A nurse is collecting data from a client who has a gastric ulcer. Which of the following should the nurse identify as a priority finding and notify the provider?

Weight loss of 2 lb (0.91 kg) from baseline

Dyspepsia

Reports being thirsty

Abdominal pain radiating to the shoulder

Answer and Explanation

The Correct Answer is D

A. Weight loss of 2 lb (0.91 kg) from baseline: Unintentional weight loss can indicate chronic illness or poor intake, but a 2-lb loss is relatively small and not an immediate sign of complication.

B. Dyspepsia: Dyspepsia (indigestion) is a common symptom of gastric ulcers and while important to manage, it is not an acute red flag requiring immediate notification.

C. Reports being thirsty: Thirst suggests dehydration or inadequate fluid intake; it is addressable and not a specific sign of a life-threatening ulcer complication.

D. Abdominal pain radiating to the shoulder: Shoulder pain with abdominal pathology suggests diaphragmatic irritation from perforation or intra-abdominal hemorrhage (referred pain via phrenic nerve) - this can indicate a surgical emergency and must be reported immediately.

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Correct Answer is A

Explanation

A. Use of NSAIDs for arthritic pain: NSAIDs inhibit prostaglandin synthesis, which reduces the protective mucus layer of the stomach and increases the risk of PUD. Clients with chronic NSAID use are at significantly higher risk for gastric ulcers.

B. Smoking history for 10 years: Smoking can delay healing of ulcers and contribute to recurrence, but it is not as direct a risk factor for developing PUD as NSAID use.

C. History of rheumatoid arthritis:RA itself does not directly cause PUD. However, clients with RA may take NSAIDs, which increases risk; the condition alone is not a primary risk factor.

D. Family history of peptic ulcer disease:While genetic predisposition may play a minor role, family history alone is not as significant as active NSAID use or other direct risk factors in increasing suspicion for PUD.

A. Implement fall precautions. B. Administer enemas to manage constipation. C. Initiate a low sodium diet. D. Measure abdominal girth daily. E. Obtain a weekly weight.

Correct Answer is ["A","C","D"]

Explanation

A. Implement fall precautions:Cirrhosis patients may develop hepatic encephalopathy (confusion, asterixis), muscle weakness, and coagulopathy (increased bleeding risk). Fall precautions reduce injury risk.

B. Administer enemas to manage constipation:Routine enemas are not universally indicated and can be harmful if used indiscriminately. However, bowel regulation is important - if hepatic encephalopathy is present, reducing ammonia (e.g., with lactulose or prescriber-directed interventions) is indicated; enemas might be ordered in specific situations but should not be a standing, routine nursing intervention without an order.

C. Initiate a low sodium diet:Low-sodium diet helps control ascites and peripheral edema in cirrhosis by reducing fluid retention - this is a standard intervention.

D. Measure abdominal girth daily:Daily abdominal girth measurement tracks ascites progression or response to diuretics/paracentesis - important for fluid management.

E. Obtain a weekly weight:Weekly weight is insufficient for fluid-shift monitoring in cirrhosis; daily weights are recommended to detect small fluid changes. So weekly weight alone is not appropriate - daily weights are preferred.

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A nurse is collecting data from a client who has a gastric ulcer. Which of the following should the nurse identify as a priority finding and notify the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of cirrhosis of the liver and renal insufficiency presents with epigastric pain and early satiety. The nurse suspects peptic ulcer disease. Which additional finding would further increase the nurse's suspicion for PUD in this client?

Correct Answer is A

Explanation

A nurse is contributing to the plan of care for a client who has cirrhosis of the liver. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

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