A client with a history of cirrhosis of the liver and renal insufficiency presents with epigastric pain and early satiety. The nurse suspects peptic ulcer disease. Which additional finding would further increase the nurse's suspicion for PUD in this client?

Use of NSAIDs for arthritic pain

Smoking history for 10 years

History of rheumatoid arthritis

Family history of peptic ulcer disease

Answer and Explanation

The Correct Answer is A

A. Use of NSAIDs for arthritic pain: NSAIDs inhibit prostaglandin synthesis, which reduces the protective mucus layer of the stomach and increases the risk of PUD. Clients with chronic NSAID use are at significantly higher risk for gastric ulcers.

B. Smoking history for 10 years: Smoking can delay healing of ulcers and contribute to recurrence, but it is not as direct a risk factor for developing PUD as NSAID use.

C. History of rheumatoid arthritis: RA itself does not directly cause PUD. However, clients with RA may take NSAIDs, which increases risk; the condition alone is not a primary risk factor.

D. Family history of peptic ulcer disease: While genetic predisposition may play a minor role, family history alone is not as significant as active NSAID use or other direct risk factors in increasing suspicion for PUD.

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Correct Answer is D

Explanation

A. "The pain radiates down to my lower back.":Pain radiating to the back is more characteristic of pancreatitis or peptic ulcer perforation into posterior structures, not the typical description for uncomplicated peptic ulcer disease.

B. "My pain is relieved by having a bowel movement.":Pain relief with defecation is more consistent with irritable bowel syndrome or lower GI functional disorders, not peptic ulcer disease.

C. "The pain is worse after I eat a meal high in fat.":Pain worse after fatty meals suggests biliary (gallbladder) disease rather than classic peptic ulcer disease.

D. "I feel so much better after eating.":Pain that improves after eating is a classic presentation for a duodenal ulcer (a type of peptic ulcer) - food buffers gastric acid and may relieve the pain temporarily.

A. Drinking orange juice regularly B. Sleeping on a large wedge-style pillow C. Consuming low-fat meats D. Eating dinner early in the evening

Correct Answer is A

Explanation

A. Drinking orange juice regularly:Citrus juices are acidic and can relax the lower esophageal sphincter and directly irritate the esophagus, worsening reflux and heartburn.

B. Sleeping on a large wedge-style pillow:Sleeping upright or with head elevated reduces nighttime reflux by using gravity to keep gastric contents in the stomach - this is helpful, not a contributor.

C. Consuming low-fat meats:Low-fat meats decrease gastric emptying delay related to fatty meals and reduce reflux risk; they are generally not a contributing factor.

D. Eating dinner early in the evening:Eating earlier (allowing 2–3 hours before lying down) reduces reflux at night; this is protective rather than contributory.

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A client with a history of cirrhosis of the liver and renal insufficiency presents with epigastric pain and early satiety. The nurse suspects peptic ulcer disease. Which additional finding would further increase the nurse's suspicion for PUD in this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client in the health clinic who is reporting epigastric pain. Which of the following statements made by the client should the nurse identify as being consistent with peptic ulcer disease?

Correct Answer is D

Explanation

A nurse is collecting data from a client who has gastroesophageal reflux disease (GERD) and reports having heartburn every night. Which of the following actions should the nurse identify as a contributing factor to the client's heartburn?

Correct Answer is A

Explanation

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