer is D

Explanation

A. Low T4, High TSH: This pattern is seen in primary hypothyroidism, where the thyroid gland is underactive.

B. Low T4, high calcitonin: This choice is unrelated to the typical lab findings in Graves' disease. Calcitonin levels are not commonly assessed in thyroid disorders like Graves' disease.

C. High PSA and estrogen levels: PSA (Prostate-Specific Antigen) and estrogen levels are unrelated to Graves' disease, which is an autoimmune hyperthyroid condition.

D. High T4, low TSH: Graves' disease is characterized by hyperthyroidism, where T4 (thyroxine) levels are elevated, and TSH (Thyroid-Stimulating Hormone) levels are suppressed due to the negative feedback mechanism.

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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?

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Naxlex Comprehensive Predictor Exams

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