Which of the following laboratory findings is most indicative of fluid volume excess in a client with liver cirrhosis?

Increased AST levels

Decreased albumin levels

High prothrombin time

Elevated serum bilirubin

Answer and Explanation

The Correct Answer is B

Rationale:

A. Elevated AST indicates hepatocellular injury, but it does not directly reflect fluid volume status.

B. In liver cirrhosis, the liver produces less albumin, leading to reduced plasma oncotic pressure. Low albumin allows fluid to leak into interstitial spaces, causing ascites, edema, and overall fluid volume excess.

C. Prolonged PT reflects impaired clotting factor synthesis in cirrhosis, not fluid status.

D. High bilirubin indicates impaired bile excretion and liver dysfunction, but it is not a direct marker of fluid overload.

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Correct Answer is C

Explanation

Rationale:
A. 59% dextrose in lactated Ringer’s is not a standard solution and would be hypertonic and unsafe.
B. 0.45% sodium chloride does not provide the glucose necessary to prevent hypoglycemia.
C. 10% dextrose in water (D10W) is correct. If TPN runs out, a dextrose-containing solution should be administered to prevent hypoglycemia until the next TPN bag is available.
D. Lactated Ringer’s does not provide sufficient glucose to maintain blood sugar during TPN interruption.

A. Clear liquids B. Soft diet C. Regular diet D. Full liquid diet

Correct Answer is A

Explanation

Rationale:
A. After the return of bowel sounds postoperatively, clear liquids (e.g., water, broth, tea, clear juice) are introduced first. This allows the gastrointestinal tract to gradually resume function and ensures the client can tolerate fluids without nausea, vomiting, or distention.

B. A soft diet is introduced later once the client tolerates clear liquids and then full liquids, as it is more complex to digest.

C. A regular diet is not started immediately after surgery; the gut needs gradual reintroduction to food.

D. Full liquids can be given after clear liquids are tolerated, as they are more substantial and include milk-based or blended foods.

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Which of the following laboratory findings is most indicative of fluid volume excess in a client with liver cirrhosis?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Which dietary advancement should be made first after the return of bowel sounds postoperatively?

Correct Answer is A

Explanation

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