A client with peptic ulcer disease (PUD) is admitted to the emergency room complaining of sudden severe upper abdominal pain. Assessment indicates an extremely tender and rigid abdomen, blood pressure 90/60 mmHg, and pulse of 110 beats/minute. Which procedure should the emergency department nurse plan for immediate implementation?

Nasogastric tube insertion.

Iced saline lavage.

Administration pantoprazole (Protonix) IV, a proton pump inhibitor.

Emergency abdominal surgery.

Answer and Explanation

The Correct Answer is D

Choice A: Nasogastric tube insertion may be indicated in the management of a client with peptic ulcer disease (PUD) to assess bleeding, relieve gastric distention, or administer medications. However, in this scenario, the client's presentation with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia suggests a potentially life-threatening condition that requires immediate intervention beyond nasogastric tube insertion.

Choice B: Iced saline lavage is not a standard procedure for managing peptic ulcer disease (PUD) or its complications. It is not the immediate intervention required for the client's presentation.

Choice C: Administration of pantoprazole (Protonix) IV, a proton pump inhibitor, is a relevant intervention for managing peptic ulcer disease (PUD), but it may not be the most immediate action needed for a client with sudden severe abdominal pain, hypotension, and tachycardia. More urgent interventions are required.

Choice D: Emergency abdominal surgery is the most appropriate and immediate intervention for a client with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia. These signs and symptoms may indicate a perforated peptic ulcer, which is a surgical emergency requiring prompt exploration and repair of the perforation to prevent peritonitis and sepsis.

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Correct Answer is D

Explanation

Choice A: Checking mental acuity is important for assessing the client's cognitive function, but it may not be the most crucial intervention in the context of left- sided heart failure.

Choice B: Measuring urinary output is a valuable assessment in clients with heart failure, but it is not the most important intervention among the choices provided.

Choice C: Inspecting for sacral edema is a relevant assessment for clients with heart failure, especially when assessing for fluid retention. However, it may not be the highest priority in this case.

Choice D: Auscultating all lung fields is the most important intervention for a client with left-sided heart failure. Left-sided heart failure often results in pulmonary congestion, and auscultating the lung fields can provide critical information about the presence of crackles, wheezes, or other abnormal breath sounds, indicating worsening heart failure.

A. Pureed regular diet. B. High protein soft diet. C. Mechanical soft diet. D. Low residue diet.

Correct Answer is C

Explanation

Choice A: A pureed regular diet may not provide enough nutritional support for a client who has lost 25% of their body weight and is experiencing stomatitis. This diet may not have the necessary nutrients to address the client's nutritional needs.

Choice B: A high protein soft diet may be appropriate for some clients, but it may still be challenging for a client with stomatitis to consume. Additionally, the focus should also be on providing adequate overall nutrition, not just protein.

Choice C: A mechanical soft diet is often recommended for clients with stomatitis because it provides foods that are easier to chew and swallow while still offering a variety of nutrients. It is a suitable option for clients who have difficulty eating due to oral mucositis (stomatitis).

Choice D: A low residue diet may not provide sufficient nutrients for a client who has lost 25% of their body weight and is experiencing difficulty eating due to stomatitis. This diet may be too restrictive for their nutritional needs.

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?

Correct Answer is D

Explanation

A client who is receiving antineoplastic chemotherapy has lost 25% of total body weight and is having difficulty eating because of stomatitis. In planning care for this client, which diet should the nurse recommend?

Correct Answer is C

Explanation

While assessing placement of a nasogastric tube (NGT), the nurse aspirates cloudy green fluid into a syringe. Which intervention should the nurse Implement?

The nurse instructs a client with Type 2 diabetes mellitus (DM) to avoid refined sugar and carbohydrates. Choosing which food indicates that the client understands the diet teaching?

A client tells the nurse about taking a variety of herbal products, including milk thistle, and has lost about thirty pounds over the last month. Which action should the nurse implement?

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The nurse is caring for an older client with that is exhibiting signs of confusion. Which intervention should the nurse implement?

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