A nurse is caring for a client who has liver cirrhosis with ascites and bleeding esophageal varices. Which of the following laboratory findings indicates that the client's gastrointestinal (GI) tract is digesting and absorbing blood?
Elevated HbA1c
Decreased chloride
Decreased bilirubin
Elevated BUN
The Correct Answer is D
A. Elevated HbA1c: HbA1c reflects average blood glucose over months and is not affected acutely by GI bleeding.
B. Decreased chloride: Chloride changes are nonspecific and not an indicator that the GI tract is digesting blood.
C. Decreased bilirubin: Bilirubin is a liver function marker; a decrease would not indicate digestion/absorption of blood.
D. Elevated BUN: Digestion and absorption of blood proteins in the GI tract increase protein load and hepatic/renal processing, often causing an acute rise in blood urea nitrogen (BUN) - an elevated BUN in the setting of upper GI bleeding suggests that blood is being digested/absorbed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Potassium 2.5 mEq/L: This is severe hypokalemia (normal ~3.5–5.0 mEq/L) and is life-threatening because it can cause cardiac arrhythmias and muscle weakness; it takes priority over the other findings.
B. Urine specific gravity 1.035: Abnormally high, indicating significant dehydration/concentrated urine, important but less immediately life-threatening than severe hypokalemia.
C. Blood glucose 150 mg/dL: Mildly elevated but not emergent in most adults; not the priority in gastroenteritis unless the patient is diabetic and symptomatic.
D. Weight loss of 3% of total body weight: This indicates fluid loss and is clinically important, but less immediately dangerous than a K⁺ of 2.5 mEq/L.
Correct Answer is D
Explanation
A. Upper left quadrant: Pain in the upper left quadrant is typically associated with disorders of the spleen, stomach, or pancreas. These structures are not directly involved in diverticular disease. Therefore, this location is not expected for diverticulitis symptoms.
B. Lower right quadrant: Lower right quadrant pain is more characteristic of appendicitis or issues involving the terminal ileum. Although bowel disorders can cause generalized pain, diverticulitis classically affects the sigmoid colon, not the right side.
C. Upper right quadrant:Upper right quadrant pain usually indicates biliary or hepatic issues, such as gallbladder disease or hepatitis. Because diverticula most commonly form in the sigmoid colon, this quadrant does not match expected findings.
D. Lower left quadrant: Pain from diverticulitis is characteristically located in the left lower quadrant, where the sigmoid colon is situated. Inflammation of diverticula in this region causes localized tenderness, cramping, and changes in bowel habits.
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