The nurse practitioner suspects that a 41-year-old man has a GI bleed. Which of the following is correct about upper versus lower GI bleeds?
Lower GI bleeding may present as hematemesis, which is the regurgitation of blood or blood mixed with stomach contents.
Black, tarry stool, also called melena, is indicative of a lower gastrointestinal disease that causes bleeding.
Black, tarry stool, also called melena, is indicative of an upper gastrointestinal disease that causes bleeding.
Upper GI bleeding may present as hematochezia, which is the passing of bright red blood via the rectum.
The Correct Answer is C
Choice A reason: Hematemesis is the vomiting of blood and is a hallmark sign of upper GI bleeding, not lower. It typically results from bleeding in the esophagus, stomach, or duodenum. Lower GI bleeding does not cause hematemesis because the bleeding occurs distal to the stomach and is not regurgitated.
Choice B reason: Melena refers to black, tarry stools caused by the digestion of blood in the gastrointestinal tract. It is a sign of upper GI bleeding, not lower. The blood must be exposed to digestive enzymes long enough to change color and consistency, which occurs in the upper GI tract.
Choice C reason: Melena is most commonly associated with upper GI bleeding, particularly from sources such as peptic ulcers, esophageal varices, or gastric erosions. The dark color results from hemoglobin breakdown during transit through the GI tract, confirming an upper origin.
Choice D reason: Hematochezia, or the passage of bright red blood per rectum, is typically associated with lower GI bleeding, such as from the colon or rectum. While rapid upper GI bleeding can occasionally present this way, it is not the typical presentation and should not be used to define upper GI bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Acanthosis nigricans is characterized by hyperpigmented, velvety plaques typically found on the neck, axillae, and other skin folds. It is strongly associated with insulin resistance and is common in individuals with obesity and type 2 diabetes.
Choice B reason: Diabetic dermopathy presents as small, round or oval, brownish atrophic patches usually on the shins. It does not involve the neck or axilla and lacks the velvety texture seen in acanthosis nigricans.
Choice C reason: Scleroderma diabeticorum involves thickening and hardening of the skin, usually on the upper back and neck, but it is less common and lacks the characteristic velvety hyperpigmentation.
Choice D reason: Necrobiosis lipoidica typically affects the lower legs and presents as yellow-brown plaques with telangiectasia and central atrophy. It is not associated with the axilla or neck and does not have a velvety appearance.
Correct Answer is D
Explanation
Choice A reason: This description applies to osteoarthritis, not osteoporosis. Osteoarthritis involves degeneration of joint cartilage and synovial structures, whereas osteoporosis affects bone density and strength.
Choice B reason: While this statement touches on bone remodeling, it inaccurately suggests that compensatory osteoblastic activity leads to structurally inferior bone. In osteoporosis, the imbalance favors osteoclastic resorption over osteoblastic formation, resulting in net bone loss.
Choice C reason: This description is characteristic of autoimmune diseases like rheumatoid arthritis. Osteoporosis is not autoimmune in nature and does not involve synovial inflammation.
Choice D reason: Osteoporosis is defined by decreased bone mass and microarchitectural deterioration due to an imbalance between bone resorption and formation. Risk factors include smoking, low BMI, Asian ethnicity, and postmenopausal status, all of which apply to this patient. The disease increases fracture risk due to weakened bone structure.
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