Which statement by the nurse explains ascites?

Inflammatory molecules have increased the permeability of the abdominal capillaries

Low aldosterone levels have caused fluid retention and peritoneal edema

The liver is not manufacturing clotting factors to prevent bleeding in the peritoneum

The body is experiencing a fluid imbalance related to changing osmotic pressures

Answer and Explanation

The Correct Answer is A

Choice A reason: Ascites results from increased permeability of peritoneal capillaries, often due to inflammatory molecules like cytokines in conditions such as liver cirrhosis or portal hypertension. This allows plasma proteins and fluid to leak into the peritoneal cavity, causing fluid accumulation. This statement accurately describes the pathophysiology of ascites in liver-related disorders.

Choice B reason: Low aldosterone levels do not cause ascites; instead, high aldosterone in liver disease (e.g., cirrhosis) promotes sodium and water retention, exacerbating fluid accumulation. This statement is inaccurate, as secondary hyperaldosteronism due to reduced liver metabolism of aldosterone is a key factor in ascites development.

Choice C reason: The liver’s failure to produce clotting factors can lead to bleeding tendencies, like variceal hemorrhage, but this does not directly cause ascites. Ascites is driven by fluid leakage from capillaries, not bleeding. This statement is inaccurate, as clotting factor deficiency is unrelated to peritoneal fluid accumulation.

Choice D reason: While fluid imbalance contributes to ascites, the primary mechanism involves portal hypertension and capillary permeability, not just osmotic pressure changes. This statement is overly vague and less accurate than the specific role of inflammatory molecules increasing capillary leakage in the peritoneal cavity.

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Correct Answer is A

Explanation

Choice A reason: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, not primarily an inflammatory disease. While low-grade inflammation may be present in some cases, IBS is characterized by altered gut motility and visceral hypersensitivity without significant inflammatory markers, unlike inflammatory bowel diseases like Crohn’s or ulcerative colitis. This statement is inaccurate.

Choice B reason: Stress is a well-documented trigger for IBS symptoms. The brain-gut axis, involving the hypothalamic-pituitary-adrenal axis, modulates gut motility and sensitivity. Psychological stress can exacerbate visceral pain, diarrhea, or constipation by altering neurotransmitter release and gut microbiome interactions, making this statement accurate for IBS pathophysiology.

Choice C reason: IBS treatment focuses on symptom relief, as there is no cure. Strategies include dietary modifications (e.g., low FODMAP diet), antispasmodics, laxatives, or antidiarrheals to manage pain, bloating, and bowel irregularities. This statement is accurate, reflecting the symptomatic approach to improving quality of life in IBS patients.

Choice D reason: IBS symptoms commonly include constipation, diarrhea, or alternating patterns, along with abdominal pain and bloating. These result from dysregulated gut motility and visceral hypersensitivity, affecting the enteric nervous system. This statement is accurate, as variable bowel habits are a hallmark of IBS diagnostic criteria.

A. The client should be careful with their diet since some foods cause adverse reactions B. Clients experience immediate improvement in symptoms C. These drugs are used when newer drugs have not been effective D. There are some drug-to-drug interactions that can contribute to hypertensive crisis

Correct Answer is B

Explanation

Choice A reason: Monoamine oxidase inhibitors (MAOIs) require dietary restrictions to avoid tyramine-rich foods (e.g., aged cheese), which can cause hypertensive crisis by increasing norepinephrine release. MAOIs inhibit monoamine breakdown, amplifying tyramine’s effects. This statement is accurate, as dietary caution is critical to prevent serious adverse reactions.

Choice B reason: MAOIs, like phenelzine, take 2-6 weeks to improve depressive symptoms by increasing monoamine levels (serotonin, norepinephrine, dopamine). Immediate improvement does not occur due to gradual synaptic changes. This statement is inaccurate, as the delayed onset is a key characteristic of MAOIs, similar to other antidepressants.

Choice C reason: MAOIs are reserved for treatment-resistant depression when newer drugs like SSRIs fail, due to their side effect profile and dietary restrictions. They effectively increase monoamine availability but are less preferred due to safety concerns. This statement is accurate, reflecting their role in refractory cases.

Choice D reason: MAOIs can cause hypertensive crisis via drug interactions (e.g., with SSRIs or sympathomimetics), as they inhibit monoamine breakdown, leading to excessive norepinephrine. This can result in severe blood pressure elevation. This statement is accurate, as drug interactions are a significant risk with MAOI therapy.

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Which statement by the nurse explains ascites?

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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