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 B

Explanation

Choice A reason: Platelet count assesses bleeding risk but does not measure warfarin’s anticoagulant effect. Warfarin inhibits clotting factors, monitored by INR. Platelet counts are relevant for antiplatelet drugs, not anticoagulants, making INR the priority for evaluating warfarin efficacy in atrial fibrillation.

Choice B reason: INR measures warfarin’s anticoagulant effect by assessing prothrombin time, reflecting vitamin K-dependent clotting factor inhibition. In atrial fibrillation, therapeutic INR (2.0–3.0) prevents thromboembolism. Monitoring INR ensures effective anticoagulation, making it the critical lab value for warfarin therapy management.

Choice C reason: Hemoglobin level detects bleeding, a warfarin side effect, but does not assess its therapeutic effect. INR directly evaluates anticoagulation, ensuring stroke prevention in atrial fibrillation. Hemoglobin is secondary, monitored for complications, not efficacy, making INR the priority lab value.

Choice D reason: Serum potassium is unrelated to warfarin’s anticoagulant action. Electrolyte imbalances may affect cardiac rhythm in atrial fibrillation, but INR measures warfarin’s effect on clotting factors, ensuring therapeutic anticoagulation, making it the essential value to monitor for medication efficacy.

A. Limit purine-rich foods B. Increase dairy consumption C. Restrict carbohydrate intake D. Encourage red meat consumption

Correct Answer is A

Explanation

Choice A reason: Limiting purine-rich foods (e.g., organ meats, shellfish) reduces uric acid production, preventing gout flares. Purines metabolize into uric acid, which forms joint crystals in gout. This dietary restriction is critical to manage symptoms and prevent painful exacerbations effectively.

Choice B reason: Increasing dairy may reduce gout risk by lowering uric acid, but it is secondary to purine restriction. Limiting purines directly decreases uric acid synthesis, addressing the primary cause of gout flares, making it the priority dietary recommendation.

Choice C reason: Restricting carbohydrates is irrelevant to gout, which results from uric acid accumulation. Purine-rich foods are the primary dietary trigger, as they increase uric acid. Limiting purines is the priority, as it directly prevents crystal formation and gout exacerbations.

Choice D reason: Encouraging red meat, high in purines, worsens gout by increasing uric acid production. Limiting purine-rich foods is critical, as it reduces uric acid and joint crystal formation, making red meat consumption counterproductive to effective gout management.

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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

A client with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor to assess the medication’s effectiveness?

Correct Answer is B

Explanation

The nurse is caring for a client with a history of gout. Which dietary recommendation should the nurse emphasize?

Correct Answer is A

Explanation

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