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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","E","F"]
Explanation
Rationale:
A. Family history increases risk for heart disease and arthritis but is not a direct risk factor for peptic ulcer disease.
B. Smoking increases gastric acid secretion, reduces mucosal healing, and significantly raises PUD risk.
C. Alcohol use is denied by the client and therefore is not a contributing factor in this case.
D. Adalimumab use (an immunosuppressant for rheumatoid arthritis/psoriasis) does not directly increase PUD risk.
E. NSAIDs inhibit prostaglandin synthesis, reducing the gastric mucosal barrier and predisposing to ulcer formation.
F. H. pylori infection is a primary cause of peptic ulcers due to its damaging effect on gastric mucosa.
Correct Answer is D
Explanation
Rationale:
A. Used to visualize the upper gastrointestinal tract (esophagus, stomach, duodenum). It does not provide information about bowel obstruction in the large intestine.
B. Allows direct visualization of the colon mucosa but is not typically used initially in suspected acute bowel obstruction due to the risk of perforation.
C. Useful for evaluating gallbladder, liver, kidneys, and sometimes bowel, but it is less sensitive for detecting large bowel obstruction.
D. A plain abdominal X-ray (KUB) is often the first-line diagnostic study for suspected large bowel obstruction. It can show dilated bowel loops, air-fluid levels, and fecal loading, which correlate with the patient’s symptoms of bloating, distention, and relief after flatulence.
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