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","D"]

Explanation

A. Using sterile water is recommended for flushing the tube before and after feeding, but it is not the most critical step in preventing complications.
B. Lowering the head of the bed to 15 degrees during feeding may increase the risk of aspiration, as a higher elevation is typically recommended.
C. Changing the feeding bag and tubing every 24 hours helps prevent bacterial contamination and reduces the risk of infection.
D. Checking for residual volume before each feeding helps ensure that the stomach is empty, reducing the risk of aspiration.
E. Adding crushed medications to the enteral formula is not recommended, as it can alter the formula's absorption and cause clogging of the tube.
F. Administering the feeding in a continuous cycle over 24 hours is typically done for certain patients, but it is not essential to prevent complications in all cases.

A. A Venturi mask allows for precise oxygen concentration delivery. B. Oxygen should be humidified when delivered at flow rates higher than 4 liters per minute. C. Oxygen toxicity can occur when high concentrations of oxygen are administered for extended periods. D. Nasal cannulas can deliver oxygen concentrations up to 90%. E. Oxygen therapy is always safe regardless of the patient's condition. F. A simple face mask can deliver higher oxygen concentrations than a non-rebreather mask.

Correct Answer is ["A","B","C"]

Explanation

A. A Venturi mask is an accurate way to deliver a specific concentration of oxygen, allowing for precise control.
B. Humidifying oxygen is recommended at flow rates higher than 4 liters per minute to prevent drying of the mucous membranes.
C. Oxygen toxicity can occur if high concentrations of oxygen are administered for prolonged periods, leading to potential lung damage.
D. Nasal cannulas typically provide a lower oxygen concentration than higher-flow devices, like a Venturi mask or non-rebreather mask.
E. Oxygen therapy is not always entirely safe regardless of the patient's condition; certain conditions require careful monitoring to prevent complications.

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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

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Correct Answer is ["C","D"]

Explanation

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