The client with cirrhosis is at risk for developing complications. Which condition is the most serious and potentially life-threatening?

Esophageal varices

Altered mental status

Low serum albumin

Decreased reflexes

Answer and Explanation

The Correct Answer is A

A)   These are dilated veins in the esophagus that can rupture and lead to life- threatening bleeding.
B)   While concerning and indicative of hepatic encephalopathy, it is not immediately life-threatening like a variceal bleed.
C)   Indicates poor nutritional status and liver function but is not as acutely dangerous as bleeding varices.
D)   This is a concern but does not represent an immediate life-threatening condition like esophageal varices.

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Correct Answer is D

Explanation

A) Breath with fecal odor could indicate hepatic encephalopathy, for which lactulose is indicated.
B) Increasing confusion is a symptom of hepatic encephalopathy suggests a need for lactulose.
C) Elevated ammonia levels indicate hepatic encephalopathy hence the need for lactulose.
D) If the client already has diarrhea, additional doses of lactulose (which acts as a laxative) could exacerbate this condition and might need to be adjusted or halted based on clinical judgment.

A. Monitor for hypertension B. Measure residual every 24 hours C. Check stools for diarrhea D. Check blood glucose every 12 hours

Correct Answer is C

Explanation

A) Monitoring for hypertension is not directly related to caring for a client with enteral feeding via a jejunostomy tube.
B) Measuring residual volume is a nursing intervention for clients with gastric feeding tubes, not jejunostomy tubes.
C) Diarrhea is a potential complication of enteral feeding, and monitoring stool output is essential to assess for this complication and adjust feeding accordingly.
D) Monitoring blood glucose levels is important for clients with diabetes but is not specific to caring for a client with enteral feeding via a jejunostomy tube.

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The client with cirrhosis is at risk for developing complications. Which condition is the most serious and potentially life-threatening?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with cirrhosis is scheduled to receive a third dose of lactulose (Cephulac) at 1800. Which current finding would cause the nurse to question administering this medication?

Correct Answer is D

Explanation

When planning care for a client receiving an enteral feeding via jejunostomy tube, which intervention would the nurse include?

Correct Answer is C

Explanation

The nurse is making a home visit to a client with chronic pancreatitis. Which data is consistent with this diagnosis?

A client with a history of chronic pancreatitis reports weight loss of 10 pounds over the last month and foul smelling stools. What would be a priority action for the nurse to take?

The nurse is admitting a client with the diagnosis of hepatic encephalopathy. Which assessment finding should the nurse anticipate?

When reviewing a client's health history, which information does the nurse identify as a risk factor for development of chronic pancreatitis?

The nurse is collecting a health history of a client admitted for possible acute pancreatitis. Which health history item would increase the client's risk for this diagnosis?

The nurse is admitting a client diagnosed with ascites. Which assessment finding would the nurse anticipate?

The nurse is providing care to a client admitted with chronic pancreatitis. Which items are appropriate to include in the discharge teaching for this client? Select all that apply.

Which question would the nurse ask to identify a risk factor for liver disease?