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. Food diary shows increased consumption of iron-rich foods. B. Reports of increased energy levels and decreased fatigue. C. Takes concurrent iron therapy without adverse effects. D. Hemoglobin level increased to 12 g/dL (7.45 mmol/L).

Correct Answer is D

Explanation

A. Food diary shows increased consumption of iron-rich foods:

While iron-rich foods are important for managing anemia, this finding does not directly indicate the effectiveness of epoetin alfa. The primary measure of epoetin alfa's effectiveness is an improvement in hemoglobin levels, not dietary changes.

B. Reports of increased energy levels and decreased fatigue:

Increased energy and decreased fatigue are positive effects and may suggest that the medication is helping. However, these symptoms are subjective and not as definitive as a measurable increase in hemoglobin levels.

C. Takes concurrent iron therapy without adverse effects:

Iron therapy is often used alongside epoetin alfa to enhance its effectiveness, but the absence of adverse effects from iron therapy does not alone confirm the effectiveness of epoetin alfa. The key indicator is the improvement in hemoglobin levels.

D. Hemoglobin level increased to 12 g/dL (7.45 mmol/L):

An increase in hemoglobin level to 12 g/dL is a direct measure of the effectiveness of epoetin alfa. This increase demonstrates that the medication is successfully stimulating red blood cell production, which is the intended therapeutic effect.

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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

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range: Hemoglobin (Hgb) [14 to 18 g/dl. (8.7 to 11.2 mmol/L)]

Correct Answer is D

Explanation

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