What is the primary cause of hepatic encephalopathy (from chronic liver disease)?
Decreased cerebral blood flow
Impaired ammonia metabolism
Hyperbilirubinemia and jaundice
Fluid and electrolyte imbalances
The Correct Answer is B
Choice A reason:
While decreased cerebral blood flow can contribute to various neurological conditions, it is not the primary cause of hepatic encephalopathy. Hepatic encephalopathy is primarily associated with liver dysfunction rather than cerebrovascular issues. Thus, this choice is incorrect.
Choice B reason:
Impaired ammonia metabolism is the primary cause of hepatic encephalopathy. When the liver is unable to adequately convert ammonia to urea due to chronic liver disease, ammonia accumulates in the bloodstream. This leads to toxic effects on the brain, resulting in the symptoms of hepatic encephalopathy. Therefore, this choice accurately reflects the underlying pathophysiology of the condition.
Choice C reason:
Hyperbilirubinemia and jaundice are common in liver disease but are not the primary causes of hepatic encephalopathy. These conditions result from impaired bilirubin metabolism and do not directly lead to the neurological manifestations seen in hepatic encephalopathy. Therefore, this choice is incorrect.
Choice D reason:
Fluid and electrolyte imbalances can occur with chronic liver disease but are not the primary cause of hepatic encephalopathy. While they may exacerbate the condition, the main issue is the accumulation of ammonia due to impaired liver function. Hence, this choice is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Left ventricular heart failure can cause severe chest pain and elevated cardiac enzymes but is not as directly associated with elevated cardiac troponin levels as a myocardial infarction. The presence of elevated troponin levels specifically indicates myocardial cell injury, which is most consistent with an MI.
Choice B reason:
Unstable angina involves chest pain that is not relieved by rest and may indicate a higher risk for an MI. However, it typically does not result in elevated cardiac troponin levels unless there is actual myocardial damage. Elevated troponin is a marker for myocardial infarction rather than just unstable angina.
Choice C reason:
Myocardial infarction (MI) is the correct answer. Elevated levels of cardiac troponin are a key indicator of myocardial infarction as they reflect heart muscle damage. The patient's severe chest pain and elevated troponin levels strongly suggest that an MI has occurred.
Choice D reason:
Prinzmetal angina, or variant angina, is characterized by chest pain caused by coronary artery spasms. While it can cause significant pain, it does not typically lead to elevated cardiac troponin levels unless it results in myocardial damage, which is less common than in an MI.
Correct Answer is D
Explanation
Choice D reason: The backup of pancreatic enzymes is the initial trigger for tissue damage in pancreatitis. When these enzymes become activated within the pancreas, they begin to digest pancreatic tissue, leading to inflammation and damage.
Choice A reason: Insulin toxicity is not a cause of tissue damage in pancreatitis. Insulin is a hormone that regulates blood sugar levels and does not play a role in the initial damage seen in pancreatitis.
Choice B reason: Autoimmune destruction of the pancreas is associated with conditions like type 1 diabetes, not pancreatitis. Pancreatitis is primarily caused by the premature activation of digestive enzymes within the pancreas.
Choice C reason: Hydrochloric acid reflux into the pancreatic duct is not a known cause of pancreatitis. The condition is related to the digestive enzymes produced by the pancreas itself, not stomach acid.
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