Nokea
The patient with cirrhosis has a rising ammonia level and is becoming disoriented. The patient's hands flap when the patient stretches out the arm. How will the nurse interpret this?
- A. As an attempt to get the nurse's attention
- B. As asterixis
- C. As an indication of respiratory obstruction from varices
- D. As spasticity
Correct Answer: B
Rationale: Asterixis is the 'flapping tremor' seen as the patient deteriorates into ammonia intoxication or hepatic encephalopathy.
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The nurse clarifies that deterioration progresses through stages before presenting with liver disease. The first stage is destruction. What is the last stage?
- A. Liver disease
- B. Inflammation
- C. Hepatic insufficiency
- D. Destruction
- E. Fibrotic regeneration
Correct Answer: A
Rationale: Liver deterioration follows a pattern of stages: destruction, inflammation, fibrotic regeneration; hepatic insufficiency then presents as liver disease.
Why is morphine contraindicated in the patient with pancreatitis?
- A. Meperidine is less expensive.
- B. Tylenol is more effective at managing this type of pain.
- C. Morphine may cause spasms of the sphincter of Oddi.
- D. These patients do not experience pain.
Correct Answer: C
Rationale: A common complaint is constant, severe pain; in such cases, meperidine is often administered. Morphine may cause spasms of the sphincter of Oddi.
Which will the nurse point out as a significant advantage of the laparoscopic cholecystectomy?
- A. Slightly more invasive, but there is less pain
- B. Can be performed on all patients of any age
- C. Can be performed even when there are large stones present in the bile duct
- D. Less invasive procedure
Correct Answer: D
Rationale: The laparoscopic cholecystectomy is less invasive and causes less pain and a quick recovery. If there are large stones present, a sphincterotomy is done before the laparoscopic cholecystectomy. Persons with bleeding tendencies, pathologic conditions of the abdomen, stones in the bile duct, and extensive adhesions are not good candidates.
is a condition characterized by yellowing of the sclera and the skin.
Correct Answer: Jaundice
Rationale: Jaundice is the discoloration of body tissues caused by abnormally high blood levels of bilirubin.
The nurse explains that the use of cyclosporine as an immunosuppressant has been successful in the reduction of rejection of liver transplants because the drug has which benefit?
- A. increases the rate of the regeneration of liver cells.
- B. can overcome complications presented by hepatitis C.
- C. increases blood supply to transplant.
- D. does not suppress bone marrow.
Correct Answer: D
Rationale: Cyclosporine is an immunosuppressant that does not cause bone marrow suppression nor does it impede healing.