A client arrives at the emergency room with symptoms of peptic ulcer disease. Which of these symptoms should the nurse identify as the priority?
Hematemesis
Abdominal bloating
Epigastric discomfort
Dyspepsia
The Correct Answer is A
Choice A reason: Hematemesis Hematemesis, or vomiting blood, is a serious symptom that usually indicates bleeding in the upper gastrointestinal tract. This could be due to a severe peptic ulcer, among other conditions1. The blood may appear red or black, and the condition can cause a person to go into hypovolemic shock, which can lead to organ failure and death if not treated immediately. Therefore, hematemesis should be identified as the priority symptom in this case. While all these symptoms can be associated with peptic ulcer disease, hematemesis is the most serious and should be prioritized due to the risk of significant blood loss and potential for hypovolemic shock.
Choice B reason: Abdominal bloating Abdominal bloating is a symptom that can be caused by various conditions, including indigestion, overeating, and certain medical conditions. While it can be uncomfortable, it is generally not as immediately life-threatening as hematemesis.
Choice C reason: Epigastric discomfort Epigastric discomfort refers to pain or discomfort in the upper abdomen, below the ribs. It can be caused by conditions such as acid reflux, GERD, overeating, lactose intolerance, and others. While it can be a symptom of a peptic ulcer, it is not typically as urgent as hematemesis.
Choice D reason: Dyspepsia Dyspepsia, also known as indigestion, can cause symptoms such as bloating, heartburn, and feeling full too quickly8910. It can be caused by a variety of factors, including certain foods, overeating, and medical conditions like GERD. While it can be a symptom of a peptic ulcer, it is generally not as immediately life-threatening as hematemesis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:Placing a cool cloth on the forehead may provide comfort but does not address intracranial pressure, which could be causing the headache[^10^].
Choice B reason:Elevating the head of the bed 30 degrees helps to decrease intracranial pressure and can alleviate headache symptoms associated with a closed head injury[^10^].
Choice C reason:Administering morphine for pain relief should be done with caution, as it can depress respiration and mask changes in the level of consciousness, which are important indicators of neurological status[^10^].
Choice D reason:A lumbar puncture is contraindicated in the presence of increased intracranial pressure due to the risk of brain herniation[^10^].
Correct Answer is D
Explanation
Choice A reason: A BUN level of 20 mg/dL is within the normal range (7-20 mg/dL) and does not indicate an increased risk of AKI.
Choice B reason: Serum Osmolality of 290 mOsm/kg H2O is within the normal range (275-295 mOsm/kg H2O) and does not suggest an increased risk of AKI.
Choice C reason: A Magnesium level of 2.0 mEq/L is within the normal range (1.7-2.2 mEq/L) and does not indicate an increased risk of AKI.
Choice D reason: An elevated serum creatinine level, such as 1.8 mg/dL, indicates decreased kidney function and is a risk factor for AKI, especially post-MI where the kidneys may be vulnerable due to reduced cardiac output and potential nephrotoxic interventions.
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