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%]

Hematocrit changes from 36% to 32%.

Hemoglobin A1C changes from 10% to 8%.

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

Guaiac test changes from positive to negative.

Answer and Explanation

The Correct Answer is A

A.   A decrease in hematocrit from 36% to 32% suggests ongoing blood loss and that the client’s GI bleeding has not yet resolved. Hematocrit is a key indicator of the client’s blood volume and oxygen- carrying capacity.
B.   Hemoglobin A1C reflects long-term blood sugar control, not current blood loss. A change in A1C is not indicative of GI bleeding resolution.
C.   An increase in prothrombin time (PT) from 12 to 18 seconds indicates clotting abnormalities, which may occur with liver dysfunction or anticoagulant therapy, but it doesn't directly relate to GI bleeding resolution.
D.   A positive to negative change in the guaiac test (fecal occult blood test) would indicate that the blood in the stool is no longer present, suggesting resolution of bleeding, which doesn’t match the question’s context.

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Correct Answer is C

Explanation

A. Nicotine’s impact on REM sleep is not as direct as this option suggests. REM sleep can be reduced, but
it is not directly linked to a decreased need for REM sleep.
B. This option may be true for some individuals, but smoking typically causes disruptions throughout the night, not just in the second half.
C. Smoking has been shown to increase sleep latency (the time it takes to fall asleep) and reduce total sleep time due to nicotine’s stimulant effect and withdrawal symptoms during sleep.
D. Difficulty falling asleep and light sleep with frequent arousals are common effects of smoking due to
nicotine’s stimulant properties and withdrawal during the night.

A. Record the findings in the client's record. B. Clean the ears to remove excess wax build up. C. Referral to an audiologist for a hearing evaluation. D. Culture the white patches for possible fungal growth.

Correct Answer is A

Explanation

A. This is an appropriate first step in documenting any unusual findings during the assessment. However, based on the presence of dense white patches, the nurse should consider a referral for further evaluation, rather than just recording the findings.
B. The dense white patches seen on the tympanic membrane are more likely related to past ear infections (such as tympanosclerosis) or other conditions, not excess wax. Cleaning the ears would not address the underlying cause and could potentially cause harm.
C. This could be a reasonable action if there were concerns about hearing loss. However, the tympanic membranes appear mostly normal apart from the white patches, so hearing loss is not strongly indicated by the findings alone. A referral might be premature unless hearing issues are suspected.
D. The dense white patches on the tympanic membranes could be indicative of tympanosclerosis, a benign condition related to previous infections or tube insertions, but fungal growth is not the most likely cause in this case.

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Naxlex Comprehensive Predictor Exams

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 C

Explanation

Correct Answer is A

Explanation

While conducting a physical assessment, the nurse shines a pen light into a client's right eye and moves the light source to check the client's left eye. Which finding indicates the need for further evaluation?

While completing an admission assessment for a client with fatigue, weakness, and unexplained weight loss, the nurse notes scleral jaundice. Which finding during percussion of the abdomen should the nurse document indicating hepatomegaly?

The nurse begins a client's musculoskeletal assessment. While using the technique of inspection, the nurse assesses for which possible findings? Select all that apply.

When the nurse is obtaining health history during an annual physical examination, the client reports having difficulty with erections for the past 8 months. Which information in the client's history should the nurse consider as a potential reason for erectile dysfunction?

During the precordium assessment, the nurse palpates the apical impulse of a client on the 5th intercostal space left mid-clavicular line. The pulse is more vigorous than expected. Which action should the nurse take in response to this finding?

An older adult client is being evaluated for admission to an assisted living facility. During the health assessment, the nurse implements which technique to determine the client's ability to reside in this environment?

The nurse is performing a head-to-toe physical examination on a known victim of intimate partner violence. The visual exam reveals several round, flat, pinpoint, red spots. How should the nurse document this finding?

The nurse is doing a health assessment of a client who smoked three packs of cigarettes every day for the last twenty years before quitting two years ago. How should the nurse document the client's pack-years? (Enter the numerical value only.)