What is the rationale for esophageal variceal bleeding in a patient with cirrhosis?

Inability of the liver to manufacture bile

A scarred liver results in Portal Hypertension

An elevated level of copper

Inability of the liver to convert NH3 to urea

Answer and Explanation

The Correct Answer is B

A. Inability of the liver to manufacture bile: This does not directly cause esophageal varices or bleeding.

B. A scarred liver results in Portal Hypertension: Cirrhosis leads to scarring of the liver, which increases resistance to blood flow and causes portal hypertension. This elevated pressure in the portal venous system leads to the development of esophageal varices, which can rupture and bleed.

C. An elevated level of copper: Elevated copper levels are associated with Wilson's disease, not the cause of esophageal variceal bleeding in cirrhosis.

D. Inability of the liver to convert NH3 to urea: This causes hepatic encephalopathy but is not related to variceal bleeding.

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Correct Answer is D

Explanation

A. Grey-Turner Sign: Grey-Turner Sign refers to bruising along the flanks, often associated with retroperitoneal hemorrhage or acute pancreatitis.

B. Steatorrhea: Steatorrhea refers to fatty stools that are pale, bulky, and foul-smelling, indicating malabsorption, not a physical exam finding on the skin.

C. Asterixis: Asterixis, also known as "liver flap," is a tremor of the hand when the wrist is extended, seen in hepatic encephalopathy, not a skin finding.

D. Cullen's Sign: Cullen's Sign is bruising around the umbilicus, indicating intra-abdominal bleeding, often seen in conditions such as acute pancreatitis or ruptured ectopic pregnancy.

A. Reoccurrence of chest pain/discomfort B. Puncture site for bleeding/hematoma C. pulse distal to puncture site D. urinary output

Correct Answer is ["A","B","C"]

Explanation

A. Reoccurrence of chest pain/discomfort: This can indicate restenosis or complications post-PCI, requiring immediate attention.

B. Puncture site for bleeding/hematoma: Bleeding at the puncture site is a common complication, so it must be closely monitored.

C. Pulse distal to puncture site: Checking the pulse distal to the puncture site helps assess for arterial occlusion or compromised blood flow, which can occur if a hematoma or clot forms.

D. Urinary output: While monitoring urinary output is important for overall assessment, it is not directly related to complications specific to PCI.

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What is the rationale for esophageal variceal bleeding in a patient with cirrhosis?

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Naxlex Comprehensive Predictor Exams

A nurse observes the following during the physical exam. How will the nurse document this finding?

Correct Answer is D

Explanation

Which of the following should the nurse assess in a patient who has just undergone a PCI (percutaneous coronary intervention) (select all that apply)

Correct Answer is ["A","B","C"]

Explanation

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