A nurse is reinforcing home safety information with an older adult client.
Which of the following statements indicates that the client needs further instruction?

Choice A rationale
Coffee ground vomitus is a symptom that indicates upper gastrointestinal bleeding. One of the conditions that can cause this symptom is a hiatal hernia. A hiatal hernia occurs when part of your stomach pushes upward through your diaphragm, and it can cause acid reflux, which can lead to esophagitis and bleeding. When the blood mixes with stomach acid, it can look like coffee grounds when vomited.
Choice B rationale
Gallbladder disease typically presents with symptoms such as abdominal pain (especially after eating), nausea, vomiting, bloating, and fever. While it can cause discomfort and complications like gallstones and inflammation, it does not typically cause coffee ground vomitus.

Choice A rationale
Surgery to increase mucus will not heal the ulcerations. Peptic ulcers are caused by an imbalance between the digestive fluids hydrochloric acid and pepsin, and the body’s ability to protect itself from these substances. The stomach and the duodenum have some protection from these acids, but if this protection is decreased, or the production of acids and pepsin is increased, an ulcer can form.
Choice B rationale
A common cause of peptic ulcer disease is an infection from Helicobacter pylori (H. pylori).
H. pylori is a bacterium that can damage the protective lining of your stomach and small intestine. This can lead to inflammation and ulcers.

Choice C rationale
Gastric ulcers do not occur more frequently than peptic ulcers. In fact, peptic ulcers include both gastric ulcers, which form on the lining of the stomach, and duodenal ulcers, which form on the lining of the upper part of the small intestine.
Choice D rationale
Erosion is not confined to the stomach and esophagus in peptic ulcer disease. Peptic ulcers can occur in the stomach and the duodenum, and less commonly, the lower esophagus.