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 B

Explanation

A. Notify the health care provider: While it may eventually be necessary to notify the healthcare provider, the immediate action should involve confirming the balloon pressure, which is within the scope of respiratory therapy.

B. Call respiratory therapy to obtain the pressure within the balloon: This is the most appropriate action. Respiratory therapists are skilled in managing and measuring the cuff pressure to ensure it is within the correct range (typically 20-30 cm H2O).

C. Add air to the balloon port: Adding air without knowing the current pressure could lead to over inflation, which might cause tracheal injury.

D. Remove air from the balloon port: Similarly, removing air could lead to underinflation, increasing the risk of aspiration or inadequate ventilation.

A. Avoid positioning the client supine. B. Limit the client's activity level. C. Administer supplemental oxygen at all times. D. Teach the client deep breathing and coughing exercises.

Correct Answer is A

Explanation

A. Avoid positioning the client supine: Orthopnea is the inability to breathe comfortably while lying flat, so the nurse should avoid placing the client in a supine position and instead elevate the head of the bed.

B. Limit the client's activity level: While activity may need to be adjusted, this is not the primary concern for orthopnea.

C. Administer supplemental oxygen at all times: Oxygen may be necessary, but the key issue with orthopnea is the need to avoid lying flat, not necessarily the need for constant supplemental oxygen.

D. Teach the client deep breathing and coughing exercises: While beneficial for other conditions, this does not directly address orthopnea, which is primarily positional.

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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

The nurse assesses the port balloon on the ETT (endotracheal tube) of an intubated patient and is unsure if the balloon is properly inflated. What is the nurse's best action?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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