A client with liver disease presents with the following laboratory results: serum albumin 4.6 g/dL (normal range: 3.5-5.5 g/dL), serum ammonia 62 mcg/dL (normal range: 15-45 mcg/dL), hematocrit 41% (normal range: 37-47%), PT 13 seconds (normal range: 11-12.5 sec). Which assessment findings are consistent with these values?

Petechiae and bruising

Jaundice and pruritus

Dyspnea and fatigue

Asterixis and confusion

Answer and Explanation

The Correct Answer is D

Choice A reason: Petechiae and bruising could be related to low platelet counts or clotting issues, but they are not directly indicated by the provided lab values.

Choice B reason: Jaundice and pruritus are symptoms associated with liver disease but are not specifically indicated by the lab values provided.

Choice C reason: Dyspnea and fatigue could be symptoms of many conditions, including liver disease, but they are not directly indicated by the lab values provided.

Choice D reason: Asterixis, a flapping tremor of the hands, and confusion are signs of hepatic encephalopathy, which can be associated with elevated serum ammonia levels, as indicated by the lab results.

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Correct Answer is A

Explanation

Choice A reason: This response acknowledges the patient's feelings and invites further discussion, which can help the nurse understand the patient's concerns and provide appropriate support.

Choice B reason: Asking about specific challenges can be helpful, but it might be too direct for an initial response when the patient is expressing a general sense of being overwhelmed.

Choice C reason: While it's true that the healthcare team will provide support, this response may not address the patient's immediate emotional needs and concerns.

Choice D reason: This response might seem dismissive of the patient's concerns and does not acknowledge the difficulty of adjusting to a chronic illness like Parkinson's disease.

A. Assess for hematuria. B. Monitor temperature. C. Evaluate skin turgor. D. Administer heparin.

Correct Answer is D

Explanation

Choice A reason: Assessing for hematuria is important but not the priority action. Hematuria can be a symptom of various conditions and does not directly address the abnormal laboratory results.

Choice B reason: Monitoring temperature is a routine action in sepsis management but does not address the immediate concern of the abnormal laboratory results, specifically the elevated aPTT and low platelet count.

Choice C reason: Evaluating skin turgor is a method to assess dehydration, which is not the immediate concern indicated by the laboratory results.

Choice D reason: The elevated aPTT and low platelet count suggest a potential coagulopathy, which could be a sign of disseminated intravascular coagulation (DIC), a complication of sepsis. Administering heparin may be part of the treatment for DIC to prevent further clotting and is a priority action in this context.

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Naxlex Comprehensive Predictor Exams

The patient with newly diagnosed Parkinson's disease states, "I just don't think I can handle having Parkinson's disease." What is the nurse's best first response?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

The nurse is assessing a client diagnosed with Parkinson's disease. Which data would the nurse anticipate? Select all that apply.

When assessing a client with sepsis, which finding would be consistent with the late phase of septic shock?

Assessment of a client with cirrhosis reveals a distended abdomen, weight gain, and dyspnea. Based on this information, what interventions would the nurse include in this client's plan of care?

The nurse caring for a client with thyroid disease notes a current T4 level of 2.9 mcg/dL (normal range: 5-11.5 mcg/dL). Which findings are consistent with this result?

The client with cirrhosis has developed spontaneous bacterial peritonitis (SBP). Which data indicates this complication of cirrhosis is occurring?

The nurse is caring for a client with sepsis. Which intervention would the nurse include to monitor for decreased tissue perfusion?

The nurse is planning discharge teaching for a client with Parkinson's disease. What information regarding levodopa/carbidopa therapy should the nurse include in this session?