A male patient is admitted to the hospital with complaints of epigastric pain, which he describes as burning and gnawing. The pain occurs 2-3 hours after eating and is somewhat relieved by food or antacids. He has a history of smoking and occasional alcohol use. Upon assessment, the patient exhibits tenderness in the epigastric region, and his vital signs are stable. The patient is diagnosed with a peptic ulcer disease (PUD). Which of the following is the most appropriate nursing intervention for this patient?

Administer a proton pump inhibitor (PPI) as prescribed to decrease gastric acid production

Provide a diet high in fiber and low in fat to promote gastrointestinal health.

Encourage the patient to eat small, frequent meals to prevent the secretion of gastric acid.

Instruct the patient to increase the intake of dairy products to help neutralize stomach acid.

Answer and Explanation

The Correct Answer is A

A. Administer a proton pump inhibitor (PPI) as prescribed to decrease gastric acid production: Proton pump inhibitors (PPIs) are a cornerstone of therapy for peptic ulcer disease as they effectively reduce gastric acid production, which helps the ulcer heal and relieves symptoms.

B. Provide a diet high in fiber and low in fat to promote gastrointestinal health: A high-fiber diet is not specifically indicated for PUD. While diet modifications may help, managing gastric acid production and avoiding irritants is more critical.

C. Encourage the patient to eat small, frequent meals to prevent the secretion of gastric acid: Although small, frequent meals may help some patients, they are not as effective in managing PUD compared to PPIs. Additionally, frequent eating can stimulate gastric acid production in some cases.

D. Instruct the patient to increase the intake of dairy products to help neutralize stomach acid:
Dairy products can initially neutralize stomach acid, but they can also stimulate further acid production, which may worsen symptoms in the long term. This is not recommended for managing PUD.

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Correct Answer is C

Explanation

A. Atorvastatin: Atorvastatin is a statin used to manage cholesterol levels. It is generally safe for use in patients with CKD.

B. Losartan: Losartan is an angiotensin II receptor blocker (ARB) used to manage hypertension and protect the kidneys in diabetic nephropathy. It can be beneficial in CKD patients.

C. Vancomycin: Vancomycin is an antibiotic known to be nephrotoxic, especially in patients with compromised kidney function. It should be used with caution or avoided in patients with CKD.

D. Aspirin: While aspirin can have adverse effects on the kidneys at high doses, its nephrotoxic potential is lower than that of vancomycin. In low doses, aspirin is commonly used for cardiovascular protection, even in patients with CKD.

A. Laxatives are contraindicated in clients who have a small bowel obstruction. B. Bulk-forming laxatives such as psyllium should be substituted for this client. C. An osmotic laxative, such as magnesium citrate, should be substituted in this client. D. The prescribed medication should be administered via NG route rather than the oral route for this client.

Correct Answer is A

Explanation

A. Laxatives are contraindicated in clients who have a small bowel obstruction. Laxatives such as senna are contraindicated in bowel obstructions because they can increase peristalsis and exacerbate the blockage, leading to complications like bowel perforation or ischemia.

B. Bulk-forming laxatives such as psyllium should be substituted for this client: Bulk-forming laxatives like psyllium would not be appropriate either because they rely on bowel movement for efficacy. They could worsen the obstruction by adding bulk.

C. An osmotic laxative, such as magnesium citrate, should be substituted in this client: Osmotic laxatives, like magnesium citrate, are also contraindicated in bowel obstruction because they draw water into the bowel, which can worsen distension and pressure on the obstructed area.

D. The prescribed medication should be administered via NG route rather than the oral route for this client: While NG tubes may be used to decompress the bowel in cases of obstruction, administering a laxative through an NG tube would still be contraindicated, as laxatives increase the risk of further complications in bowel obstruction.

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Naxlex Comprehensive Predictor Exams

A patient with chronic kidney disease (CKD) is being evaluated for medication management. Which of the following medications should be avoided due to its potential nephrotoxic effects?

Correct Answer is C

Explanation

A nurse is reviewing medications for a client who has just been diagnosed with a small bowel obstruction. The nurse should withhold senna prescribed orally based on understanding of which of the following?

Correct Answer is A

Explanation

A patient with acute pancreatitis is being discharged from the hospital. Which statement made by the patient indicates a need for further teaching regarding their discharge instructions?

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestation should the nurse expect to find?

A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

A patient with ascites has been admitted to your unit. Which of the following safety precautions should you reinforce to prevent complications?

A nurse is reinforcing teaching to a client who has been newly diagnosed with hepatitis C. The client asks how they could have contracted the virus. Which of the following nurse responses best explains how the client may have become infected with hepatitis C?

A patient with a history of ulcerative colitis presents to the emergency department with severe abdominal pain, frequent bloody diarrhea, and signs of dehydration. Which medication should the nurse anticipate administering during this exacerbation of ulcerative colitis?