A registered nurse (RN) assesses a patient with cirrhosis and finds ascites with pitting edema of the feet and legs. Which factor contributes to edema and ascites in patients with cirrhosis?
Diminished serum albumin levels causes water to shift from blood to tissue.
Portal hypotension causes a fluid shift from the abdominal cavity into the portal veins.
Hypoaldosteronism causes a fluid volume deficit: shifting water from blood into tissue.
Aberrations of the portal system cause a back-up of blood that leads to hydronephrosis.
The Correct Answer is A
A. Diminished serum albumin levels cause water to shift from blood to tissue: In cirrhosis, liver dysfunction leads to decreased production of albumin, a protein that helps maintain oncotic pressure. Low albumin levels cause fluid to shift from the vascular space into the tissues, resulting in ascites and peripheral edema.
B. Portal hypotension causes a fluid shift from the abdominal cavity into the portal veins: Portal hypertension, not hypotension, is a common feature of cirrhosis, but it leads to ascites by increasing pressure in the portal venous system, not by shifting fluid into the portal veins.
C. Hypoaldosteronism causes a fluid volume deficit: shifting water from blood into tissue: Cirrhosis often leads to hyperaldosteronism, not hypoaldosteronism, resulting in sodium and water retention, which contributes to edema.
D. Aberrations of the portal system cause a back-up of blood that leads to hydronephrosis: Hydronephrosis is related to obstruction of the urinary tract, not a complication of portal hypertension or cirrhosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. An increased serum calcitonin level: Calcitonin is involved in lowering blood calcium levels, so increased levels would not indicate hypercalcemia but rather a compensatory mechanism to lower calcium.
B. An increased number of osteocytes: Osteocytes are bone cells, and their number is not a direct indicator of hypercalcemia. Osteoclasts and osteoblasts are more relevant to bone metabolism.
C. Elevated plasma magnesium levels: Elevated magnesium levels are not specifically indicative of hypercalcemia and can be related to other conditions.
D. An increased parathyroid hormone (PTH) level: Hypercalcemia can be associated with increased PTH levels, particularly in primary hyperparathyroidism. Elevated PTH can lead to increased calcium release from bones.
Correct Answer is C
Explanation
A. A sudden, explosive, disorderly charge of neurons causes a transient aberration in brain function: This describes the pathophysiology of seizures, not myasthenia gravis.
B. Loss of the myelin sheath surrounding peripheral nerves causes asymmetric weakness: This describes multiple sclerosis, not myasthenia gravis.
C. Destruction of acetylcholine receptors causes muscle weakness with prolonged activity: Myasthenia gravis is an autoimmune disease where antibodies attack acetylcholine receptors at the neuromuscular junction, leading to muscle weakness, especially after repeated use.
D. A bacterial inflammatory illness that causes headache and photophobia: This describes meningitis, not myasthenia gravis.
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