A client with cirrhosis and portal hypertension has developed esophageal varices.
For which complication is this client most at risk?
Angina.
Hemorrhage.
Gastroesophageal reflux.
Hypoglycemia.
The Correct Answer is B
Choice A rationale
Angina is chest pain resulting from reduced blood flow to the heart muscle, typically caused by coronary artery disease and myocardial ischemia. While a patient with severe blood loss might experience secondary cardiac stress, angina is not a direct or primary complication of esophageal varices. The pathology of varices is rooted in venous congestion within the portal system, which is entirely distinct from the arterial atherosclerotic processes that characterize coronary heart disease.
Choice B rationale
Esophageal varices are dilated, fragile submucosal veins that develop due to portal hypertension, which redirects blood flow from the liver to systemic collateral vessels. These vessels have thin walls and are under high pressure, making them extremely susceptible to rupture. A rupture leads to massive upper gastrointestinal hemorrhage, which is a leading cause of mortality in patients with cirrhosis. Maintaining hemodynamic stability and preventing these bleeds is the primary goal of clinical management.
Choice C rationale
Gastroesophageal reflux involves the backflow of acid into the esophagus, primarily due to sphincter dysfunction. While patients with cirrhosis may have increased abdominal pressure from ascites that could worsen reflux, it is not the most critical risk associated with varices. The presence of varices themselves does not cause acid reflux; rather, the mechanical fragility of the veins poses a much more immediate and lethal threat of bleeding compared to the mucosal irritation of reflux.
Choice D rationale
Hypoglycemia can occur in patients with end-stage cirrhosis because the liver is responsible for gluconeogenesis and glycogen storage. If the liver fails, glucose regulation is impaired. However, esophageal varices are a vascular complication of portal hypertension, not a metabolic complication of liver cell failure. While both issues can exist in the same patient, the specific presence of varices does not cause low blood sugar; it specifically predisposes the patient to vascular rupture.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Stress is considered a modifiable risk factor because individuals can adopt various coping mechanisms and lifestyle changes to reduce its impact on the body. Chronic stress triggers the sympathetic nervous system, leading to sustained elevations in cortisol and adrenaline, which increase blood pressure. Through techniques such as mindfulness, cognitive behavioral therapy, or environmental adjustments, a patient can successfully lower their stress levels and subsequently reduce their risk for hypertension.
Choice B rationale
Obesity is a modifiable risk factor that is directly linked to metabolic and cardiovascular health. Excessive adipose tissue increases systemic vascular resistance and places a higher demand on the heart to pump blood. However, weight can be managed and reduced through a combination of caloric restriction and increased physical energy expenditure. Achieving a healthy Body Mass Index significantly lowers the mechanical and chemical strain on the circulatory system.
Choice C rationale
Gender is a non-modifiable risk factor because it is determined by biological sex chromosomes and the resulting hormonal profile established at birth. Statistical data shows that men often develop hypertension earlier in life compared to premenopausal women, largely due to the protective effects of estrogen. Since an individual cannot change their biological sex or the innate hormonal framework they were born with, it is classified as a permanent risk characteristic.
Choice D rationale
Sodium intake is a modifiable risk factor because it is entirely dependent on an individual's nutritional choices and eating habits. High sodium consumption leads to water retention and increased extracellular fluid volume, which directly raises blood pressure levels. By adhering to a low-sodium diet, such as the DASH diet, patients can effectively decrease the osmotic pressure within their vessels. This behavioral change is a cornerstone of non-pharmacological hypertension management.
Correct Answer is B
Explanation
Choice A rationale
Aphasia is a neurological communication disorder resulting from damage to the language centers of the brain, typically the left hemisphere. It affects the ability to speak, write, and understand language. It does not relate to the physical act of swallowing or the transport of food from the mouth to the stomach. Patients with aphasia may have perfectly functional swallowing mechanisms but cannot find the words to express their needs or understand verbal instructions given to them.
Choice B rationale
Dysphagia is the medical term for difficulty swallowing. it can occur in the oral, pharyngeal, or esophageal phases of swallowing. It is often caused by neurological conditions like stroke, or mechanical obstructions such as tumors or strictures. Dysphagia increases the risk of aspiration pneumonia and malnutrition. Normal swallowing is a coordinated process involving multiple cranial nerves. Assessment often includes a bedside swallow evaluation or a modified barium swallow study to determine the safety of oral intake.
Choice C rationale
Dyspnea is the clinical term for shortness of breath or difficult, labored breathing. It is a subjective sensation of breathlessness reported by the patient. While dyspnea and swallowing difficulties can coexist, especially in patients with neuromuscular respiratory failure, they are distinct physiological processes. Dyspnea relates to the respiratory system and gas exchange, whereas the finding mentioned in the prompt specifically identifies an issue with the digestive tract's upper entry point and the coordination of swallowing.
Choice D rationale
Angina is chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. It is a symptom of coronary artery disease. The pain is often described as pressure, squeezing, or fullness in the chest. Angina is related to cardiovascular ischemia and is entirely unrelated to the mechanical or neurological process of swallowing food or liquids. Treatment usually involves nitroglycerin or beta-blockers to reduce the oxygen demand of the myocardium.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.