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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A rationale
Proteinuria, or the presence of an abnormal amount of protein in the urine, is a hallmark sign of glomerulonephritis. It occurs due to the increased permeability of the glomerular filtration barrier.
Choice B rationale
Hypertension is often associated with glomerulonephritis. The damage to the glomeruli can lead to salt and water retention, contributing to high blood pressure.
Choice C rationale
Periorbital edema, which is swelling around the eyes, is a common early symptom of glomerulonephritis. It is caused by fluid retention and leakage into the tissue.
Choice D rationale
Hypotension is not typically associated with glomerulonephritis. In fact, hypertension is more common due to the reasons mentioned above.
Choice E rationale
Hematuria, or blood in the urine, is another common finding in glomerulonephritis. It results from the inflammation and damage to the glomeruli, allowing red blood cells to leak into the urine.
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.
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