The nurse is caring for a client with advanced cirrhosis. Which of the following clinical manifestations should the nurse recognize as a serious complication of this condition?
Frequent nosebleeds and bruising
Urinary retention
No bowel movement in three days
Increased blood glucose
The Correct Answer is A
Choice A reason: Frequent nosebleeds and bruising are indicative of coagulopathy, a common complication in advanced cirrhosis due to the liver's impaired ability to synthesize clotting factors. This can lead to an increased tendency to bleed.
Choice B reason: Urinary retention is not typically associated with cirrhosis. Instead, cirrhosis can lead to renal dysfunction known as hepatorenal syndrome, characterized by the failure of the kidneys to filter waste from the blood².
Choice C reason: While constipation can occur in cirrhosis, no bowel movement in three days is not a direct complication of cirrhosis. However, it could be related to the overall health status of the patient or medications used.
Choice D reason: Increased blood glucose is not a direct complication of cirrhosis. Cirrhosis primarily affects the metabolism of proteins and fats and does not directly cause hyperglycemia unless there is concurrent diabetes or metabolic syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A reason: Pain occurring 30 to 60 minutes after a meal is a common symptom of gastric ulcers due to the increased gastric acid secretion during digestion that can aggravate the ulcer.
Choice B reason: Pain at night is also typical for gastric ulcers as the circadian rhythm can influence acid secretion, potentially leading to increased discomfort during the night.
Choice C reason: A sensation of bloating can be associated with gastric ulcers due to delayed gastric emptying or increased sensitivity of the stomach lining.
Choice D reason:Pain relieved by eating is indicative of gastric ulcers because food can act as a buffer to stomach acid, temporarily relieving pain².
Choice E reason:Pain upon palpation of the epigastric region is expected in clients with gastric ulcers due to the localized inflammation and sensitivity of the stomach lining².
Correct Answer is ["60"]
Explanation
- Step 1: Identify the required dose in grams. The client is scheduled to receive 30 grams of lactulose.
- Step 2: Identify the concentration of the available solution. The available solution contains 5 grams of lactulose per 10 mL.
- Step 3: Calculate the volume of solution needed to deliver the required dose. We can set up a proportion to solve for this:
- 5 grams is to 10 mL as 30 grams is to X mL.
- In other words, 5 g : 10 mL = 30 g : X mL.
- Step 4: Solve for X using cross-multiplication and division:
- Cross-multiplication gives us: 5 g × X mL = 30 g × 10 mL.
- Simplifying this gives us: 5X = 300.
- Dividing both sides by 5 gives us: X = 300 ÷ 5.
- Calculating the division gives us: X = 60.
60 mL of the lactulose solution should be poured into the medication cup to administer the required dose of 30 grams.
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