EDAPT PATHOPHYSIOLOGY
QUESTIONS WEEK 5-8 EXAM
QUESTIONS AND ANSWERS
The nurse practitioner (NP) counsels a client with alcoholic cirrhosis about
dietary recommendations. Which of the following recommendations should
the NP include? Select all that apply.
A. Limit fats
B. Eat several small meals a day
C. Limit alcohol intake to one drink per day
D. Consume a low protein diet
E. Limit sodium intake
A, B, E
Clients with alcoholic cirrhosis should abstain from alcohol consumption to
prevent further liver damage. A well-balanced diet with adequate protein is
necessary to prevent muscle loss and avoid malnutrition. A diet high in fats can
,stress the liver. Limiting fats is important because when the liver is damaged,
the production of bile may be affected, causing digestive symptoms.
Excessive sodium can lead to fluid retention and worsen edema and ascites,
common complications of cirrhosis. Eating smaller, more frequent meals can
help prevent bloating and discomfort, which are common symptoms of
cirrhosis.
Luis Corrales (pronouns he/him/his), 56 years old, presents with a
distended abdomen, hepatomegaly, jaundice, and sudden weight gain.
History of chronic alcohol misuse. Blood pressure 120/90 mmHg, heart rate
84 bpm, respiratory rate 16 bpm, temperature 98.7 °F (37° C) oral, pulse
oximetry 97% on room air.
The nurse practitioner (NP) suspects the client likely has ___________. The
NP should order __________.
cholecystitis, cirrhosis, or pancreatitis
ciprofloxacin, spironolactone, or pancrelipase
cirrhosis, spironolactone
The client's presentation with a history of alcohol misuse, distended abdomen,
hepatomegaly, jaundice, and sudden weight gain is indicative of cirrhosis with
ascites. The NP should order a diuretic such as spironolactone to treat the
ascites.
Cholecystitis is less likely given the absence of specific symptoms such as right
upper quadrant abdominal pain, fever, and leukocytosis. Cholecystitis would be
treated with an antibiotic like ciprofloxacin.
Pancreatitis is also less likely based on the absence of typical symptoms such as
severe abdominal pain, nausea, vomiting, and elevated pancreatic enzymes.
Pancrelipase is used for clients with pancreatic insufficiency to help digest fats,
proteins, and carbohydrates.
46 yo male presents with confusion and abdominal distention. His partner,
Luis, reports pt has gained at least 15 lbs. in the last month, has not been
,sleeping well, and has been uncharacteristically agitated at home and
work the past three days.He appears restless and is disoriented to time,
place, and people. He is slow to answer questions but appears in no obvious
distress. Mild jaundice is noted. Gynecomastiais noted. Abdomen is
moderately distended, firm, and slightly tender. Bowel sounds are active.
Guarding, rebound tenderness are negative. No masses are palpated.
Select the chart findings that require further follow-up.
All.
46 yo male presents with confusion and abdominal distention. His partner,
Luis, reports pt has gained at least 15 lbs. in the last month, has not been
sleeping well, and has been uncharacteristically agitated at home and
work the past three days.He appears restless and is disoriented to time,
place, and people. He is slow to answer questions but appears in no obvious
distress. Mild jaundice is noted. Gynecomastiais noted. Abdomen is
moderately distended, firm, and slightly tender.
The nurse practitioner (NP) orders laboratory tests. Which of the lab
findings are indicative of liver cirrhosis? Select all that apply.
Serum albumin: Decreased
Prothrombin time (PT): Prolonged
Aspartate transaminase (AST): Elevated
Serum bilirubin: Elevated
Alkaline phosphatase (ALP): Elevated
Platelet count: Increased
Alanine transaminase (ALT): Elevated
All except increased PLT
Serum bilirubin levels are typically elevated in liver cirrhosis due to impaired
bilirubin metabolism. ALT, AST, and ALP levels are typically elevated in liver
cirrhosis due to liver damage. Serum albumin levels are typically decreased in
liver cirrhosis due to impaired liver synthesis. PT levels are typically elevated in
, serious liver damage or cirrhosis due to the liver's compromised ability to
synthesize clotting factors and maintain normal coagulation function.
Platelet counts are often decreased (not increased) in liver cirrhosis due to portal
hypertension and splenic sequestration.
Pt dx with liver cirrhosis. Serum alpha-fetoprotein (AFP) is elevated.
Which of the following hypotheses likely describes Ib's current condition?
Select all that apply.
A. There may be evidence of liver fibrosis.
B. There may be evidence of worsening liver function impairment.
C. There may be evidence of pancreatitis.
D. There may be evidence of hepatocellular carcinoma.
B, D
Chronic inflammation and regenerative processes in cirrhosis may contribute to
the development of hepatocellular carcinoma (HCC), a type of liver cancer. Ib
has a history of chronic alcoholism and liver cirrhosis and is at risk for
developing hepatocellular carcinoma. AFP is a biomarker for HCC and
indicates worsening liver function impairment.
Pancreatitis primarily presents with severe abdominal pain, which is not a
prominent symptom in this case. Pancreatitis does not typically cause jaundice,
confusion, or agitation. AFP levels are not typically elevated in pancreatitis.
Liver fibrosis is the process by which excessive scar tissue forms in the liver in
response to chronic liver injury. It is a precursor to cirrhosis. Ib is diagnosed
with chronic cirrhosis. AFP levels are not typically elevated in liver fibrosis.
