The nurse reviews a client's laboratory results for a client admitted with gastrointestinal (GI) bleeding who has no visible hemorrhoids on inspection of the anal area. Which laboratory test indicates that the client's bleeding is not yet resolved?
Reference Range:
Hematocrit (Hct) [42% to 52% (0.42 to 0.52 volume fraction)]
Prothrombin time (PT) [11.0 to 12.5 seconds (85%-100%)] Glycosylated hemoglobin (A1C) [4% to 5.9%]
Hematocrit changes from 36% to 32%.
Hemoglobin A1C changes from 10% to 8%.
Prothrombin time (PT) changes from 12 seconds to 18 seconds.
Guaiac test changes from positive to negative.
The Correct Answer is A
A. A decrease in hematocrit from 36% to 32% suggests ongoing blood loss and that the client’s GI bleeding has not yet resolved. Hematocrit is a key indicator of the client’s blood volume and oxygen- carrying capacity.
B. Hemoglobin A1C reflects long-term blood sugar control, not current blood loss. A change in A1C is not indicative of GI bleeding resolution.
C. An increase in prothrombin time (PT) from 12 to 18 seconds indicates clotting abnormalities, which may occur with liver dysfunction or anticoagulant therapy, but it doesn't directly relate to GI bleeding resolution.
D. A positive to negative change in the guaiac test (fecal occult blood test) would indicate that the blood in the stool is no longer present, suggesting resolution of bleeding, which doesn’t match the question’s context.
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Related Questions
Correct Answer is D
Explanation
A. This is unlikely to be associated with perimenopause. Often, perimenopause is linked to hormonal fluctuations that can lead to decreased libido rather than an increase.
B. While cessation of menstruation may indicate menopause, it is not typically seen during the perimenopausal phase, which is the time leading up to menopause. Perimenopause is characterized by irregular periods, not complete cessation.
C. Perimenopausal symptoms typically involve a decrease in vaginal moisture due to reduced estrogen levels. Excessive vaginal moisture would not be indicative of perimenopause and might suggest an infection or other conditions.
D. This is a classic symptom of perimenopause. Hormonal fluctuations during this time can lead to hot flashes and night sweats, which are commonly experienced as part of the transition toward menopause.
Correct Answer is D
Explanation
A. This is a normal finding where the right pupil constricts when the light is directed at it, and the left pupil constricts consensually as well. This suggests normal function of the pupillary light reflex pathway, and no further evaluation is needed.
B. This also indicates normal pupillary function. Equal pupil size and appropriate constriction to light are typical findings, suggesting no immediate issues with the nervous system.
C. Pupil size should not change in response to distance unless there is a near response (accommodation). If the pupil size changes to distance of the light source instead of light reflex, this suggests potential abnormality in the pupillary reflex response.
D. This is an abnormal finding. A "notched" iris suggests possible damage or congenital anomalies, and minimal change in pupil size may indicate impaired pupil reflexes, requiring further evaluation to rule out neurological or ophthalmologic issues.
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