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Patient Data

Exhibits

Initial testing is complete, and the nurse reviews the laboratory and imaging results.

Choose the most likely options for the information missing from the statements by selecting from the lists of options provided.

The nurse recognizes that the client likely has

. Laboratory findings that support diagnosis of this disease process include and .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A","dropdown-group-3":"A"}

Rationale for Correct Choices:

  • Alcoholic cirrhosis: The client has a history of chronic heavy alcohol use, jaundice, RUQ tenderness, a distended abdomen, and abnormal liver ultrasound findings, all consistent with alcoholic cirrhosis. The presence of regenerative nodules and a nodular liver surface on imaging further supports this diagnosis.
  • Aspartate aminotransferase (AST): The AST is elevated at 120 U/L (normal range: 10–40 U/L), which commonly occurs in alcoholic liver disease. In alcoholic cirrhosis, AST levels often exceed ALT and indicate ongoing hepatocellular injury.
  • Ammonia: The client’s ammonia level is elevated at 90 mcg/dL (normal: 15–45 mcg/dL), suggesting impaired hepatic clearance and early signs of hepatic encephalopathy, both seen in advanced liver disease such as cirrhosis.

Rationale for Incorrect Choices:

  • Acute pancreatitis: The client does not report severe epigastric pain radiating to the back, which is typical for pancreatitis. There is also no elevation of serum lipase or amylase, and imaging does not show pancreatic inflammation or edema.
  • Hepatitis A: Hepatitis A usually presents with acute onset of symptoms like fever, malaise, and dark urine. It is typically short-term and not associated with the chronic liver changes (nodular liver, regenerative nodules) found in this client.
  • Chloride: While slightly elevated, the chloride level is not specific to liver disease and has minimal diagnostic value in cirrhosis. It is not typically used as a marker for hepatic dysfunction or alcoholic liver disease.
  • White blood cell count: The WBC count is elevated (16,000/mm³), but this can be attributed to various causes such as inflammation or infection. It does not specifically support the diagnosis of cirrhosis like AST and ammonia levels do.


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Related Questions

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

Explanation

Rationale:

A. Family history: A family history of aneurysms or vascular disease is a non-modifiable risk factor. While it provides valuable context for risk assessment, it cannot be changed through behavioral interventions.

B. Hypertension: Elevated blood pressure contributes significantly to the development and progression of aortic aneurysms. Teaching the client to manage blood pressure through medications, diet, and lifestyle is essential to reducing further vascular damage.

C. Obesity: Excess body weight increases the strain on the cardiovascular system and is associated with elevated blood pressure, insulin resistance, and atherosclerosis. Weight management strategies should be emphasized in post-discharge education.

D. High cholesterol: Hyperlipidemia accelerates atherosclerosis, which weakens arterial walls and promotes aneurysm formation. Dietary changes, medication adherence, and lipid monitoring are important components of long-term care.

E. Age: Advancing age is a major risk factor for aortic aneurysms, especially in individuals over 65. However, it is non-modifiable and therefore not the focus of preventive teaching.

F. Male gender: Being male increases the risk of developing abdominal aortic aneurysms compared to females, but gender is non-modifiable. Patient education should instead focus on risks the client can change or control.

G. Coronary artery disease: While CAD and AAA share many of the same causes (like smoking and hypertension), CAD itself is a co-existing condition rather than a risk factorthat can be modified to fix the aorta. However, managing the causes of CAD (like high cholesterol) is what the nurse would actually teach.

H. Tobacco use: Smoking is one of the strongest modifiable risk factors for aortic aneurysm development and rupture. Smoking cessation significantly decreases progression rates and improves overall vascular health.

Correct Answer is C

Explanation

Rationale:

A. Immunosuppressive therapy:This is a common treatment for aplastic anemia when a matched donor is unavailable, especially in older children and adults. However, it is less curative and carries a higher risk of relapse compared to bone marrow transplantation.

B. Chemotherapy: Chemotherapy is not the primary treatment for aplastic anemia. It is mainly used in malignancies. In some cases, chemotherapy may precede transplantation or be part of immunosuppressive therapy, but it is not curative alone.

C. Bone marrow transplantation: This is the treatment of choice and offers the best prognosis, particularly in children with a matched sibling donor. It provides a potential cure by replacing the defective marrow with healthy stem cells.

D. Blood transfusions: Transfusions manage symptoms and prevent complications like anemia or bleeding but do not treat the underlying cause. Long-term use increases the risk of iron overload and alloimmunization.

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