A nurse is providing care for a patient who has peritonitis. Which of the following conditions is the highest priority for the nurse to monitor?

Respiratory failure

Diabetes

Sepsis

Heart attack

Answer and Explanation

The Correct Answer is C

Choice A reason: Respiratory failure is a concern in peritonitis if abdominal distension impairs diaphragm movement, but it is not the highest priority. Sepsis, from bacterial spread, poses a more immediate life-threatening risk, causing systemic inflammation and shock. Monitoring respiratory status is secondary to addressing the infectious source driving peritonitis complications.

Choice B reason: Diabetes is not a direct complication of peritonitis. While it may complicate management by predisposing to infections, peritonitis itself does not cause diabetes. Sepsis is the primary concern, as bacterial peritonitis can rapidly progress to systemic infection, requiring urgent antibiotics and monitoring to prevent multi-organ failure.

Choice C reason: Sepsis is the highest priority in peritonitis, as bacterial contamination from gastrointestinal perforation or infection can lead to systemic inflammatory response syndrome, shock, and organ failure. Early recognition of fever, tachycardia, and hypotension is critical to initiate antibiotics and fluids, preventing mortality in this life-threatening complication of peritonitis.

Choice D reason: Heart attack is not a primary complication of peritonitis. While sepsis may strain the cardiovascular system, increasing myocardial demand, peritonitis itself does not cause coronary occlusion. Sepsis is the more immediate threat, as it drives systemic inflammation and shock, requiring urgent intervention to prevent progression to multi-organ dysfunction.

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Correct Answer is D

Explanation

Choice A reason: CPTT (likely a typo for aPTT, activated partial thromboplastin time) measures clotting time in the intrinsic pathway, used to monitor heparin therapy. It does not detect protein fragments from fibrinolysis. In DVT, aPTT is normal unless anticoagulation is involved, making it unhelpful for detecting fibrin degradation products.

Choice B reason: INR (international normalized ratio) assesses the extrinsic clotting pathway, primarily for warfarin monitoring. It does not measure fibrin degradation products like D-dimer. In DVT, INR is typically normal unless the patient is on anticoagulants, so it is not useful for confirming fibrinolysis or diagnosing DVT.

Choice C reason: Impedance plethysmography is a non-invasive test measuring blood flow changes in veins, used to detect DVT by identifying obstructions. It does not measure protein fragments or fibrinolysis products. It assesses physical blood flow, not biochemical markers, making it irrelevant for detecting fibrin degradation in DVT.

Choice D reason: D-dimer is a specific test for fibrin degradation products, elevated in DVT due to fibrinolysis of clots. A high D-dimer indicates active clot breakdown, supporting DVT diagnosis. It is sensitive but not specific, requiring imaging confirmation, but it directly addresses the question of detecting protein fragments from fibrinolysis.

A. NSTEMI B. Myxedema C. SIADH D. Thyroid storm crisis

Correct Answer is B

Explanation

Choice A reason: NSTEMI (non-ST-elevation myocardial infarction) is a heart attack caused by coronary artery occlusion, leading to myocardial ischemia. Symptoms include chest pain and elevated cardiac enzymes, not bradycardia, hyponatremia, or altered consciousness. Hypothyroidism does not directly cause NSTEMI, and these symptoms align with metabolic, not cardiac, pathology.

Choice B reason: Myxedema coma is a life-threatening complication of severe hypothyroidism, characterized by bradycardia, hyponatremia, hypotension, altered consciousness, and respiratory depression. Hypothyroidism slows metabolism, leading to fluid retention, low sodium, and reduced cardiac output. These symptoms match the patient’s presentation, making myxedema coma the most likely diagnosis in this scenario.

Choice C reason: SIADH causes hyponatremia due to excessive antidiuretic hormone, leading to water retention. However, it does not typically cause bradycardia, hypotension, or respiratory difficulty. SIADH is not a complication of hypothyroidism, and the patient’s symptoms, including altered consciousness, align more closely with myxedema coma than SIADH’s water imbalance.

Choice D reason: Thyroid storm is a life-threatening hyperthyroidism complication, presenting with tachycardia, hyperthermia, and agitation. The patient’s bradycardia, hypotension, and hyponatremia are opposite to thyroid storm’s hypermetabolic state. Hypothyroidism leads to myxedema coma, not thyroid storm, making this choice inconsistent with the patient’s clinical presentation and lab findings.

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A nurse is providing care for a patient who has peritonitis. Which of the following conditions is the highest priority for the nurse to monitor?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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