Nursing Elites

1. Which finding indicates to the nurse that lactulose (Cephulac) is effective for a 72-year-old man who has advanced cirrhosis?

• A. The patient is alert and oriented.
• B. The patient denies nausea or anorexia.
• C. The patient's bilirubin level decreases.
• D. The patient has at least one stool daily.

Correct answer: A

Rationale: The correct answer is 'The patient is alert and oriented.' In a patient with advanced cirrhosis, lactulose is used to lower ammonia levels and prevent encephalopathy. A patient being alert and oriented indicates that the medication is effective in achieving this goal. While lactulose may help with constipation, the primary purpose in cirrhosis is to reduce ammonia levels, not to address constipation directly. Denying nausea or anorexia is not a specific indicator of lactulose's effectiveness in treating cirrhosis. Bilirubin levels decreasing are not directly related to lactulose's therapeutic effect on cirrhosis.

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