The nurse is caring for a client who has a peptic ulcer that is actively bleeding. Which finding would the nurse Immediately report to the physician?

hemoglobin 7.8

blood pressure = 118/78

occult blood in stool

epigastric pain that is worse on palpation

Answer and Explanation

The Correct Answer is A

A. Hemoglobin 7.8: This finding indicates a low hemoglobin level, which suggests significant blood loss, likely due to the actively bleeding peptic ulcer. Hemoglobin levels below normal can indicate anemia, and a level of 7.8 is particularly concerning. This finding should be immediately reported to the physician because it suggests ongoing bleeding and the need for intervention to stabilize the client's hemoglobin levels and prevent further complications such as hypovolemic shock.
B. Blood pressure = 118/78: This blood pressure reading falls within the normal range for most adults. While monitoring blood pressure is important, this finding alone may not be immediately concerning in the context of a bleeding peptic ulcer.
C. The presence of occult blood in the stool suggests gastrointestinal bleeding, which is consistent with the actively bleeding peptic ulcer. While this finding is significant, it may not require immediate reporting to the physician as it is expected in the context of the client's condition.
D. Epigastric pain is a common symptom of peptic ulcer disease, and worsening pain on palpation may indicate peritonitis or perforation, which are serious complications of peptic ulcers. However, if the pain is severe or associated with signs of peritonitis it should be promptly reported to the physician for further evaluation and management.

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Correct Answer is D

Explanation

NPH insulin typically peaks in its action approximately 4 to 8 hours after administration. Given that the client received the insulin at 0730, the peak time for signs of hypoglycemia would likely occur between 1100 and 1500.

A. Neutralized gastric acid B. Reduced stomach motility C. Reduced duodenal pH D. An increased barrier to pepsin

Correct Answer is A

Explanation

A. Magnesium hydroxide is an antacid medication that works by neutralizing gastric acid in the stomach. Therefore, if the medication achieves the desired therapeutic effect, the nurse should expect neutralization of gastric acid, which can alleviate the burning sensation in the esophagus associated with GERD.
B. Magnesium hydroxide does not directly affect stomach motility. Instead, its primary action is to neutralize gastric acid. Therefore, reducing stomach motility is not an expected outcome of magnesium hydroxide administration.
C. Magnesium hydroxide primarily acts within the stomach to neutralize gastric acid and does not significantly affect the pH of the duodenum. Therefore, reduced duodenal pH is not an expected outcome of magnesium hydroxide administration.
D. Pepsin is an enzyme involved in the digestion of proteins and can contribute to tissue damage if refluxed into the esophagus. Although reducing gastric acidity can indirectly decrease the activity of pepsin, magnesium hydroxide does not directly increase the barrier to pepsin.

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The nurse is caring for a client who has a peptic ulcer that is actively bleeding. Which finding would the nurse Immediately report to the physician?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is A

Explanation

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