A nurse is assessing a client with suspected fluid volume overload. Which finding requires further action?

Choice A reason: Excessive stomach acid secretion is not the correct answer because it is not a diagnostic test, but a possible cause of peptic ulcer disease. Peptic ulcers are sores that develop in the lining of the stomach or duodenum due to damage from stomach acid and digestive enzymes.

Choice B reason: An incompetent pyloric sphincter is not the correct answer because it is not a diagnostic test, but a possible complication of peptic ulcer disease. The pyloric sphincter is a muscular valve that controls the passage of food from the stomach to the small intestine. If it becomes damaged or weakened, it can cause gastric outlet obstruction, which is a blockage of the stomach.

Choice C reason: A metabolic acid-base imbalance is not the correct answer because it is not a diagnostic test, but a possible consequence of peptic ulcer disease. Peptic ulcers can cause bleeding, perforation, or gastric outlet obstruction, which can affect the acid-base balance of the body. For example, vomiting can cause metabolic alkalosis, which is a condition where the blood is too alkaline.

Choice D reason: An infection with Helicobacter pylori is the correct answer. Helicobacter pylori is a type of bacteria that can infect the stomach and duodenum and cause inflammation and ulcers. It is the most common cause of peptic ulcer disease. The health care provider can order a diagnostic test to detect the presence of Helicobacter pylori in the client's stomach or blood, such as a urea breath test, a stool antigen test, or a blood antibody test.

Choice A reason: Dark-colored stools are an adverse effect of orlistat, a medication that blocks the absorption of fat in the intestines. The unabsorbed fat can cause the stools to become oily, foul-smelling, and dark in color. This can indicate a serious condition called steatorrhea, which can lead to malnutrition and vitamin deficiencies.

Choice B reason: Constipation is not an adverse effect of orlistat. In fact, orlistat can cause the opposite problem of diarrhea, especially if the client consumes too much fat in their diet. Constipation may be caused by other factors, such as dehydration, lack of fiber, or medication side effects.

Choice C reason: Nausea is not an adverse effect of orlistat. Nausea may be a symptom of other conditions, such as gastritis, gastroenteritis, or pregnancy. Nausea may also be caused by other medications, such as antibiotics, opioids, or chemotherapy drugs.

Choice D reason: Abdominal pain is not an adverse effect of orlistat. Abdominal pain may be a sign of other conditions, such as appendicitis, gallstones, or kidney stones. Abdominal pain may also be caused by other medications, such as NSAIDs, steroids, or oral contraceptives.