The laboratory findings of a client with cirrhosis of the liver indicate high serum ammonia levels. As a result of this increased ammonia level, which symptom is this client likely to exhibit?

Sclera are yellow.

Shortness of breath on exertion.

Impaired skin integrity.

Altered level of consciousness.

Answer and Explanation

The Correct Answer is D

Choice A reason: Yellow sclera (jaundice) result from bilirubin accumulation in cirrhosis, not high ammonia levels. Ammonia toxicity affects the brain, causing neurological symptoms. While jaundice is common in cirrhosis, it is unrelated to ammonia, making this incorrect for the symptom linked to elevated serum ammonia.

Choice B reason: Shortness of breath on exertion may occur in cirrhosis due to ascites or hepatopulmonary syndrome, but it is not caused by high ammonia levels. Ammonia primarily affects the brain, leading to encephalopathy. This symptom is unrelated to ammonia toxicity, making it an incorrect choice.

Choice C reason: Impaired skin integrity may occur in cirrhosis from pruritus or edema, but it is not directly linked to high ammonia levels. Ammonia causes cerebral toxicity, manifesting as neurological changes. Skin issues are secondary complications, making this incorrect for the primary symptom of elevated ammonia.

Choice D reason: High serum ammonia in cirrhosis leads to hepatic encephalopathy, causing altered consciousness, from confusion to coma. Ammonia crosses the blood-brain barrier, disrupting neurotransmitter function and cerebral metabolism. This is the primary symptom of ammonia toxicity, aligning with cirrhosis’s neurological complications, per hepatology evidence.

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Correct Answer is D

Explanation

Choice A reason: Artificial sweeteners do not directly contribute to diabetic nephropathy. Nephropathy results from chronic hyperglycemia damaging glomerular vessels. Sweeteners may affect diet but lack evidence linking them to renal damage, making this incorrect compared to elevated HbA1c, the primary driver of diabetic complications.

Choice B reason: Frequent hypoglycemia may cause acute symptoms but does not directly cause nephropathy. Chronic hyperglycemia, reflected by high HbA1c, damages renal glomeruli, leading to nephropathy. Hypoglycemia is a treatment complication, not a risk factor for renal damage, making this an incorrect choice.

Choice C reason: Moderate alcohol consumption may affect overall health but is not a primary risk factor for diabetic nephropathy. Chronic hyperglycemia, indicated by elevated HbA1c, drives glomerular damage. Alcohol’s impact is less direct, making this incorrect compared to the established link between poor glycemic control and nephropathy.

Choice D reason: Consistently elevated HbA1c reflects chronic hyperglycemia, the primary cause of diabetic nephropathy. High glucose levels damage glomerular capillaries, leading to proteinuria and renal decline. This is a well-established risk factor, supported by endocrinology evidence, making it the correct choice for increased nephropathy risk.

A. Decreased amount of acetylcholine. B. Increased amount of serotonin. C. Disruption in the myelin sheath. D. Diminished amount of dopamine.

Correct Answer is D

Explanation

Choice A reason: Decreased acetylcholine is not the primary cause of Parkinson’s disease. Parkinson’s results from dopamine loss in the substantia nigra, disrupting motor control. Acetylcholine imbalance may occur in other conditions like Alzheimer’s, but it is not the pathophysiological basis for Parkinson’s motor symptoms.

Choice B reason: Increased serotonin is not linked to Parkinson’s disease. Parkinson’s is caused by dopamine depletion in the basal ganglia, leading to motor dysfunction. Serotonin imbalances may affect mood, but they are not the core mechanism, making this incorrect for the disease’s pathophysiological basis.

Choice C reason: Disruption in the myelin sheath occurs in multiple sclerosis, not Parkinson’s. Parkinson’s involves neuronal loss in the substantia nigra, reducing dopamine. Myelin is unrelated to Parkinson’s motor symptoms, making this incorrect, as dopamine deficiency is the established pathophysiological mechanism driving the disease.

Choice D reason: Parkinson’s disease is caused by a diminished amount of dopamine due to degeneration of substantia nigra neurons. Dopamine deficiency disrupts basal ganglia function, causing tremors, rigidity, and bradykinesia. This is the core pathophysiological basis, supported by neurological evidence linking dopamine loss to Parkinson’s symptoms.

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The laboratory findings of a client with cirrhosis of the liver indicate high serum ammonia levels. As a result of this increased ammonia level, which symptom is this client likely to exhibit?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which factor in the history of a client with diabetes mellitus increases the client’s risk for nephropathy?

Correct Answer is D

Explanation

Which is the pathophysiological basis for Parkinson’s disease?

Correct Answer is D

Explanation

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