A client with a history of peptic ulcer disease reports epigastric pain. Which action should the nurse take first?

Administer an antacid as prescribed

Assess the characteristics of the pain

Check for recent NSAID use

Obtain a stool sample for occult blood

Answer and Explanation

The Correct Answer is B

Choice A reason: Administering an antacid relieves epigastric pain but is premature without assessing pain characteristics. Pain in peptic ulcer disease may indicate complications like perforation, requiring urgent evaluation. Assessment guides whether antacids or other interventions are appropriate, prioritizing patient safety.

Choice B reason: Assessing pain characteristics (e.g., location, intensity, radiation) is the first step, as epigastric pain in peptic ulcer disease may signal complications like bleeding or perforation. This data guides interventions, ensuring timely management of potentially life-threatening conditions, making it the priority action.

Choice C reason: Checking NSAID use identifies ulcer triggers but is secondary to pain assessment. Pain characteristics determine urgency, as severe or radiating pain may indicate perforation, requiring immediate action. Assessment provides critical data before investigating contributing factors like medication history.

Choice D reason: Obtaining a stool sample for occult blood detects gastrointestinal bleeding but is not the first step. Assessing pain characteristics identifies urgent complications like perforation, guiding whether diagnostic tests or interventions are needed, making pain assessment the initial priority.

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Correct Answer is C

Explanation

Choice A reason: Hemoccult tests detect blood in sputum, indicating hemoptysis, a TB symptom, but do not confirm Mycobacterium tuberculosis infection. Sputum culture is required for definitive diagnosis, as hemoccult only identifies bleeding, which is nonspecific and can occur in other respiratory conditions.

Choice B reason: Chest x-ray or CT scans show pulmonary abnormalities like cavitary lesions in TB but are not confirmatory. Radiographic findings suggest TB but require microbiological confirmation via sputum culture, as similar patterns occur in other lung diseases, making imaging supportive but not diagnostic.

Choice C reason: Sputum culture positive for Mycobacterium tuberculosis is the gold standard for TB diagnosis. It directly identifies the pathogen, confirming active infection. Other tests like skin tests or imaging are suggestive but not definitive, as they cannot distinguish active TB from latent or other conditions.

Choice D reason: A positive PPD skin test indicates TB exposure or latent infection but does not confirm active disease. False positives occur with prior BCG vaccination or nontuberculous mycobacteria. Sputum culture is needed to verify active TB, making the skin test less definitive.

A. Palpate for joint warmth and swelling B. Measure range of motion in all joints C. Assess grip strength bilaterally D. Observe gait and posture

Correct Answer is A

Explanation

Choice A reason: Palpating for joint warmth and swelling is the best technique for early rheumatoid arthritis, as it detects synovitis, a hallmark of the disease. Inflamed joints are warm, swollen, and tender due to autoimmune-driven synovial proliferation, enabling early identification and intervention to prevent joint damage.

Choice B reason: Measuring range of motion assesses joint function but is less specific for early rheumatoid arthritis. Reduced motion occurs later, after significant synovial inflammation or damage. Palpating for warmth and swelling directly identifies active synovitis, making it more effective for early detection.

Choice C reason: Assessing grip strength evaluates muscle and joint function but is nonspecific for early rheumatoid arthritis. Weakness may result from pain or later joint damage. Palpating for warmth and swelling targets synovial inflammation, the earliest sign, making it the preferred technique for early diagnosis.

Choice D reason: Observing gait and posture detects functional limitations but is not specific for early rheumatoid arthritis. Gait changes occur with advanced disease or other conditions. Palpating for joint warmth and swelling directly identifies synovial inflammation, the primary early feature, making it more diagnostic.

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A client with a history of peptic ulcer disease reports epigastric pain. Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a private room with airborne precautions pending diagnostic test results. Which diagnostic test should the nurse review to confirm the diagnosis of TB?

Correct Answer is C

Explanation

Which technique should the nurse use when assessing for early signs of rheumatoid arthritis?

Correct Answer is A

Explanation

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