the nurse is caring for a client with cirrhosis which manifestations indicate deficient vitamin k absorption caused by this liver disease
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Nursing Elites

ATI RN

ATI Gastrointestinal System

1. The nurse is caring for a client with cirrhosis. Which manifestations indicate deficient vitamin K absorption caused by this liver disease?

Correct answer: C

Rationale: A liver disorder, such as cirrhosis, can disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting factor). Because of this, the nurse should monitor the client for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from decreased estrogen metabolism by the diseased liver.

2. A nurse is reviewing the results of serum laboratory studies drawn on a client who is suspected of having hepatitis. The nurse interprets that an elevation in which of the following studies is the most specific indicator of the disease?

Correct answer: C

Rationale: Laboratory indicators of hepatitis include elevated liver enzymes, serum bilirubin level, and erythrocyte sedimentation rate is nonspecific test that indicates the presence of inflammation somewhere in the body. Elevated blood urea nitrogen may indicate renal dysfunction. A hemoglobin level is unrelated to this diagnosis.

3. A client with irritable bowel syndrome is being prepared for discharge. Which of the following meal plans should the nurse give the client?

Correct answer: B

Rationale: A high fiber, low-fat diet is recommended for clients with irritable bowel syndrome to promote bowel regularity and reduce symptoms.

4. The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:

Correct answer: C

Rationale: Regularly assessing respiratory status is crucial when a Sengstaken-Blakemore tube is inserted to control bleeding in esophageal varices.

5. A patient has an acute upper GI hemorrhage. Your interventions include:

Correct answer: D

Rationale: For a patient with an acute upper GI hemorrhage, your interventions include treating shock and diagnosing the bleeding source.

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