The nurse observes that a client is experiencing melena. Which serum laboratory test should the nurse monitor in response to this finding?

White blood cell count (WBC).

Glucose.

Blood urea nitrogen (BUN).

Hematocrit.

Answer and Explanation

The Correct Answer is D

Choice A Reason:
White blood cell count (WBC) is inappropriate. White blood cell count is typically monitored to assess for signs of infection or inflammation. While it's important to monitor WBC count in certain situations, such as suspected infection, melena itself is not directly indicative of an increased risk of infection. Therefore, monitoring WBC count may not be the most immediate response to the finding of melena.
Choice B Reason:
Glucose is inappropriate. Glucose monitoring is essential for patients with diabetes or those at risk of hypoglycemia or hyperglycemia. However, melena is not directly related to glucose metabolism or regulation. Therefore, monitoring glucose levels would not be the most relevant response to the finding of melena.
Choice C Reason:
Blood urea nitrogen (BUN) is inappropriate. Blood urea nitrogen is often monitored to assess kidney function and hydration status. While severe bleeding can potentially lead to hypovolemia and prerenal azotemia (elevated BUN due to decreased renal perfusion), monitoring BUN would not be the immediate response to the finding of melena. Instead, assessing for signs of hypovolemia and monitoring other markers of blood loss, such as hematocrit, would be more appropriate.
Choice D Reason:
Hematocrit is appropriate. Melena refers to the passage of black, tarry stools containing blood that has been digested. It indicates upper gastrointestinal bleeding, typically from the stomach or upper small intestine. Monitoring the hematocrit level is important because significant bleeding, as indicated by melena, can lead to a decrease in the hematocrit level due to the loss of red blood cells and plasma volume. Monitoring the hematocrit helps assess the severity of the bleeding and guides treatment decisions, such as the need for blood transfusions. Therefore, the nurse should monitor the hematocrit level in response to the finding of melena.

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Correct Answer is D

Explanation

Choice A Reason:

Get the most difficult questions over with first is not the best approach because starting with the most difficult questions may put the client on the defensive or make them feel uncomfortable, hindering open communication. It's important to build rapport and establish trust with the client before addressing sensitive topics.

Choice B Reason:

Asking questions in a vague, non-specific format is not effective because vague and non-specific questions may result in ambiguous or incomplete responses, making it difficult to gather accurate information about the client's alcohol and substance use. Clear and specific questions are necessary to obtain relevant details.

Choice C Reason:

Sharing personal values to put the client at ease is not recommended as it can compromise the nurse's professional boundaries and may influence the client's responses. The focus of the interview should be on the client, and the nurse should maintain a neutral and non-judgmental stance.

Choice D Reason:

Begin with questions that are less sensitive in nature is the best approach because it allows the nurse to establish rapport and build trust with the client before addressing more sensitive topics such as alcohol and substance use. Starting with less threatening questions helps the client feel more comfortable and willing to disclose information, facilitating open communication and rapport-building.

A. Number of attempts to quit smoking. B. Packs of cigarettes smoked per day. C. Client's current age. D. Number of years the client smoked. E. Age when the client started smoking.

Correct Answer is ["B","D"]

Explanation

Choice A Reason

Number of attempts to quit smoking is incorrect. While the number of attempts to quit smoking may provide insight into the client's smoking cessation efforts and motivation, it is not directly relevant to calculating smoking pack years. Pack years specifically quantify the amount and duration of smoking, rather than cessation attempts.

Choice B Reason:

Packs of cigarettes smoked per day is correct. The number of packs of cigarettes smoked per day is a crucial factor in calculating smoking pack years. Pack years are calculated by multiplying the number of packs smoked per day by the number of years the individual has smoked. This information provides a quantitative measure of smoking exposure over time.

Choice C Reason:

Client's current age is incorrect. While the client's current age may be relevant in assessing overall health, risks associated with smoking and in discussing smoking cessation strategies, it is not directly used in the calculation of smoking pack years. Pack years are based on the total duration of smoking and the average daily consumption of cigarettes, not the client's current age.

Choice D Reason:

Number of years the client smoked is correct. The number of years the client has smoked is a critical piece of information for calculating smoking pack years. Pack years are calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the individual has smoked. This helps quantify the duration of smoking history.

Choice E Reason:

While knowing the start age helps the nurse estimate the number of years smoked, the actual number of years is the specific data point required for the calculation. If a client started at 15 but quit for a decade in between, the start age alone would lead to an inaccurate calculation.

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The nurse observes that a client is experiencing melena. Which serum laboratory test should the nurse monitor in response to this finding?

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Naxlex Comprehensive Predictor Exams

Which is the best approach for the nurse to use when interviewing a client about alcohol and substance use?

Correct Answer is D

Explanation

When obtaining a client's health history related to smoking cigarettes, the nurse plans to determine the client's smoking pack years. Which information should the nurse obtain for this calculation? Select all that apply.

Correct Answer is ["B","D"]

Explanation

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