A client has been administered lactulose for several days. Which therapeutic response should the nurse expect for a client with hepatic encephalopathy?

Rationale: A. Ability to ambulate independently: Ambulation may improve as overall health stabilizes, but it is not a direct therapeutic effect of lactulose. The drug is aimed at reducing ammonia levels, which affects mental rather than motor function. B. Increase in urine output: Lactulose is not a diuretic and does not promote urinary excretion. Its mechanism involves trapping ammonia in the stool and promoting its elimination through the gastrointestinal tract. C. Reduction in number of liquid stools: Lactulose often causes frequent loose stools as part of its therapeutic effect. A reduction in stools would not reflect effectiveness; rather, it may indicate insufficient dosing or reduced ammonia clearance. D. Improved mental status: Lactulose decreases serum ammonia levels by reducing its absorption in the intestine. Lowering ammonia helps alleviate the neuropsychiatric symptoms of hepatic encephalopathy, leading to clearer thinking and improved mental function.