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%]

Guaiac test changes from positive to negative.

Hematocrit changes from 36% to 32%.

Prothrombin time (PT) changes from 12 seconds to 18 seconds.

Hemoglobin A1C changes from 10% to 8%.

Answer and Explanation

The Correct Answer is B

A. Guaiac test changes from positive to negative: The guaiac test detects occult blood in stool. A negative result after being positive suggests that the bleeding has stopped, but it does not directly reflect the resolution of bleeding as hematocrit and hemoglobin levels would. While useful for identifying ongoing bleeding, it is not the most reliable indicator of blood volume loss over time.

B. Hematocrit changes from 36% to 32%: A decrease in hematocrit, from 36% to 32%, indicates a loss of red blood cells and suggests that the client’s GI bleeding has not yet resolved. The hematocrit is a direct reflection of blood volume and RBC concentration, so a decline would point to continued blood loss, especially in the setting of GI bleeding.

C. Prothrombin time (PT) changes from 12 seconds to 18 seconds: An increased PT suggests a clotting issue, possibly related to liver dysfunction or anticoagulant therapy. However, PT changes are not a direct indicator of blood loss resolution in the setting of GI bleeding. While it may indicate an issue with coagulation, it is not the best indicator of ongoing blood loss.

D. Hemoglobin A1C changes from 10% to 8%: Hemoglobin A1C is a test for long-term blood glucose control and is unrelated to acute bleeding events. A change in A1C levels would indicate changes in glucose control, not blood loss or resolution of bleeding, making it irrelevant to this scenario.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. A change in awareness of surroundings: Altered awareness or sudden changes in level of consciousness can signal acute neurological issues such as stroke, brain injury, infection, or metabolic imbalances. This is a serious red flag requiring immediate medical evaluation to prevent potential deterioration.

B. Reduced fine motor skills: While reduced fine motor skills can indicate a neurological issue, it typically develops gradually due to conditions like arthritis, neurological disorders, or aging and may be monitored unless associated with other acute symptoms. It is not usually an emergency unless sudden in onset.

C. A negative Babinski reflex: A negative Babinski reflex is a normal finding in adults, indicating intact central nervous system function. It does not suggest the need for medical follow-up in the absence of other abnormal signs.

D. Diminished short term memory over the past year: Gradual memory decline may indicate cognitive changes like dementia, stress or early signs of cognitive impairment but it typically requires routine, not immediate, follow-up unless there's a rapid worsening or associated concerning symptoms.

A. He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals. B. He would sleep soundly during the first half of the night, with increased arousals during the second half. C. Increase sleep latency, and reduce total sleep time. D. Decrease the need for rapid eye movement (REM) sleep.

Correct Answer is A

Explanation

A. He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals: Nicotine is a stimulant that can interfere with sleep by increasing heart rate and causing difficulty in falling asleep. Smokers also tend to experience more fragmented sleep, with frequent awakenings and lighter sleep stages due to withdrawal symptoms during the night which include restlessness, irritability, and difficulty relaxing.

B. He would sleep soundly during the first half of the night, with increased arousals during the second half: This is not typically associated with smoking. While nicotine withdrawal can cause sleep disruption, it does not usually result in sound sleep in the first half of the night followed by arousals. Smoking-related sleep disturbances are more generalized throughout the night.

C. Increase sleep latency, and reduce total sleep time: While nicotine can increase sleep latency (the time it takes to fall asleep), smoking is more likely to cause fragmented sleep and increased arousals rather than just reducing total sleep time. The effect on sleep is often more about poor-quality sleep than simply reduced duration.

D. Decrease the need for rapid eye movement (REM) sleep: Nicotine does not decrease the need for REM sleep, but it disrupts the sleep cycle, including REM sleep, by causing lighter sleep and more frequent awakenings. Smokers tend to have a lower proportion of REM sleep due to these disruptions, but not necessarily a decreased need for it.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing older adult clients in a community health clinic. Which assessment finding is an indicator for immediate medical follow-up?

Correct Answer is A

Explanation

An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?

Correct Answer is A

Explanation

The nurse continues a neurologic assessment of the cranial nerve XI (spinal accessory) for a client as seen in the picture. Which instruction should the nurse give the client to complete this assessment?

After checking a client's pupillary response to light, the practical nurse (PN) tells the registered nurse (RN) that the client's pupils are constricted with minimal response to light. Before verifying the PN's findings, which action should the RN take?

The nurse auscultates the precordium of a client who is diagnosed with mitral valve regurgitation and hears a grade IV systolic murmur. When documenting the comparison of systolic murmurs, which characteristics should the nurse use to support this systolic finding?

An older adult male client reports nocturia with difficulty starting his urine stream. Which additional assessment should the nurse perform to obtain further data related to this information?

When assessing a client's mouth, which finding requires immediate follow-up by the nurse?

The nurse is obtaining a health history for a client being admitted for new onset seizures. Which action should the nurse implement to accurately record the health history findings?

The nurse examines a client who is concerned about the amount of menstrual flow she is having. Which finding indicates an abnormality related to the client's current menstruation?