A nurse is caring for a patient diagnosed with peptic ulcer disease. Which complication would result in gastric contents spilling into the patient's peritoneal cavity?
Hemorrhage
Dumping syndrome
Perforation
Gastric outlet obstruction
The Correct Answer is C
Choice A rationale
Hemorrhage refers to bleeding, which can be a serious complication of peptic ulcer disease but does not lead to the spilling of gastric contents into the peritoneal cavity.
Choice B rationale
Dumping syndrome is a condition where food moves too quickly from the stomach to the small intestine, which can cause symptoms like nausea and abdominal pain, but it does not involve the leakage of gastric contents into the peritoneal cavity.
Choice C rationale
Perforation is the correct answer because it describes a hole forming in the wall of the stomach or duodenum, allowing gastric contents to spill into the peritoneal cavity, leading to peritonitis, which is a severe and life-threatening condition.
Choice D rationale
Gastric outlet obstruction is a blockage at the end of the stomach that prevents contents from entering the small intestine, which can cause vomiting and abdominal pain, but it does not result in the leakage of gastric contents into the peritoneal cavity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale
Removing catheters as soon as they are no longer necessary can significantly reduce the risk of catheter-associated urinary tract infections (CAUTIs)¹.
Choice B rationale
While it is important for clients to urinate when they feel the urge, this practice alone is not specifically targeted at reducing the rate of urinary tract infections.
Choice C rationale
Teaching proper perineal care, including wiping from front to back, can help prevent the spread of bacteria to the urethra and reduce the risk of UTIs¹.
Choice D rationale
Continuing prescribed antibiotics until the full course is completed, even if symptoms improve, is crucial to ensure all bacteria are eliminated and to prevent antibiotic resistance³.
Choice E rationale
Adequate fluid intake helps flush bacteria from the urinary tract, which can decrease the incidence of UTIs¹.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: A new ileal conduit is a permanent life change that requires the client to learn complex self-care skills. The uncertainty regarding stoma management, fear of appliance leakage in public, and the lifestyle adjustments required often lead to significant anxiety. The nurse must address these psychological stressors during the initial postoperative period to promote successful adaptation.
Choice B reason: The continuous drainage of urine from the stoma creates a high risk for peristomal skin breakdown. Urine is caustic to the skin, and moisture trapped under the skin barrier can lead to maceration, dermatitis, or fungal infections. Maintaining a secure, well-fitted appliance and assessing the skin frequently are essential nursing interventions for this risk.
Choice C reason: Surgical creation of an ileal conduit involves bowel resection and ureteral implantation, increasing the risk for peritonitis or wound infection. Furthermore, since the conduit is a direct pathway to the kidneys without a sphincter, the client is at lifelong risk for ascending urinary tract infections or pyelonephritis requiring vigilant monitoring.
Choice D reason: While postoperative patients require fluid monitoring, an ileal conduit does not typically cause a chronic fluid volume deficit. Unlike an ileostomy, where significant water and electrolytes are lost through liquid stool, the ileal conduit simply transports urine. Unless there is excessive surgical bleeding or unrelated dehydration, this is not a primary risk.
Choice E reason: The permanent diversion of urine to an external pouch on the abdomen significantly alters the client's physical appearance and "normal" elimination process. Concerns regarding sexual function, clothing choices, and the presence of a stoma frequently lead to a disturbed body image, necessitating supportive counseling and referral to an ostomy nurse.
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