46 yo male presents with confusion and abdominal distention. His partner,
Luis, reports pt has gained at least 15 lbs. in the last month, has not been
sleeping well, and has been uncharacteristically agitated at home and
work the past three days.He appears restless and is disoriented to time,
place, and people. He is slow to answer questions but appears in no obvious
QUESTIONS WEEK 5-8 EXAM
QUESTIONS AND ANSWERS
The nurse practitioner (NP) counsels a client with alcoholic cirrhosis about
dietary recommendations. Which of the following recommendations should
the NP include? Select all that apply.
A. Limit fats
B. Eat several small meals a day
C. Limit alcohol intake to one drink per day
D. Consume a low protein diet
E. Limit sodium intake
A, B, E
Clients with alcoholic cirrhosis should abstain from alcohol consumption to
prevent further liver damage. A well-balanced diet with adequate protein is
necessary to prevent muscle loss and avoid malnutrition. A diet high in fats can
,stress the liver. Limiting fats is important because when the liver is damaged,
the production of bile may be affected, causing digestive symptoms.
Excessive sodium can lead to fluid retention and worsen edema and ascites,
common complications of cirrhosis. Eating smaller, more frequent meals can
help prevent bloating and discomfort, which are common symptoms of
cirrhosis.
Luis Corrales (pronouns he/him/his), 56 years old, presents with a
distended abdomen, hepatomegaly, jaundice, and sudden weight gain.
History of chronic alcohol misuse. Blood pressure 120/90 mmHg, heart rate
84 bpm, respiratory rate 16 bpm, temperature 98.7 °F (37° C) oral, pulse
oximetry 97% on room air.
The nurse practitioner (NP) suspects the client likely has ___________. The
NP should order __________.
cholecystitis, cirrhosis, or pancreatitis
ciprofloxacin, spironolactone, or pancrelipase
cirrhosis, spironolactone
The client's presentation with a history of alcohol misuse, distended abdomen,
hepatomegaly, jaundice, and sudden weight gain is indicative of cirrhosis with
ascites. The NP should order a diuretic such as spironolactone to treat the
ascites.
Cholecystitis is less likely given the absence of specific symptoms such as right
upper quadrant abdominal pain, fever, and leukocytosis. Cholecystitis would be
treated with an antibiotic like ciprofloxacin.
Pancreatitis is also less likely based on the absence of typical symptoms such as
severe abdominal pain, nausea, vomiting, and elevated pancreatic enzymes.
Pancrelipase is used for clients with pancreatic insufficiency to help digest fats,
proteins, and carbohydrates.
46 yo male presents with confusion and abdominal distention. His partner,
Luis, reports pt has gained at least 15 lbs. in the last month, has not been
,sleeping well, and has been uncharacteristically agitated at home and
work the past three days.He appears restless and is disoriented to time,
place, and people. He is slow to answer questions but appears in no obvious
distress. Mild jaundice is noted. Gynecomastiais noted. Abdomen is
moderately distended, firm, and slightly tender. Bowel sounds are active.
Guarding, rebound tenderness are negative. No masses are palpated.
Select the chart findings that require further follow-up.
All.
46 yo male presents with confusion and abdominal distention. His partner,
Luis, reports pt has gained at least 15 lbs. in the last month, has not been
sleeping well, and has been uncharacteristically agitated at home and
work the past three days.He appears restless and is disoriented to time,
place, and people. He is slow to answer questions but appears in no obvious
distress. Mild jaundice is noted. Gynecomastiais noted. Abdomen is
moderately distended, firm, and slightly tender.
The nurse practitioner (NP) orders laboratory tests. Which of the lab
findings are indicative of liver cirrhosis? Select all that apply.
Serum albumin: Decreased
Prothrombin time (PT): Prolonged
Aspartate transaminase (AST): Elevated
Serum bilirubin: Elevated
Alkaline phosphatase (ALP): Elevated
Platelet count: Increased
Alanine transaminase (ALT): Elevated
All except increased PLT
Serum bilirubin levels are typically elevated in liver cirrhosis due to impaired
bilirubin metabolism. ALT, AST, and ALP levels are typically elevated in liver
cirrhosis due to liver damage. Serum albumin levels are typically decreased in
liver cirrhosis due to impaired liver synthesis. PT levels are typically elevated in
, serious liver damage or cirrhosis due to the liver's compromised ability to
synthesize clotting factors and maintain normal coagulation function.
Platelet counts are often decreased (not increased) in liver cirrhosis due to portal
hypertension and splenic sequestration.
Pt dx with liver cirrhosis. Serum alpha-fetoprotein (AFP) is elevated.
Which of the following hypotheses likely describes Ib's current condition?
Select all that apply.
A. There may be evidence of liver fibrosis.
B. There may be evidence of worsening liver function impairment.
C. There may be evidence of pancreatitis.
D. There may be evidence of hepatocellular carcinoma.
B, D
Chronic inflammation and regenerative processes in cirrhosis may contribute to
the development of hepatocellular carcinoma (HCC), a type of liver cancer. Ib
has a history of chronic alcoholism and liver cirrhosis and is at risk for
developing hepatocellular carcinoma. AFP is a biomarker for HCC and
indicates worsening liver function impairment.
Pancreatitis primarily presents with severe abdominal pain, which is not a
prominent symptom in this case. Pancreatitis does not typically cause jaundice,
confusion, or agitation. AFP levels are not typically elevated in pancreatitis.
Liver fibrosis is the process by which excessive scar tissue forms in the liver in
response to chronic liver injury. It is a precursor to cirrhosis. Ib is diagnosed
with chronic cirrhosis. AFP levels are not typically elevated in liver fibrosis.
46 yo male presents with confusion and abdominal distention. His partner,
Luis, reports pt has gained at least 15 lbs. in the last month, has not been
sleeping well, and has been uncharacteristically agitated at home and
work the past three days.He appears restless and is disoriented to time,
place, and people. He is slow to answer questions but appears in no obvious
