A client is admitted for observation with reports of progressively increasing fatigue over the past month and a brief episode of dizziness that occurred today. The client has a history of heartburn and indigestion that is self-treated with ibuprofen and antacids. Which assessment finding should the nurse report immediately to the healthcare provider?

Reference Range:

Guaiac stool [negative]

Hemoglobin (14 to 18 g/dl. (140 to 180 g/L)]

Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]

Gastric Acid pH (1.5 to 3.5)

Positive guaiac of stool.

Hematocrit 42% (0.42 volume fraction).

Gastric pH 2.0.

Hemoglobin 13 g/dL (130 g/L).

Answer and Explanation

The Correct Answer is A

A) Positive guaiac of stool:
A positive guaiac test indicates the presence of occult (hidden) blood in the stool, which may suggest gastrointestinal bleeding. Given the client’s history of heartburn, indigestion, and self-treatment with ibuprofen and antacids, gastrointestinal irritation or ulceration may be occurring, leading to bleeding. Gastrointestinal bleeding can cause fatigue, dizziness, and other symptoms. Therefore, it is essential to report this finding immediately to the healthcare provider for further evaluation and management.

B) Hematocrit 42% (0.42 volume fraction):
A hematocrit level within the reference range (42% to 52%) is considered normal. While a slight decrease in hematocrit may indicate anemia, it is not an urgent finding that requires immediate reporting. The client’s hematocrit level of 42% is within the normal range, so it does not warrant immediate concern.

C) Gastric pH 2.0:
A gastric pH of 2.0 falls within the normal range (1.5 to 3.5) for gastric acid pH. This finding indicates normal gastric acidity and does not suggest an acute problem that requires immediate reporting to the healthcare provider.

D) Hemoglobin 13 g/dL (130 g/L):
A hemoglobin level of 13 g/dL is slightly below the lower end of the reference range (14 to 18 g/dL) but does not indicate a critical condition requiring immediate intervention. While it may suggest mild anemia, it is not an urgent finding that necessitates immediate reporting to the healthcare provider.

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Free Nursing Study Resources

Correct Answer is ["200"]

Explanation

The nurse should program the infusion pump to deliver 200 mL/hr.

Although the medication dosage is 400 mg, the infusion pump rate is determined by the total volume of the IV fluid (including the medication) and the desired infusion time.

In this case:

Total volume of IV bag (D,W): 200 mL

Infusion time: 1 hour

Since the medication is already diluted in the 200 mL bag, the entire volume needs to be delivered over the course of the hour. Therefore, the nurse should program the pump to deliver the full 200 mL of the solution at a rate of:

200 mL / 1 hour = 200 mL/hr

A. Monitor for any signs of sexual dysfunction. B. Decrease cigarette use to a pack per day. C. Notify the healthcare provider of lethargy. D. Take the medication an hour after antacids.

Correct Answer is B

Explanation

A) Monitor for any signs of sexual dysfunction: Cimetidine has anti-androgenic effects. It can cause gynecomastia (breast swelling) and erectile dysfunction in men, which should be monitored.

B) Decrease cigarette use to a pack per day: This statement requires additional instruction because the goal for a client with peptic ulcer disease (PUD) is to stop smoking entirely, not just reduce it.

C) Notify the healthcare provider of lethargy: In some patients—especially the elderly or those with renal impairment—Cimetidine can cross the blood-brain barrier and cause CNS side effects like confusion, lethargy, or hallucinations.

D) Take the medication an hour after antacids: Antacids can interfere with the absorption of Cimetidine. They should be spaced out, typically taking the antacid 1 hour before or after the Cimetidine.

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Naxlex Comprehensive Predictor Exams

A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (D,W) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

Correct Answer is ["200"]

Explanation

A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

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