Nokea
What is the primary cause of jaundice in a client with liver cirrhosis?
- A. Decreased bile production
- B. Increased bilirubin levels
- C. Hepatic inflammation
- D. Portal hypertension
Correct Answer: B
Rationale: The primary cause of jaundice in a client with liver cirrhosis is increased bilirubin levels. Liver cirrhosis impairs the liver's ability to process bilirubin, leading to its accumulation in the bloodstream. This excess bilirubin then causes the yellow discoloration of the skin and eyes characteristic of jaundice.
Incorrect Choices:
A: Decreased bile production is not the primary cause of jaundice in liver cirrhosis. While decreased bile flow may contribute to jaundice, it is secondary to the impaired bilirubin processing.
C: Hepatic inflammation is a common feature of liver cirrhosis but is not the direct cause of jaundice in this context.
D: Portal hypertension is a complication of liver cirrhosis but is not the primary cause of jaundice.
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Why is a client with ascites scheduled for a paracentesis procedure?
- A. To diagnose liver disease
- B. To relieve abdominal pressure
- C. To assess kidney function
- D. To reduce blood pressure
Correct Answer: B
Rationale: The correct answer is B: To relieve abdominal pressure. Paracentesis is performed to drain excess fluid from the abdominal cavity, which helps alleviate symptoms like abdominal distension and discomfort in clients with ascites. It does not serve the purpose of diagnosing liver disease (A), assessing kidney function (C), or reducing blood pressure (D). The primary goal of paracentesis in this context is to provide symptomatic relief by removing the accumulated fluid, thereby reducing pressure on surrounding organs and improving the client's comfort and overall well-being.
What instruction should the nurse include in the discharge teaching for a patient with hypothyroidism prescribed levothyroxine?
- A. Take the medication with meals.
- B. Take the medication in the morning on an empty stomach.
- C. Discontinue the medication if you feel better.
- D. Double the dose if a dose is missed.
Correct Answer: B
Rationale: The correct answer is B: Take the medication in the morning on an empty stomach. Levothyroxine should be taken on an empty stomach, preferably 30 minutes to 1 hour before breakfast, to ensure optimal absorption. Food can interfere with absorption, so taking it with meals (choice A) is not recommended. Discontinuing the medication if feeling better (choice C) is dangerous as it can lead to a relapse of hypothyroidism. Doubling the dose if a dose is missed (choice D) can result in overdose and adverse effects. Therefore, choice B is the best option for optimal effectiveness of levothyroxine therapy.
A patient with severe anemia is prescribed erythropoietin. What is the primary action of this medication?
- A. Stimulate white blood cell production
- B. Increase platelet count
- C. Promote red blood cell production
- D. Enhance clotting factor production
Correct Answer: C
Rationale: The correct answer is C: Promote red blood cell production. Erythropoietin is a hormone that stimulates the bone marrow to produce more red blood cells, helping to treat anemia. It does not stimulate white blood cell production (A), increase platelet count (B), or enhance clotting factor production (D). White blood cells are involved in the immune response, platelets are responsible for clotting, and clotting factors are proteins involved in the blood clotting process. Therefore, the primary action of erythropoietin is to specifically target red blood cell production to address anemia.
When caring for a client with hepatic encephalopathy, why is a low-protein diet recommended by the nurse?
- A. Hyperglycemia
- B. Hypoglycemia
- C. Increased ammonia levels
- D. Electrolyte imbalance
Correct Answer: C
Rationale: The correct answer is C: Increased ammonia levels. In hepatic encephalopathy, the liver is unable to metabolize ammonia into urea, leading to increased ammonia levels in the blood. A low-protein diet helps reduce ammonia production in the gut, thereby decreasing ammonia levels in the blood and improving symptoms. Hyperglycemia (A) and hypoglycemia (B) are not directly related to the rationale for a low-protein diet in hepatic encephalopathy. Electrolyte imbalance (D) is not specifically addressed by a low-protein diet in this context.
In a patient with chronic kidney disease (CKD) receiving erythropoietin therapy, what laboratory result should the nurse monitor to evaluate the effectiveness of this therapy?
- A. Serum creatinine
- B. White blood cell count
- C. Hemoglobin level
- D. Serum potassium
Correct Answer: C
Rationale: Rationale: The correct answer is C, hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in CKD patients with anemia. Monitoring hemoglobin levels helps assess the effectiveness of the therapy in improving anemia. If hemoglobin levels increase, it indicates the therapy is working.
Summary of incorrect choices:
A: Serum creatinine - This measures kidney function, not the effectiveness of erythropoietin therapy for anemia in CKD patients.
B: White blood cell count - Monitors immune function, not related to erythropoietin therapy for anemia.
D: Serum potassium - Important for monitoring electrolyte balance in CKD patients but not specific to assessing erythropoietin therapy effectiveness.