The healthcare provider prescribes lactulose for a patient with hepatic encephalopathy. What will the nurse assess to determine the effectiveness of this medication?

Decreased ammonia levels

Relief of constipation

Decreased liver enzymes

Relief of abdominal pain

Answer and Explanation

The Correct Answer is A

Choice A reason:Lactulose is used in hepatic encephalopathy primarily to lower blood ammonia levels. It works by converting ammonia in the intestines into ammonium, which is then excreted³. Therefore, a decrease in ammonia levels would indicate the effectiveness of the medication.

Choice B reason:While lactulose can relieve constipation due to its laxative effect, relief of constipation is not the primary indicator of its effectiveness in treating hepatic encephalopathy³.

Choice C reason:Decreased liver enzymes are not a direct measure of lactulose's effectiveness in hepatic encephalopathy. Liver enzymes are indicators of liver function, not ammonia levels³.

Choice D reason:Relief of abdominal pain is not a specific indicator of lactulose's effectiveness in hepatic encephalopathy. The medication's primary role is to reduce ammonia levels, not to alleviate pain³.

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Correct Answer is C

Explanation

Choice A reason: Hypophosphatemia refers to an abnormally low level of phosphate in the blood. The normal range for serum phosphate in adults is typically around 2.5 to 4.5 mg/dL. In the context of acute kidney injury (AKI), the kidneys’ ability to excrete phosphate is impaired, which can actually lead to hyperphosphatemia, not hypophosphatemia. Therefore, while phosphate levels are important to monitor in AKI, hypophosphatemia is not typically expected.

Choice B reason: Hypercalcemia is characterized by an elevated level of calcium in the blood, with the normal range being approximately 8.5 to 10.2 mg/dL. AKI can sometimes be associated with hypercalcemia, particularly if there is extensive tissue breakdown or rhabdomyolysis. However, it is not as commonly expected as hyperkalemia. Hypercalcemia in AKI is more often secondary to other underlying conditions rather than a direct result of the kidney injury itself.

Choice C reason: Hyperkalemia is a common electrolyte imbalance in AKI and refers to a high level of potassium in the blood. The normal range for serum potassium is about 3.5 to 5.0 mEq/L. In AKI, the kidneys’ ability to excrete potassium is compromised, leading to an accumulation of potassium in the blood. This can be life-threatening, causing cardiac dysrhythmias and muscle weakness. Hyperkalemia is a key concern in AKI management and is often expected in this condition. While all the listed electrolyte imbalances can occur in various clinical scenarios, hyperkalemia is the most commonly expected electrolyte disturbance in a patient with acute kidney injury. It is crucial for healthcare providers to monitor and manage electrolyte levels carefully in AKI to prevent complications.

Choice D reason: Hypernatremia means an elevated sodium level in the blood, with the normal range being 135 to 145 mEq/L. While sodium balance can be affected in AKI, hypernatremia is not typically expected. It is more commonly associated with conditions that cause a loss of water or an intake of sodium, such as diabetes insipidus or excessive salt ingestion. In AKI, the focus is often on managing fluid overload rather than sodium excess.

A. Shortness of breath B. Difficulty swallowing C. Upper chest pain D. Diaphoresis E. Cough F. Hoarseness

Correct Answer is ["A","B","C","E","F"]

Explanation

Choice A: Shortness of breath Shortness of breath can occur with a TAA due to the aneurysm compressing the trachea or the lung tissue. As the aneurysm enlarges, it can impinge on respiratory structures, leading to difficulty in breathing. A thoracic aortic aneurysm (TAA) is a bulging or dilation in the wall of the aorta as it passes through the chest cavity. TAAs can be life-threatening if they rupture or dissect and are often difficult to detect because they tend to grow slowly and usually do not cause symptoms until they become large or rupture.

Choice B: Difficulty swallowing Difficulty swallowing, or dysphagia, may be experienced if a TAA exerts pressure on the esophagus. This can happen when the aneurysm is located in the aortic arch, where the esophagus is in close proximity.

Choice C: Upper chest pain Upper chest pain is a common symptom of TAA and may be described as a deep, steady pain that can radiate to the back, neck, or jaw. The pain is caused by the stretching of the aortic wall and may be a warning sign of an impending rupture.

Choice D: Diaphoresis Diaphoresis, or excessive sweating, is not typically a direct symptom of a TAA. However, it can be associated with acute aortic syndromes, such as aortic dissection or rupture, which are medical emergencies.

Choice E: Cough A persistent cough can be a sign of a TAA, especially if the aneurysm is pressing against the trachea or bronchial tubes. The cough may sometimes produce blood if the aneurysm is causing erosion into these structures.

Choice F: Hoarseness Hoarseness can result from a TAA if the aneurysm compresses the recurrent laryngeal nerve, which controls the muscles of the voice box. This is known as Ortner’s syndrome or cardiovocal syndrome.

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The healthcare provider prescribes lactulose for a patient with hepatic encephalopathy. What will the nurse assess to determine the effectiveness of this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory test results from a client who has acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

Correct Answer is C

Explanation

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Correct Answer is ["A","B","C","E","F"]

Explanation

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