A nurse is gathering information from a patient who is experiencing a perforation of a peptic ulcer. Which of the following symptoms should the nurse anticipate?
High hemoglobin
Yellowing of the skin
Acute, sharp, and severe abdominal pain
High hematocrit .
The Correct Answer is C
Choice A rationale
High hemoglobin is not typically a symptom of a perforated peptic ulcer. Hemoglobin is a protein in red blood cells that carries oxygen. While changes in hemoglobin levels can indicate various health conditions, they are not directly associated with a perforated peptic ulcer.
Choice B rationale
Yellowing of the skin, or jaundice, is a symptom typically associated with liver disease, not a perforated peptic ulcer. Jaundice occurs when there’s too much bilirubin, a yellow-orange substance, in your blood.
Choice C rationale
Acute, sharp, and severe abdominal pain is a common symptom of a perforated peptic ulcer. A perforated peptic ulcer is a medical emergency that occurs when an ulcer goes through all the layers of the stomach or duodenum wall, creating a hole. This allows stomach or intestinal contents to leak into the abdominal cavity, causing severe abdominal pain.
Choice D rationale
High hematocrit is not typically a symptom of a perforated peptic ulcer. Hematocrit is the proportion of your total blood volume that is composed of red blood cells. While changes in hematocrit levels can indicate various health conditions, they are not directly associated with a perforated peptic ulcer. Dumping syndromeDumping syndrome Explore
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A rationale
While allowing grieving is an important aspect of holistic care for a client with esophageal cancer, it is not the priority nursing intervention. Emotional support and counseling are crucial, but they do not take precedence over interventions aimed at maintaining the client’s physical health.
Choice B rationale
Preventing aspiration is the priority nursing intervention for a client with esophageal cancer. Aspiration, or the inhalation of food, stomach acid, or saliva into the lungs, can lead to pneumonia and other serious complications. Therefore, measures to prevent aspiration, such as educating the client on safe swallowing techniques, elevating the head of the bed during meals, and monitoring for signs of aspiration, are crucial.
Choice C rationale
Managing pain relief is an important aspect of care for a client with esophageal cancer, but it is not the priority nursing intervention. Pain management strategies, such as administering prescribed analgesics and providing comfort measures, are part of a comprehensive care plan
but do not take precedence over interventions aimed at preventing immediate life-threatening complications like aspiration.
Choice D rationale
Maintaining nutritional intake is an important aspect of care for a client with esophageal cancer, but it is not the priority nursing intervention. Nutritional support, such as providing a balanced diet, encouraging small frequent meals, and possibly arranging for a consultation with a dietitian, are important but do not take precedence over interventions aimed at preventing immediate life-threatening complications like aspiration.
Correct Answer is D
Explanation
Choice A rationale
Increasing daily fiber intake does not cause peptic ulcer disease. While a high-fiber diet can have many health benefits, there is no direct link between fiber intake and the development of peptic ulcers.
Choice B rationale
Drinking hot tea with honey does not cause peptic ulcer disease. While certain foods and drinks can exacerbate the symptoms of an existing ulcer, they do not cause the ulcer itself.
Choice C rationale
Taking Lasix (furosemide) daily does not cause peptic ulcer disease. Lasix is a diuretic used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It is not associated with the development of peptic ulcers.
Choice D rationale
Taking too many ibuprofen during the day can cause peptic ulcer disease. Nonsteroidal anti- inflammatory drugs (NSAIDs), such as ibuprofen, can irritate or inflame the lining of your stomach and small intestine, leading to ulcers.
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