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:
Amoxicillin is an antibiotic used to treat bacterial infections. It has no role in the management of atrial fibrillation, which is a cardiac rhythm disorder. Antibiotics do not address the prevention of thromboembolism or the control of heart rate or rhythm.
Choice B reason:
Reglan (metoclopramide) is a medication used to treat gastroesophageal reflux disease (GERD) and gastroparesis. It does not have any indication for use in atrial fibrillation. The management of atrial fibrillation focuses on rate or rhythm control and anticoagulation.
Choice C reason:
Rivaroxaban (Xarelto) is an anticoagulant that is commonly prescribed for patients with atrial fibrillation to prevent stroke and systemic embolism. Since atrial fibrillation increases the risk of thromboembolism, anticoagulation is a crucial component of the treatment plan to reduce the risk of stroke.
Choice D reason:
Omeprazole is a proton pump inhibitor used to treat acid-related stomach issues such as GERD. It is not relevant to the management of atrial fibrillation. The primary concerns in managing atrial fibrillation are controlling the heart rate and preventing thromboembolism, which omeprazole does not address.
Correct Answer is A
Explanation
Choice A reason:
Vitamin K (phytonadione) is the antidote for warfarin overdose. It works by promoting the synthesis of clotting factors that are inhibited by warfarin, thereby reversing the anticoagulant effects. In cases of excessive warfarin intake, administering vitamin K helps restore normal clotting function.
Choice B reason:
Protamine sulfate is the antidote for heparin overdose, not warfarin. It works by neutralizing the anticoagulant effects of heparin, but it has no effect on warfarin-induced anticoagulation. Therefore, it is not appropriate for this situation.
Choice C reason:
A PTT lab test measures the effectiveness of the intrinsic pathway of coagulation and is primarily used to monitor heparin therapy. It is not relevant for managing warfarin overdose, as warfarin affects the extrinsic pathway, which is measured by the PT/INR test.
Choice D reason:
While an INR lab test is essential for monitoring the therapeutic levels of warfarin, the immediate need in this situation is to reverse the effects of the overdose. Administering vitamin K is the necessary intervention to counteract the excessive anticoagulation caused by warfarin.
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