A 72-year-old patient was admitted with epigastric pain caused by a peptic ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?

Chest pain relieved with eating or drinking water

Burning epigastric pain 90 minutes after breakfast

Back pain three or four hours after eating a meal

Rigid abdomen and vomiting following indigestion

Answer and Explanation

The Correct Answer is D

Choice A rationale
Chest pain that is relieved with eating or drinking water is not typically indicative of a complication from a peptic ulcer. This symptom may be related to conditions like gastroesophageal reflux disease (GERD).

Choice B rationale
Burning epigastric pain after eating is a common symptom of a peptic ulcer and, while uncomfortable, does not usually require an urgent change in the plan of care unless it significantly worsens or is accompanied by other concerning symptoms.

Choice C rationale
Back pain after eating can be associated with a peptic ulcer if the ulcer is located at the back of the stomach or the pain radiates; however, it does not typically warrant an urgent change in care without other symptoms.

Choice D rationale
A rigid abdomen and vomiting following indigestion can indicate a perforated ulcer, which is a medical emergency. This requires immediate intervention and possibly surgical consultation, thus warranting an urgent change in the nursing plan of care.

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Correct Answer is C

Explanation

Choice A rationale
A high calcium diet and hypercalcemia are not directly associated with pyelonephritis. While dietary habits and blood calcium levels can impact overall health, they do not typically contribute to the development of pyelonephritis.

Choice B rationale
Long-term use of ibuprofen can lead to kidney damage, which may increase the risk of pyelonephritis, especially if there is pre-existing kidney impairment. However, it is not as directly related to pyelonephritis as a history of UTIs.

Choice C rationale
A history of UTIs is relevant to pyelonephritis, as the infection can ascend from the lower urinary tract to the kidneys. Recurrent UTIs are a risk factor for pyelonephritis, making this the most likely report from the client.

Choice D rationale
Genetic diseases can have various impacts on health, but there is no common genetic disease that directly causes pyelonephritis. This choice is less likely to be relevant to the client's current condition.

A. Obtain orders from the health care provider to discontinue catheters as soon as possible. B. Remind clients to urinate right away when they have an urge and to completely empty their bladder. C. Promote perineal care that includes wiping the perineum from front to back. D. Encourage continuing prescribed antibiotics even if the client's symptoms have subsided. E. Encourage adequate fluid intake every day if appropriate.

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

Explanation

Choice A rationale
Removing catheters as soon as they are no longer necessary can significantly reduce the risk of catheter-associated urinary tract infections (CAUTIs)¹.

Choice B rationale

While it is important for clients to urinate when they feel the urge, this practice alone is not specifically targeted at reducing the rate of urinary tract infections.

Choice C rationale

Teaching proper perineal care, including wiping from front to back, can help prevent the spread of bacteria to the urethra and reduce the risk of UTIs¹.

Choice D rationale

Continuing prescribed antibiotics until the full course is completed, even if symptoms improve, is crucial to ensure all bacteria are eliminated and to prevent antibiotic resistance³.

Choice E rationale

Adequate fluid intake helps flush bacteria from the urinary tract, which can decrease the incidence of UTIs¹.

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A 72-year-old patient was admitted with epigastric pain caused by a peptic ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

Correct Answer is C

Explanation

In an effort to decrease the rate of urinary tract infections, which of the following should the nurse manager teach the nursing staff? (Select all that apply)

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

Explanation

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A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?

A nurse is caring for a patient diagnosed with peptic ulcer disease. Which complication would result in gastric contents spilling into the patient's peritoneal cavity?

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