A nurse is assessing a client who has cirrhosis.
Which of the following is an expected finding for this client?

Moist skin.

Blood in the urine.

Spider angiomas.

Tarry stools.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Moist skin is not typically associated with cirrhosis. Cirrhosis often leads to dry, itchy skin due to bile salt accumulation under the skin.

Choice B rationale

Blood in the urine is not a common finding in cirrhosis. This symptom is more indicative of urinary tract issues or kidney problems.

Choice C rationale

Spider angiomas are a common finding in clients with cirrhosis. These are small, dilated blood vessels that appear close to the surface of the skin and are caused by increased estrogen levels due to liver dysfunction.

Choice D rationale

Tarry stools indicate gastrointestinal bleeding, which can occur in cirrhosis due to varices, but it is not a primary expected finding.

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

Explanation

Choice A rationale

Prealbumin level is an important indicator of nutritional status. Low prealbumin levels can indicate poor nutrition, which can delay wound healing. Adequate protein intake is essential for tissue repair and regeneration.

Choice B rationale

History of diabetes mellitus is a significant factor that can delay wound healing. Diabetes can impair blood flow and reduce the supply of oxygen and nutrients to the wound, leading to slower healing.

Choice C rationale

History of hyperlipidemia is not directly associated with delayed wound healing. While it can contribute to other health issues, it is not a primary factor in wound healing.

Choice D rationale

Wound infection is a major factor that can delay wound healing. Infections can cause inflammation, tissue damage, and increased exudate, all of which can impede the healing process.

Choice E rationale

Decreased pedal perfusion indicates poor blood flow to the lower extremities. Adequate blood flow is crucial for delivering oxygen and nutrients to the wound site, and decreased perfusion can significantly delay healing.

Choice F rationale

Fasting blood glucose levels are important in managing diabetes. High blood glucose levels can impair the immune response and reduce the body’s ability to heal wounds effectively.

A. Red skin with edema in the nail beds. B. Black fingertips surrounded by an erythematous rash. C. A white appearance to the skin that is insensitive to touch. D. A pink edematous hand.

Correct Answer is C

Explanation

Choice A rationale

Red skin with edema in the nail beds is more indicative of a superficial injury or inflammation, such as cellulitis or a mild burn, rather than frostbite.

Choice B rationale

Black fingertips surrounded by an erythematous rash suggest gangrene or severe necrosis, which can occur in advanced stages of frostbite but is not an initial finding.

Choice C rationale

A white appearance to the skin that is insensitive to touch is a classic sign of frostbite. The lack of sensation is due to the freezing of tissues and nerves, and the white color indicates a lack of blood flow to the affected area.

Choice D rationale

A pink edematous hand is more indicative of a mild inflammatory response or early stages of frostbite before the tissue has frozen. It does not represent the more severe presentation of frostbite.

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A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client. Select the 5 findings that can cause delayed wound healing.

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

Explanation

The emergency service team brings a homeless client found lying in an alley to the emergency department. An assessment is performed, and the client is suspected of having frostbite of the hands. Which finding would the nurse expect to note in this condition?

Correct Answer is C

Explanation

Select the 5 findings that can cause delayed wound healing.

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A nurse is assessing a client who has cirrhosis.
Which of the following is an expected finding for this client?