A client with advanced cirrhosis has been admitted to the medical-surgical unit. The nurse is assessing the client and identifies which of the following findings as indicators of hepatic encephalopathy? (Select all that apply).

Asterixis

Change in orientation

Anorexia

Ascites

Fetor hepaticus

Answer and Explanation

Correct Answer : A,B,E

Choice A reason: Asterixis, also known as "liver flap," is a tremor of the hand when the wrist is extended, often seen in hepatic encephalopathy as a result of altered brain function.

Choice B reason: A change in orientation, including confusion and altered consciousness, is a hallmark of hepatic encephalopathy, reflecting the brain's impaired ability to process information.

Choice C reason: Anorexia may be present in cirrhosis, but it is not a specific indicator of hepatic encephalopathy.

Choice D reason: Ascites is a common complication of cirrhosis due to portal hypertension but is not a direct indicator of hepatic encephalopathy.

Choice E reason: Fetor hepaticus, a musty odor of the breath, is a distinctive symptom of hepatic encephalopathy caused by the presence of mercaptans in the breath as the liver fails to break down sulfur-containing amino acids.

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Correct Answer is A

Explanation

Aspiration is a common complication in patients with dysphagia post-stroke due to impaired swallowing reflexes, leading to food or liquid entering the lungs.

Choice B reason: Gastroesophageal reflux disease could be a concern but is not directly related to dysphagia post-stroke.

Choice C reason: Peptic ulcer disease is not typically a complication of dysphagia post-stroke.

Choice D reason: Dumping syndrome is related to rapid gastric emptying post-meal, not dysphagia post-stroke.

A. Hypoxemia B. Confusion C. Dyspnea D. Bradycardia E. Hypocarbia

Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason: Hypoxemia, or low oxygen levels in the blood, is a primary indicator of ARF as the lungs are unable to adequately oxygenate the blood.

Choice B reason: Confusion can result from hypoxemia or hypercapnia (high carbon dioxide levels) as the brain is sensitive to changes in blood gas levels.

Choice C reason: Dyspnea, or difficulty breathing, is a hallmark symptom of ARF as the lungs struggle to maintain adequate gas exchange.

Choice D reason: Bradycardia, or a slow heart rate, is not typically associated with ARF. Tachycardia, or a fast heart rate, is more common as the body attempts to compensate for hypoxemia.

Choice E reason: Hypocarbia, or low carbon dioxide levels, can occur in ARF if the body is attempting to compensate for hypoxemia by hyperventilating.

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A client with advanced cirrhosis has been admitted to the medical-surgical unit. The nurse is assessing the client and identifies which of the following findings as indicators of hepatic encephalopathy? (Select all that apply).

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who had a stroke and has dysphagia. For which of the following complications should the nurse monitor the client?

Correct Answer is A

Explanation

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Correct Answer is ["A","B","C","E"]

Explanation

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