What diagnostic test should the nurse anticipate for an older patient who is vomiting "coffee-ground" emesis?
Endoscopy
Barium studies
Angiography
Gastric analysis
The Correct Answer is A
"Coffee-ground" emesis is a term used to describe vomit that has the appearance of coffee grounds, which indicates that the vomit contains partially digested blood. This is a serious symptom that could be indicative of an upper gastrointestinal bleed. An endoscopy is a diagnostic test that allows healthcare providers to visually examine the upper gastrointestinal tract and identify the source of bleeding.
Barium studies and angiography are not typically used to diagnose upper gastrointestinal bleeds. Gastric analysis may be useful in other diagnostic situations, but it is not the most appropriate test for a patient with "coffee-ground" emesis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The patient received 38 U of NPH insulin at 7:00 AM, and by 1:00 PM, the insulin has been active for approximately 6 hours. The patient has missed lunch, which may lead to hypoglycemia, especially with the activity of the insulin.
Sending a glass of orange juice will provide the patient with a quick source of glucose to prevent hypoglycemia. If testing is further delayed, the nurse may request that the patient be allowed to eat lunch first or save the lunch tray for later, but immediate intervention is necessary to prevent hypoglycemia. Discontinuing the evening dose of insulin is not an appropriate action and should not be considered without consulting the healthcare provider.
Correct Answer is B
Explanation
Glycosylated hemoglobin (HbA1c) is a measure of the average blood glucose levels over the past 2-3 months. An HbA1c level of less than 7% is associated with a reduced risk of microvascular and macrovascular complications in patients with diabetes. This is a critical goal because uncontrolled blood glucose levels can lead to complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease.
While options a, c, and d are also important in the management of diabetes, they are not as critical as achieving glycemic control. Choosing a diet that distributes calories throughout the day can help regulate blood glucose levels and prevent hypoglycemia. Following a diet and exercise plan that results in weight loss can also help improve glycemic control and reduce the risk of complications. Understanding the reasons for eliminating simple sugars in the diet is important for overall diabetes education, but it is not the most important goal in the plan of care for this patient at this time.
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