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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":"D"}

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

Explanation

Rationale:
A. Full volume of pedal pulses: Pedal pulses reflect peripheral arterial circulation, not neuropathic pain. Pregabalin does not affect vascular flow, so this finding is unrelated to the medication’s intended effect.

B. Reduced level of pain: Pregabalin is an anticonvulsant used to treat neuropathic pain by modulating nerve signals. A reduction in reported pain confirms that the medication is helping manage the client’s diabetic nerve pain.

C. Granulating tissue in foot ulcer: Wound healing is influenced by infection control, circulation, and blood glucose management—not directly by pregabalin. While important, this finding does not measure the drug’s effectiveness for neuropathy.

D. Improved visual acuity: Visual changes are not treated with pregabalin and may be associated with diabetic retinopathy. Pregabalin does not improve vision and is not indicated for ocular complications of diabetes.

Correct Answer is B

Explanation

Rationale:

A. Self-description of pain: Pain assessment is important in general care but is not directly related to assessing for obstructive sleep apnea. OSAS is more concerned with sleep patterns, airway obstruction, and associated risk factors like weight and anatomy rather than pain.

B. Body mass index: BMI is a key factor in determining OSAS risk. Obesity, especially central adiposity, contributes to pharyngeal narrowing and increased airway resistance during sleep. A high BMI is one of the most significant predictors of obstructive sleep apnea.

C. Level of consciousness: While decreased alertness can result from sleep deprivation caused by OSAS, it is a non-specific finding. It may support further evaluation but does not directly assess the risk for OSAS or its underlying causes.

D. Breath sounds: Although breath sounds can reveal lung pathology, they typically remain normal in OSAS unless another respiratory condition is present. They are not the most important assessment for evaluating sleep-disordered breathing risk.

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