A nurse is assessing a client with chronic liver failure who tells the nurse he is experiencing spontaneous episodes of bleeding and has noted increased areas of bruising on his arms. The nurse suspects the client has a deficiency in which of the following vitamins?

Thiamine

Vitamin C

Vitamin K

Folic acid

Answer and Explanation

The Correct Answer is C

A. Thiamine deficiency is often associated with neurological symptoms, such as Wernicke-Korsakoff syndrome, rather than spontaneous bleeding or bruising. Thiamine does not directly impact the coagulation process.
B. Vitamin C deficiency can lead to scurvy, which includes symptoms such as bleeding gums and poor wound healing. However, it is not typically associated with the spontaneous bleeding and bruising seen in chronic liver failure.
C. Vitamin K is essential for the synthesis of clotting factors produced by the liver. In chronic liver failure, the liver's ability to produce these factors is impaired, leading to an increased risk of bleeding and bruising due to vitamin K deficiency.
D. Folic acid deficiency is more commonly linked to anemia and certain neurological issues, but it does not cause spontaneous bleeding or bruising. It does not directly affect coagulation factors as vitamin K does.

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Correct Answer is D

Explanation

A. DKA occurs due to a significant deficiency of insulin rather than issues with cell response to insulin. The condition leads to high blood glucose and ketone production because there is not enough insulin to regulate glucose levels effectively.
B. DKA is primarily associated with diabetes mellitus type 1, not type 2. It can occur due to a lack of insulin and is not solely caused by illness, although illness can exacerbate it.
C. DKA is not limited to clients with diabetes mellitus type 1 who experience septic shock. It can occur in anyone with type 1 diabetes due to severe insulin deficiency, though septic shock can complicate the condition.
D. DKA results from a complete absence of insulin, which is characteristic of poorly controlled or undiagnosed diabetes mellitus type 1. This insulin deficiency leads to elevated blood glucose levels and ketone formation.

A. Anuria B. Hypotension C. Decreased level of consciousness D. Increased respiratory rate

Correct Answer is D

Explanation

A. Anuria, or the absence of urine output, occurs in later stages of shock when there is significant renal hypoperfusion. It is not an early indicator of shock.
B. Hypotension is a classic sign of shock, but it generally occurs after compensatory mechanisms have failed. It is not the earliest indicator.
C. A decreased level of consciousness occurs later in the progression of shock due to decreased cerebral perfusion. It is not the earliest sign of shock.
D. Increased respiratory rate is often the earliest indicator of shock. As the body attempts to compensate for decreased oxygen delivery and tissue perfusion, the respiratory rate increases to enhance oxygenation and eliminate excess carbon dioxide. This compensatory mechanism is typically one of the first signs that shock is developing.

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A nurse is assessing a client with chronic liver failure who tells the nurse he is experiencing spontaneous episodes of bleeding and has noted increased areas of bruising on his arms. The nurse suspects the client has a deficiency in which of the following vitamins?

Nursing Test Bank

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Explanation

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