A nurse is caring for a client with liver failure and is performing an assessment of the client's increased risk of bleeding. The nurse recognizes that this risk is related to the client's inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function?

Alterations in glucose metabolism

Retention of bile salts

Inadequate production of albumin by hepatocytes

Inability of the liver to use vitamin K

Answer and Explanation

The Correct Answer is D

A. Alterations in glucose metabolism are common in liver disease but are not directly linked to impaired clotting factor production.
B. Retention of bile salts causes symptoms like pruritus and jaundice, not bleeding due to prothrombin deficiency.
C. Inadequate albumin production contributes to fluid shifts and edema, not directly to impaired clotting.
D. The liver requires vitamin K to synthesize clotting factors, including prothrombin. In liver failure, impaired vitamin K utilization leads to decreased prothrombin production and increased bleeding risk.

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

Explanation

A. The gallbladder is often removed during the Whipple procedure to allow reconstruction of the bile drainage system.
B. A portion of the stomach (usually the distal part) may be removed as part of the surgery.
C. The duodenum (first part of the small intestine) is removed because it is closely connected to the pancreas and bile duct.
D. Part of the common bile duct is removed to clear the area around the pancreas and bile drainage pathways.
E. The rectum is not involved or removed in the Whipple procedure; it is unrelated anatomically.

A. Proteinuria and hyperkalemia B. Hemorrhage and hypercalcemia C. Weight loss and hypoglycemia D. Malabsorption and hyperglycemia

Correct Answer is D

Explanation

A. Proteinuria and hyperkalemia are not commonly associated with pancreatic surgery.
B. Hemorrhage may be an acute post-op complication, but hypercalcemia is not typically related to pancreatic surgery.
C. Weight loss and hypoglycemia may occur, but they are often secondary to broader problems such as malabsorption or endocrine dysfunction.
D. Malabsorption can occur due to reduced pancreatic enzyme production after surgery, leading to nutrient deficiencies. Hyperglycemia is also common, as insulin production may be impaired if pancreatic tissue is removed, increasing the risk for diabetes mellitus.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with pancreatic cancer who has been scheduled for a pancreaticoduodenectomy (Whipple procedure). During health education, the client should be informed that this procedure will involve the removal of which of the following? Select all that apply.

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

Explanation

Correct Answer is D

Explanation

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