Elevated serum ammonia level causes which complication of cirrhosis?
Hepatic encephalopathy
Jaundice
Ascites
Peripheral neuropathies
The Correct Answer is A
Choice A reason: Hepatic encephalopathy is a severe complication of cirrhosis caused by elevated serum ammonia levels. When the liver is unable to effectively remove ammonia from the blood due to cirrhosis, ammonia accumulates and crosses the blood-brain barrier, leading to neurological symptoms such as confusion, altered mental status, and even coma. This condition is directly related to the liver's impaired ability to detoxify the blood, making it the most consistent complication associated with elevated serum ammonia levels.
Choice B reason: Jaundice is a common symptom of cirrhosis, but it is not directly caused by elevated serum ammonia levels. Jaundice occurs due to the liver's inability to process bilirubin, a byproduct of red blood cell breakdown, leading to its accumulation in the blood and tissues. While jaundice is a sign of liver dysfunction, it is not specifically linked to ammonia levels.
Choice C reason: Ascites is the accumulation of fluid in the abdominal cavity and is a common complication of cirrhosis. It occurs due to portal hypertension and hypoalbuminemia, which result from liver dysfunction. Although ascites is a significant complication, it is not directly caused by elevated serum ammonia levels.
Choice D reason: Peripheral neuropathies are nerve damage that can occur in various conditions, but they are not typically associated with elevated serum ammonia levels in cirrhosis. Peripheral neuropathies can result from nutritional deficiencies, metabolic disorders, or other underlying conditions, but they are not a direct consequence of ammonia accumulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
Choice A reason: Low T4 levels do not indicate hyperthyroidism. In fact, low levels of T4 are typically associated with hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormones.
Choice B reason: High T4 levels are indicative of hyperthyroidism. In hyperthyroidism, the thyroid gland is overactive and produces excessive amounts of thyroid hormone (T4), leading to elevated T4 levels in the blood.
Choice C reason: Low TSH levels are also indicative of hyperthyroidism. The pituitary gland secretes TSH to regulate thyroid hormone production. When thyroid hormone levels are high, as in hyperthyroidism, the pituitary gland reduces TSH secretion, resulting in low TSH levels.
Choice D reason: High TSH levels are not associated with hyperthyroidism. Elevated TSH levels are more commonly seen in hypothyroidism, where the thyroid gland is underactive, and the pituitary gland compensates by increasing TSH production to stimulate the thyroid gland.
Correct Answer is D
Explanation
Choice A reason: This statement is incorrect because the combination of heparin and warfarin does not dissolve the blood clot faster. Instead, these medications have different mechanisms of action. Heparin works quickly to prevent further clot formation, while warfarin takes several days to reach therapeutic levels and maintain anticoagulation over the long term.
Choice B reason: While the risk of a blood clot in the lungs (pulmonary embolism) is a concern, the necessity of using both heparin and warfarin is not because of the need for multiple blood thinners but rather due to their complementary pharmacokinetics. Heparin provides immediate anticoagulation, whereas warfarin requires time to become effective.
Choice C reason: This statement is also incorrect. Heparin does not dissolve clots but works to prevent the extension of existing clots and the formation of new ones. Warfarin, likewise, does not dissolve clots but prevents further clot formation by inhibiting vitamin K-dependent clotting factors.
Choice D reason: This is the accurate response. Heparin works immediately, providing rapid anticoagulation, which is essential for acute management of venous thromboembolism. On the other hand, warfarin takes several days to achieve its anticoagulant effect because it works by inhibiting the synthesis of vitamin K-dependent clotting factors. Therefore, the patient is initially placed on heparin to provide immediate protection against clotting while warfarin is started simultaneously. Once warfarin reaches a therapeutic level, heparin can be discontinued, and warfarin can maintain long-term anticoagulation.
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