A nurse is caring for an older adult patient who has just been admitted to the intensive care unit with a diagnosis of confusion/delirium.The patient has an end-stage liver failure diagnosis with increasing ascites.
Their spouse Questions the nurse about the patient’s mental status because they state that the patient is usually lucid. Which of the following is likely the contributing factor for the admitting diagnosis?

This is likely related to new-onset dementia.

This is likely related to new-onset schizophrenia.

This is likely related to new-onset hepatic encephalopathy.

This is likely related to a new-onset UTI.

Answer and Explanation

The Correct Answer is C

Choice C rationale
Hepatic encephalopathy is a condition that can cause confusion or delirium in patients with end-stage liver disease and increasing ascites. It occurs when the liver is unable to remove toxins from the blood, such as ammonia, which can then accumulate in the brain and affect mental function. This condition is common in patients with cirrhosis or end-stage liver disease, and can manifest as confusion, changes in sleep patterns, mood alterations, and, in severe cases, coma.
Choice A rationale
While dementia can cause confusion and changes in mental status, it is typically a progressive condition that develops over time. In the context of a patient with end-stage liver failure and

increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice B rationale
Schizophrenia is a chronic mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. It is not typically associated with end-stage liver disease or ascites. In the context of a patient with end-stage liver failure and increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice D rationale
While a urinary tract infection (UTI) can cause confusion, especially in older adults, it would not typically be the primary suspect in a patient with end-stage liver failure and increasing ascites. In such a patient, hepatic encephalopathy is a more likely cause of confusion or delirium.

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Correct Answer is A

Explanation

Choice A rationale
Sleep problems are a common non-gastrointestinal symptom associated with IBS345. These can include difficulty falling asleep, frequent awakenings during the night, and feeling unrefreshed upon waking.
Choice B rationale
General muscle aches are not typically associated with IBS. While some people with IBS may experience discomfort or pain in various parts of their body, these symptoms are not usually described as muscle aches.
Choice C rationale
Paresthesias, or abnormal sensations such as tingling or prickling, are not typically associated with IBS345.
Choice D rationale
Restlessness is not typically associated with IBS. However, some people with IBS may experience increased anxiety or stress, which could potentially lead to feelings of restlessness.

A. You should avoid or cut down on alcohol and caffeine which can aggravate GERD. B. It is okay to take aspirin with GERD. C. You should avoid possible mercury containing foods such as some seafood because of their risk to GERD. D. There is no causal link between lying down after eating and increased onset of GERD.

Correct Answer is A

Explanation

Choice A rationale
Gastroesophageal reflux disease (GERD) is a condition where stomach acid frequently flows back into the esophagus, causing discomfort. Certain lifestyle habits and diet can trigger or worsen GERD symptoms. Alcohol and caffeine are among the substances that can aggravate

GERD123. They can relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus. Therefore, reducing or avoiding alcohol and caffeine can help manage GERD symptoms.
Choice B rationale
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can cause or worsen GERD symptoms. It can irritate the esophagus and stomach lining, leading to heartburn and other GERD symptoms. Therefore, it’s not advisable to take aspirin if you have GERD12.
Choice C rationale
While it’s important to avoid mercury-containing foods due to their potential health risks, there’s no specific link between these foods and GERD12. GERD is primarily triggered by foods that relax the lower esophageal sphincter, cause stomach distension, or irritate the esophagus. Mercury-containing foods do not fall into these categories.
Choice D rationale
Lying down after eating can indeed increase the onset of GERD123. When you lie down, it’s easier for stomach acid to backflow into the esophagus. This is why it’s recommended to wait at least 2-3 hours after eating before lying down.

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a patient with irritable bowel syndrome (IBS). The nurse recalls which non-gastrointestinal symptom is associated with the diagnosis.

Correct Answer is A

Explanation

A nurse is educating a patient about the risk factors for GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include?

Correct Answer is A

Explanation

A nurse is preparing discharge instructions for a patient who has been treated for acute pancreatitis. Which of the following statements is important to include in the instructions?

A nurse is caring for a client who is receiving one unit of packed red blood cells (RBCs) due to intraoperative blood loss. The client reports chills and back pain, and their blood pressure is 80/64 mm Hg. What should be the nurse’s first action?

A nurse is performing an assessment on a patient who has osteoarthritis of the knee. Which of the following assessment findings should the nurse expect?

A nurse is caring for a patient who has rheumatoid arthritis and tells the nurse that she wears a copper bracelet to help her feel better. Which of the following responses should the nurse make?

After thyroid surgery, the nurse suspects damage to the parathyroid glands when the patient develops which of the following?

A nurse is caring for a patient who has cirrhosis of the liver and is having difficulty eliminating alcohol consumption because many of their friends drink alcohol socially. Which of the following steps should the nurse include to motivate the patient to change?

A nurse is attending to a client who has just been admitted due to an acute exacerbation of ulcerative colitis. What should be the nurse’s initial course of action?

A nurse is educating a patient who has a history of ulcerative colitis and has recently been diagnosed with anemia. Which of the following symptoms of colitis should the nurse identify as a contributing factor to the development of anemia?