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    HESI RN health assessment proctored exam

    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%]

    Explanation & Rationale

    A. Guaiac test changes from positive to negative: The guaiac test detects occult blood in stool. A negative result after being positive suggests that the bleeding has stopped, but it does not directly reflect the resolution of bleeding as hematocrit and hemoglobin levels would. While useful for identifying ongoing bleeding, it is not the most reliable indicator of blood volume loss over time.B. Hematocrit changes from 36% to 32%: A decrease in hematocrit, from 36% to 32%, indicates a loss of red blood cells and suggests that the client’s GI bleeding has not yet resolved. The hematocrit is a direct reflection of blood volume and RBC concentration, so a decline would point to continued blood loss, especially in the setting of GI bleeding.C. Prothrombin time (PT) changes from 12 seconds to 18 seconds: An increased PT suggests a clotting issue, possibly related to liver dysfunction or anticoagulant therapy. However, PT changes are not a direct indicator of blood loss resolution in the setting of GI bleeding. While it may indicate an issue with coagulation, it is not the best indicator of ongoing blood loss.D. Hemoglobin A1C changes from 10% to 8%: Hemoglobin A1C is a test for long-term blood glucose control and is unrelated to acute bleeding events. A change in A1C levels would indicate changes in glucose control, not blood loss or resolution of bleeding, making it irrelevant to this scenario.

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