You are receiving shift report on a patient with intrahepatic biliary disease (cirrhosis). The nurse tells you the patient’s bilirubin levels are very high. Based on your knowledge, what could you expect to see regarding this patient? (Select all that apply)
Yellowing of the sclera
Dark brown urine
Frothy light-colored urine
Jaundice of the skin
Bluish mucous membranes
Correct Answer : A,B,D
Choice A reason: Yellowing of the sclera (icterus) is expected with high bilirubin in cirrhosis, as impaired liver function causes bilirubin accumulation. Conjugated bilirubin deposits in the sclera, visible early due to its vascularity, making this a correct clinical finding.
Choice B reason: Dark brown urine results from excess conjugated bilirubin excreted by the kidneys in cirrhosis. High bilirubin levels overwhelm liver clearance, leading to bilirubinuria, which darkens urine, making this a correct and common finding in this condition.
Choice C reason: Frothy light-colored urine is not associated with high bilirubin. Light urine suggests dilute urine or low bilirubin excretion, opposite to the dark urine seen in cirrhosis, making this an incorrect finding for this patient’s condition.
Choice D reason: Jaundice of the skin occurs with elevated bilirubin in cirrhosis, as bilirubin deposits in tissues. This yellowish discoloration is a hallmark of liver dysfunction, reflecting impaired bilirubin metabolism, making this a correct clinical manifestation.
Choice E reason: Bluish mucous membranes suggest cyanosis from hypoxemia, not related to high bilirubin. Cirrhosis causes jaundice, not oxygenation issues, unless complicated by other conditions, making this an incorrect finding for this patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Nerve damage from the prosthetic may cause local discomfort, but pain in the entire absent arm suggests phantom limb pain. This is less likely than neural misfiring, so it’s incorrect.
Choice B reason: Heart attack referred pain typically affects the left arm but is unlikely in a prosthetic limb. Phantom limb pain explains pain in the absent arm, so this is incorrect.
Choice C reason: Muscle strain affects existing muscles, not a prosthetic arm. Phantom limb pain, from neural signals in the brain, explains pain in the missing limb, so this is incorrect.
Choice D reason: Phantom limb pain occurs when the brain perceives pain in an amputated limb, common in prosthetic users. This matches Mr. Jones’s pain in his prosthetic arm, making it correct.
Correct Answer is ["A","C"]
Explanation
Choice A reason: DiGeorge disease involves thymic hypoplasia or aplasia, impairing T-cell development. This is a primary cause, leading to immune deficiency, making it a correct choice for the condition’s etiology.
Choice B reason: B-cell maturation is generally preserved in DiGeorge disease, as it primarily affects T-cells due to thymic defects. T-cell issues are central, so this is incorrect for the cause.
Choice C reason: T cells cannot mature in DiGeorge disease due to thymic underdevelopment, causing severe immunodeficiency. This is a core feature of the syndrome, making it a correct choice for the cause.
Choice D reason: Humans lack a bursa; B-cell maturation occurs in bone marrow. DiGeorge affects the thymus and T-cells, not a nonexistent bursa, so this is incorrect for the cause.
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