A nurse caring for a client with hepatitis is providing education to the client about portal hypertension. Which of the following will the nurse include in the teaching?

"Increased pressure from portal hypertension contributes to the abdominal swelling."

"Portal hypertension is caused by the heart overworking."

"Portal hypertension develops when the cirrhosis begins to resolve."

"Eating high sodium foods and a stressful lifestyle contribute to portal hypertension."

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct answer because portal hypertension means that there is high blood pressure in the portal vein, which carries blood from the digestive organs to the liver. When the liver is damaged by hepatitis, it becomes scarred and obstructs the blood flow, causing increased pressure in the portal vein. This leads to fluid accumulation in the abdomen, called ascites, which causes abdominal swelling.

Choice B reason: This is incorrect because portal hypertension is not caused by the heart overworking but by liver damage. The heart does not pump blood into the portal vein, but into the hepatic artery, which supplies oxygenated blood to the liver.

Choice C reason: This is incorrect because portal hypertension does not develop when cirrhosis begins to resolve, but when it progresses. Cirrhosis is a chronic condition that causes irreversible scarring of the liver tissue, which worsens over time and increases portal hypertension.

Choice D reason: This is incorrect because eating high-sodium foods and a stressful lifestyle do not cause portal hypertension, but they can aggravate it. High-sodium foods can increase fluid retention and worsen ascites, while stress can increase blood pressure and worsen bleeding complications. The nurse should advise the client to limit sodium intake and manage stress levels.

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Free Nursing Study Resources

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

Explanation

Choice A Reason: This is correct because clinical obesity is a risk factor for metabolic syndrome. Clinical obesity is defined by having a body mass index (BMI) of 30 or higher, or a waist circumference of more than 40 inches for men or 35 inches for women. Obesity can increase insulin resistance and inflammation, which can lead to metabolic syndrome.

Choice B Reason: This is correct because elevated blood pressure is a risk factor for metabolic syndrome. Elevated blood pressure is defined by having a systolic blood pressure of 130 mm Hg or higher, or a diastolic blood pressure of 85 mm Hg or higher. High blood pressure can damage the blood vessels and increase the risk of cardiovascular disease, which is associated with metabolic syndrome.

Choice C Reason: This is correct because high triglycerides are a risk factor for metabolic syndrome. Triglycerides are a type of fat that circulates in the blood and provides energy for the cells. High triglycerides are defined by having a level of 150 mg/dL or higher. High triglycerides can increase the risk of fatty liver disease and pancreatitis, which are related to metabolic syndrome.

Choice D Reason: This is correct because hypercholesterolemia is a risk factor for metabolic syndrome. Hypercholesterolemia is defined by having a total cholesterol level of 200 mg/dL or higher, or a low-density lipoprotein (LDL) cholesterol level of 100 mg/dL or higher. LDL cholesterol is also known as "bad" cholesterol because it can build up in the arteries and cause plaque formation and narrowing, which can lead to cardiovascular disease and metabolic syndrome.

Choice E Reason: This is correct because hyperglycemia is a risk factor for metabolic syndrome. Hyperglycemia is defined by having a fasting blood glucose level of 100 mg/dL or higher, or a hemoglobin A1c level of 5.7% or higher. Hemoglobin A1c is a measure of average blood glucose over three months. Hyperglycemia can indicate impaired glucose metabolism and insulin resistance, which are hallmarks of metabolic syndrome.

A. Measure the abdominal girth B. Have the client extend their arms C. Have the client flex and extend their foot D. Ask the client to walk heel to toe

Correct Answer is B

Explanation

Choice A Reason: Measuring the abdominal girth is not related to asterixis, which is a tremor of the hand when the wrist is extended. It may indicate ascites, which is a complication of cirrhosis, but not asterixis.

Choice B Reason: This is the correct choice. Asterixis is a flapping tremor of the hand when the wrist is extended, sometimes said to resemble a bird flapping its wings. It is caused by abnormal function of the diencephalic motor centers that regulate the muscles involved in maintaining posture. It is a sign of hepatic encephalopathy, which is a neuropsychiatric disorder that occurs in patients with liver disease.

Choice C Reason: Having the client flex and extend their foot is not related to asterixis, which affects the hand and wrist. It may test for ankle clonus, which is a rhythmic contraction of the calf muscles when the foot is dorsiflexed. It indicates an upper motor neuron lesion, but not hepatic encephalopathy.

Choice D Reason: Asking the client to walk heel to toe is not related to asterixis, which affects the hand and wrist. It may test for balance and coordination, which can be impaired in patients with hepatic encephalopathy, but it is not a specific sign of asterixis.

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A nurse caring for a client with hepatitis is providing education to the client about portal hypertension. Which of the following will the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

A client asks the nurse to explain what metabolic syndrome is. Which of the following will the nurse include in education about risk factors for this syndrome? (Select all that apply.)

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

Explanation

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence?

Correct Answer is B

Explanation

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