A 60-year-old patient with a history of peptic ulcer disease is admitted to the hospital with complaints of coffee-ground emesis and melena. What is the nurse's most appropriate initial action?

Encourage the patient to take deep breaths and relax.

Prepare the patient for an abdominal ultrasound.

Administer oral proton pump inhibitors as prescribed.

Initiate intravenous (IV) access and administer fluids as prescribed.

Answer and Explanation

The Correct Answer is D

A.   Encouraging the patient to relax and breathe deeply does not address the immediate concerns of potential hemorrhage.
B.   An abdominal ultrasound is not the first step in managing potential GI bleeding; stabilization is the priority.
C.   Proton pump inhibitors are important for managing peptic ulcer disease, but the immediate priority is
stabilizing the patient’s condition.
D.   Initiating IV access and administering fluids as prescribed is essential to stabilize the patient, manage shock, and address potential blood loss from gastrointestinal bleeding.

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Correct Answer is C

Explanation

A. Furosemide is a diuretic and is not associated with PML.
B. Metoprolol is a beta-blocker and does not cause PML.
C. Natalizumab is an immunosuppressant used for multiple sclerosis and has been linked to the development of PML, a serious brain infection.
D. Pregabalin is used for neuropathic pain and does not carry a risk for PML.

A. Elevated ketones in the urine B. Presence of nitrites in the urine C. Low specific gravity D. Presence of glucose in the urine

Correct Answer is B

Explanation

A. Elevated ketones in the urine can indicate diabetic ketoacidosis or starvation but is not specific to a UTI.
B. Nitrites are commonly found in the urine of patients with UTIs due to bacterial conversion of urinary nitrates to nitrites. This is a hallmark finding of a UTI.
C. Low specific gravity indicates diluted urine, which is not a direct indicator of a UTI.
D. Glucose in the urine could indicate diabetes but is not a typical finding for a UTI.

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A 60-year-old patient with a history of peptic ulcer disease is admitted to the hospital with complaints of coffee-ground emesis and melena. What is the nurse's most appropriate initial action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has multiple sclerosis and is experiencing progressive multifocal leukoencephalopathy (PML). Which of the following medications should the nurse recognize is associated with the development of PML?

Correct Answer is C

Explanation

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Explanation

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