A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

Methylprednisolone

Enoxaparin

Pantoprazole

Ibuprofen

Answer and Explanation

The Correct Answer is C

A.   Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B.   Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C.   Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D.   Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Elevated serum cholesterol is a common finding in hypothyroidism. The thyroid hormones play a role in regulating lipid metabolism, so low levels of thyroid hormones can lead to increased cholesterol levels. This is a typical finding in Hashimoto's disease, as it often results in hypothyroidism.
B. In Hashimoto's disease, which leads to hypothyroidism, TSH levels are usually elevated rather than low. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones (T3 and T4). When the thyroid gland is underactive and not producing enough hormones, the pituitary gland compensates by increasing TSH production. Therefore, a low TSH level would not be expected in Hashimoto's disease.
C. Free T4 (thyroxine) is typically low in hypothyroidism. Hashimoto's disease causes an underactive thyroid gland, which leads to decreased production of thyroid hormones, including free T4. Elevated free T4 would not be consistent with the diagnosis of Hashimoto's disease.
D. Elevated ACTH is more relevant to conditions involving the adrenal glands, such as Addison's disease or Cushing's syndrome. It is not a typical finding in Hashimoto's disease. Hashimoto's primarily affects thyroid function and does not directly impact ACTH levels.

A. The bleeding occurs from peptic ulcers in the stomach. B. This type of bleeding is treated by giving chewable aspirin. C. The bleeding occurs from tears in the lining of the duodenum. D. The bleeding occurs from a tear in the mucosal lining where the esophagus meets the stomach.

Correct Answer is D

Explanation

A. Peptic ulcers are sores that develop on the lining of the stomach, small intestine, or esophagus due to the erosion caused by stomach acid. A Mallory-Weiss tear is not related to peptic ulcers. Instead, it results from a different type of injury related to forceful vomiting or retching.
B. Chewable aspirin is not a treatment for Mallory-Weiss tears. In fact, aspirin can exacerbate bleeding and is typically avoided in situations where gastrointestinal bleeding is present. Mallory-Weiss tears are generally managed by supportive measures and sometimes endoscopic interventions, not with aspirin.
C. A Mallory-Weiss tear specifically affects the mucosal lining at the junction of the esophagus and the stomach, not the duodenum. The duodenum is part of the small intestine, and tears or bleeding here are not characteristic of Mallory-Weiss syndrome.

D. A Mallory-Weiss tear is a tear or laceration in the mucosal lining at the gastroesophageal junction (where the esophagus meets the stomach). It is typically caused by severe vomiting or retching, which can lead to the tear and subsequent upper gastrointestinal bleeding.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a client who has a new diagnosis of Hashimoto's disease. Which of the following lab results would the nurse expect to find?

Correct Answer is A

Explanation

The patient is admitted with upper GI bleeding following an episode of forceful vomiting due to excessive alcohol intake. The nurse suspects a Mallory-Weiss tear. Which of the following is true of a Mallory-Weiss tear?

Correct Answer is D

Explanation

A nurse is assessing a client who is 12 hours postoperative following a thyroidectomy. Which of the following findings is indicative of thyrotoxic crisis?

A nurse is caring for a client with an acute heart failure exacerbation. Which of the following medications are commonly prescribed to manage heart failure? (Select all that apply.)

A client who is receiving chemotherapy for breast cancer is experiencing myelosuppression as a side effect of the treatment. Which of the following is a manifestation directly related to myelosuppression?

A client who received a kidney transplant 3 months ago is in the nephrologists office for a follow up appointment. Which finding would indicate that the client is experiencing a complication which is common after a kidney transplant?

A nurse in the emergency department is admitting a client. Exhibits For each of the following findings in the client's medical record, click to specify if they are consistent with unstable angina or a myocardial infarction (MI). Each finding may support more than one disease process.

A nurse is assessing a client who has chronic kidney disease and notes that the client has small crystals on his forehead. The nurse understands that this manifestation is a result of an excess of which substance in the body?

A nurse is discussing the importance of following a low-sodium diet with a client who has heart failure. Which of the following food items would be appropriate for this patient to choose?