Which are the early (prodromal) clinical manifestations of hepatitis. (Select all that apply).
Itching
Vomiting
Fatigue
Jaundice
Hyperalgia (increased sensitivity to pain)
Correct Answer : B,C,E
A. Itching: Pruritus typically develops during the icteric phase of hepatitis when bilirubin accumulates in the tissues. It is not considered an early or prodromal symptom but occurs later as jaundice becomes evident.
B. Vomiting: Nausea and vomiting are common prodromal symptoms of hepatitis due to liver inflammation and its impact on digestion. These gastrointestinal symptoms often occur before jaundice or other late signs become apparent.
C. Fatigue: Fatigue is one of the most frequently reported early symptoms of hepatitis. It results from the body's immune response and reduced liver function and may begin days or weeks before jaundice or dark urine appears.
D. Jaundice: Jaundice typically marks the transition to the icteric phase of hepatitis and follows the prodromal phase. It appears as liver dysfunction progresses and bilirubin accumulates in the bloodstream and tissues.
E. Hyperalgia (increased sensitivity to pain): Increased pain sensitivity, particularly in the upper right quadrant, can occur early in hepatitis due to liver inflammation. This symptom may accompany general malaise and precedes more visible signs like jaundice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Diverticulitis: This condition involves inflammation or infection of diverticula (small pouches) in the colon wall, typically presenting with localized pain and not characterized by “cobblestone” appearance or skipped lesions seen on colonoscopy.
B. Crohn's Disease: The description of “cobblestone” mucosa, skipped lesions, and thickened bowel walls resembling “lead pipes” are classic features of Crohn’s disease. It can affect any part of the gastrointestinal tract and presents with patchy, transmural inflammation causing thickening and characteristic endoscopic findings.
C. Diverticulosis: This condition involves the presence of diverticula without inflammation. It does not cause the cobblestone or skipped lesion appearance seen in inflammatory bowel disease and is generally asymptomatic unless complicated by diverticulitis.
D. Ulcerative Colitis: This disease causes continuous inflammation usually starting in the rectum and extending proximally, leading to a loss of haustral markings but does not typically present with skipped lesions or a cobblestone appearance. The colon wall tends to be thin rather than thickened.
Correct Answer is ["A","B","C","E"]
Explanation
A. Blood glucose levels in DKA are typically higher than in HHS: In fact, HHS usually presents with higher blood glucose levels than DKA—often exceeding 600 mg/dL, while DKA typically ranges from 250 to 600 mg/dL.
B. DKA involves significant ketosis and metabolic acidosis, while HHS typically does not: DKA is characterized by the breakdown of fats into ketones, leading to metabolic acidosis. HHS typically lacks significant ketosis because insulin levels, while low, are still sufficient to suppress ketogenesis.
C. DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes: DKA usually occurs in individuals with type 1 diabetes due to absolute insulin deficiency. HHS is more often seen in type 2 diabetics who still produce some insulin but not enough to prevent severe hyperglycemia and dehydration.
D. None of the above: This choice is incorrect, as B, C, and E are valid differences between DKA and HHS.
E. HHS patients often have more severe dehydration than DKA patients: HHS leads to profound osmotic diuresis over a longer period, causing extreme dehydration. DKA progresses faster but with less total fluid loss compared to HHS.
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