The nurse is caring for a client with stable esophageal varices. Which of the following actions is most important?

Maintain a patent airway and prevent aspiration

Monitor the effects of ant-hypertensive medications

Prepare the client for immediate portal shunting surgery

Perform fecal occult testing on all stools

Answer and Explanation

The Correct Answer is B

A. Maintain a patent airway and prevent aspiration: While maintaining a patent airway is always important, esophageal varices do not typically cause aspiration unless they rupture. This choice would be a priority in an acute bleed, not in a stable client.

B. Monitor the effects of antihypertensive medications: Beta-blockers (e.g., propranolol) are commonly prescribed to reduce portal hypertension, preventing variceal rupture. Monitoring the effects of these medications is crucial in maintaining hemodynamic stability.

C. Prepare the client for immediate portal shunting surgery: Surgical shunting is considered for refractory cases with severe, recurrent bleeding. A client with stable varices does not require immediate surgery.

D. Perform fecal occult testing on all stools: Esophageal varices cause upper GI bleeding, which manifests as hematemesis or melena, not occult blood in the stool.

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Correct Answer is A

Explanation

A. Obstruction of the bile duct: Biliary cirrhosis (now called primary or secondary biliary cholangitis) can occur due to prolonged bile duct obstruction, leading to liver damage and cirrhosis.

B. Hepatitis C: Hepatitis C can cause cirrhosis, but it is not a direct cause of biliary cirrhosis. Instead, it leads to post-viral cirrhosis.

C. Hepatotoxic medications: Certain medications (e.g., acetaminophen overdose) can cause liver damage, but they do not specifically cause biliary cirrhosis.

D. Excessive alcohol consumption: Alcohol abuse can cause alcoholic cirrhosis, but not biliary cirrhosis.

Correct Answer is ["45"]

Explanation

30g x 10g ×15ml=45ml

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The nurse is caring for a client with stable esophageal varices. Which of the following actions is most important?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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Explanation

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