A male client is admitted for observation because he is reporting progressively increasing fatigue over the past month and a brief episode of dizziness that occurred today. He has a history of heartburn and indigestion that he self-treats with ibuprofen and antacids. Which assessment finding should the nurse report immediately to the healthcare provider?

Reference Ranges:
Hemoglobin (14 to 18 g/dL (8.7 to 11.2 mmol/L)]
Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]
Gastric pH [1.5 to 3.5]

Hematocrit 42% (0.42 volume fraction).

Hemoglobin 13 g/dL (8.07 mmol/L).

Positive guaiac of stool.

Gastric pH 2.0.

Answer and Explanation

The Correct Answer is C

A. Hematocrit 42% (0.42 volume fraction):
A hematocrit of 42% is within the normal reference range for males (42% to 52%). While it is important to monitor hematocrit levels, this finding alone does not indicate an immediate issue.

B. Hemoglobin 13 g/dL (8.07 mmol/L):
A hemoglobin level of 13 g/dL is slightly below the normal range for males (14 to 18 g/dL). However, it is not critically low and may not require immediate intervention without additional context or symptoms.

C. Positive guaiac of stool:
A positive guaiac test for stool indicates the presence of occult blood in the stool, which could suggest gastrointestinal bleeding. Given the client's history of heartburn, indigestion, and use of ibuprofen (a nonsteroidal anti-inflammatory drug that can cause gastrointestinal bleeding), this finding is concerning and should be reported immediately to the healthcare provider for further evaluation and management.

D. Gastric pH 2.0:
A gastric pH of 2.0 is within the normal range for gastric acid, as the normal pH of gastric acid typically ranges from 1.5 to 3.5. This finding is expected and does not indicate an immediate problem related to the client's symptoms.

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Correct Answer is B

Explanation

A. High density lipoprotein (HDL):
HDL levels are important for cardiovascular health as higher levels are associated with a lower risk of coronary artery disease. However, atorvastatin primarily targets LDL levels. While increasing HDL is beneficial, it is not the primary measure of atorvastatin's effectiveness.

B. Low density lipoprotein (LDL):
Atorvastatin is a statin medication used to lower LDL cholesterol levels, which is a major risk factor for coronary artery disease. A decrease in LDL levels indicates that the medication is having its desired effect, reducing the risk of cardiovascular events.

C. Creatine phosphokinase (CK):
CK levels are monitored to assess muscle damage or side effects related to statin use, such as rhabdomyolysis. While important for safety monitoring, changes in CK levels do not directly reflect the effectiveness of atorvastatin in managing cholesterol levels.

D. Prothrombin time (PT):
PT is used to evaluate blood clotting ability and is not directly related to the effectiveness of atorvastatin. It is more relevant for monitoring anticoagulant therapy rather than statin therapy for cholesterol management.

A. Offer both drugs together with a meal. B. Administer iodine one hour before PTU. C. Schedule both medications at bedtime. D. Give parental dose once every 24 hours.

Correct Answer is B

Explanation

A. Offer both drugs together with a meal:
Propylthiouracil (PTU) and Lugol's solution are typically not administered together with a meal. Lugol's solution, a strong iodine solution, is generally taken separately from PTU to avoid potential interactions and ensure optimal absorption of each medication.

B. Administer iodine one hour before PTU:
Lugol’s solution (iodine) is usually given before PTU because iodine can decrease the vascularity of the thyroid gland and make the thyroid gland less active, which helps PTU work more effectively. This timing helps optimize the therapeutic effects of both medications.

C. Schedule both medications at bedtime:
The timing of administration for PTU and Lugol’s solution is based on their specific interactions and pharmacokinetics rather than convenience. Scheduling them at bedtime does not align with the recommended practice for their optimal effectiveness.

D. Give parental dose once every 24 hours:
Both PTU and Lugol’s solution are not administered as a single dose every 24 hours. PTU is typically given multiple times per day to maintain effective blood levels, and Lugol’s solution is usually given as directed by the healthcare provider, often several times a day but not necessarily in a single 24-hour dose.

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing the client's laboratory values. Which serum laboratory value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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