The nurse admits a client with sepsis that has developed cool ecchymotic fingertips and toes. The healthcare provider (HCP) determines that the client has developed disseminated intravascular coagulation (DIC). Which findings support the pathophysiology of DIC?

Hematuria and hemoptysis.

Polyuria and productive cough.

Glucosuria and lethargy.

Frothy urine and anorexia.

Answer and Explanation

The Correct Answer is A

Choice A reason: DIC involves widespread microthrombi formation and clotting factor consumption, leading to bleeding tendencies. Hematuria and hemoptysis reflect microvascular bleeding from depleted coagulation factors, common in sepsis-induced DIC. These findings align with DIC’s pathophysiology, where simultaneous clotting and hemorrhage occur, causing ecchymotic extremities, as seen in this client.

Choice B reason: Polyuria and productive cough are unrelated to DIC. Polyuria suggests renal or endocrine issues, and productive cough indicates respiratory infection. DIC causes bleeding and clotting abnormalities, not these symptoms. These findings do not support the pathophysiology of sepsis-induced DIC, which manifests as hemorrhagic tendencies like hematuria.

Choice C reason: Glucosuria and lethargy suggest diabetes or metabolic issues, not DIC. DIC involves coagulopathy, leading to bleeding or thrombosis, not glucose excretion or fatigue alone. These symptoms are unrelated to the microthrombi and bleeding diathesis of DIC, making them inconsistent with the client’s ecchymotic presentation.

Choice D reason: Frothy urine indicates proteinuria or renal disease, and anorexia is nonspecific. Neither directly relates to DIC’s coagulopathy, which causes bleeding (e.g., hematuria) due to clotting factor depletion. These findings do not support DIC’s pathophysiology, as they lack connection to the hemorrhagic or thrombotic features seen in

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Correct Answer is D

Explanation

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.

A. Daily consumption of artificial sweeteners. B. Frequent episodes of hypoglycemia. C. Moderate alcohol consumption. D. Consistently elevated hemoglobin A1C (HbA1c) levels.

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.

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The nurse admits a client with sepsis that has developed cool ecchymotic fingertips and toes. The healthcare provider (HCP) determines that the client has developed disseminated intravascular coagulation (DIC). Which findings support the pathophysiology of DIC?

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

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

Correct Answer is D

Explanation

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