A nurse in a provider's office is caring for a client who has a medical history of rheumatoid arthritis and psoriasis, and a family history of heart disease and arthritis. The client has a 60-year smoking history and denies alcohol or other substance use. They are positive for Helicobacter pylori and are on medication for peptic ulcer disease (PUD). Which three findings from the client's medical record increase their risk for peptic ulcer disease?
Family history
Smoking history
Alcohol use
Positive for H. pylori
NSAID use
Correct Answer : B,D,E
Choice A rationale
While family history can contribute to the risk of developing certain conditions, it is not a direct risk factor for peptic ulcer disease.
Choice B rationale
A long-term smoking history is a known risk factor for peptic ulcer disease as it can increase gastric acid secretion and reduce the production of substances that protect the stomach lining.
Choice C rationale
The client denies alcohol use; therefore, it is not a contributing risk factor in this case. However, alcohol use is generally a risk factor for PUD due to its irritating effect on the stomach lining.
Choice D rationale
Being positive for Helicobacter pylori is one of the strongest risk factors for peptic ulcer disease. This bacterium damages the protective mucosal layer of the stomach and duodenum, leading to chronic inflammation and allowing acid to injure the underlying tissue. It is the leading cause of most gastric and duodenal ulcers worldwide.
Choice E rationale
NSAID use is a well-established risk factor for peptic ulcer disease as these medications can disrupt the protective lining of the stomach, leading to ulcers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A rationale
Applying a new patch at the onset of anginal pain is not recommended for transdermal nitroglycerin. This medication is used for long-term prevention of angina, not for immediate relief.
Choice B rationale
Covering the patch with plastic wrap is not necessary and is not a standard instruction for the use of transdermal nitroglycerin patches.
Choice C rationale
Applying a new patch each morning ensures that the medication is delivered consistently throughout the day, which is important for the management of stable angina.
Choice D rationale
Removing the patch for 10 to 12 hours daily, typically at night, helps prevent tolerance to the medication, ensuring its effectiveness.
Choice E rationale
Applying the patch to a hairless area and rotating sites helps to prevent skin irritation and ensures better adherence of the patch to the skin.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale
Anxiety, while a valid concern, is not directly a risk associated with the physical complications of an ileal conduit. However, it can be an emotional response to the surgery and the changes it brings.
Choice B rationale
Impaired skin integrity is a significant risk for clients with an ileal conduit due to the potential for irritation from the stoma appliance and the risk of skin breakdown around the stoma site.
Choice C rationale
Infection is a risk due to the potential for bacteria to enter through the stoma or for urinary tract infections to develop, given the changes in the urinary system's structure and function.
Choice D rationale
Fluid volume deficit is a risk for clients with an ileal conduit because of the potential for increased fluid loss through the stoma, necessitating careful monitoring and management of fluid intake and output.
Choice E rationale
Disturbed body image is a risk due to the physical changes and the presence of a stoma, which can affect the client's perception of their body and self-image.
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