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 B
Explanation
Choice A reason: Necrotic bladder implies tissue death, not a nerve-related obstruction. Neurogenic bladder, caused by nerve supply interruption, leads to functional obstruction, making this incorrect for the described condition.
Choice B reason: Neurogenic bladder results from nerve supply interruption, causing dysfunctional bladder control and obstruction. This matches the description of a functional urinary tract issue, making it the correct term.
Choice C reason: Retrograde bladder is not a medical term; retrograde refers to urine backflow. Neurogenic bladder accurately describes nerve-related obstruction, so this is incorrect for the condition.
Choice D reason: Obstructed bladder is vague and not specific to nerve issues. Neurogenic bladder directly addresses nerve supply disruption causing obstruction, making this incorrect for the term.
Correct Answer is B
Explanation
Choice A reason: Vasodilation increases blood flow, causing redness and heat, but doesn’t directly cause fluid leakage. Increased capillary permeability allows fluid to escape into tissues, causing edema, so this is incorrect for the primary cause of inflammatory edema.
Choice B reason: Increased capillary permeability, triggered by inflammatory mediators, allows plasma to leak into tissues, causing edema. This is the primary mechanism during inflammation, making it the correct choice for the cause of edema in the process.
Choice C reason: Neutrophil emigration fights infection but doesn’t directly cause fluid accumulation. Capillary permeability changes lead to edema, so this is incorrect for the cause of swelling in inflammation.
Choice D reason: Endothelial cell contraction contributes to permeability but is a secondary mechanism. Increased capillary permeability is the overarching process causing fluid leakage and edema, so this is less precise and incorrect.
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