An adult client presents with gnawing epigastric pain. The pain is worse when the client is hungry and abates after eating something. Which problem do these symptoms suggest?

Esophagitis.

Peptic ulcer disease (PUD).

Gastroesophageal reflux (GERD).

Chronic pancreatitis.

Answer and Explanation

The Correct Answer is B

The symptoms described, including gnawing epigastric pain that worsens when hungry and improves after eating, are classic manifestations of peptic ulcer disease (PUD). Peptic ulcers are erosions in the mucosal lining of the stomach or duodenum, often caused by Helicobacter pylori infection or nonsteroidal anti-inflammatory drugs (NSAIDs). The pain typically occurs when the stomach is empty and is relieved by food intake due to the buffering effect of food on gastric acid. This pattern of pain is known as "hunger pain" or "meal-related pain" and is characteristic of PUD.

A. Esophagitis:
Esophagitis refers to inflammation of the esophagus, often due to reflux of gastric contents into the esophagus. Symptoms may include heartburn, difficulty swallowing, and chest pain, but the pain is typically not related to hunger and food intake as described in the scenario.

C. Gastroesophageal reflux (GERD):
GERD involves the reflux of gastric contents into the esophagus, leading to symptoms such as heartburn, regurgitation, and chest pain. While GERD can cause epigastric discomfort, the described pattern of pain worsening with hunger and improving after eating is more indicative of PUD.

D. Chronic pancreatitis:
Chronic pancreatitis is characterized by inflammation and irreversible damage to the pancreas, leading to persistent abdominal pain, often radiating to the back. While epigastric pain is a feature of chronic pancreatitis, the relief of pain after eating is not typically seen, making it less likely in this scenario.

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Correct Answer is B

Explanation

Answer: B. Opening a bar soap package.

Rationale:

A) Telephoning a family member:
Using a telephone is considered an instrumental activity of daily living (IADL), which involves more complex tasks required for independent living, such as managing communication. While important, it does not directly assess the physical and motor skills required for basic self-care.

B) Opening a bar soap package:
Opening a bar soap package involves fine motor skills and hand coordination, which are necessary for performing basic activities of daily living (ADLs). ADLs refer to essential self-care tasks like bathing, dressing, and grooming. Being able to open soap indicates the client has the dexterity needed for personal hygiene.

C) Sorting a collection of socks:
Sorting socks is more cognitive than motor-oriented, and it assesses organization skills, which are more aligned with IADLs rather than ADLs. It does not specifically evaluate the client’s ability to perform tasks related to basic self-care.

D) Reading a short paragraph:
Reading a paragraph evaluates literacy or cognitive function but is not directly related to performing ADLs. ADLs focus on physical activities necessary for daily living, such as dressing, eating, or bathing.

A. Cardiac atrophy. B. Cardiac enlargement. C. Benign variation. D. Expected finding. E. None F. None

Correct Answer is B

Explanation

Answer: B. Cardiac enlargement.

Rationale:

A) Cardiac atrophy:
Cardiac atrophy refers to the reduction in the size of the heart muscles and is not typically detected through percussion. It would present differently, likely through imaging or echocardiography, rather than an increase in the area of dullness during percussion.

B) Cardiac enlargement:
Percussion revealing dullness extending from the 5th left intercostal space upward to the 2nd left intercostal space suggests an increase in the size of the heart. This pattern indicates cardiac enlargement, as the heart’s borders have extended beyond their typical boundaries, which are usually confined to the 5th left intercostal space along the midclavicular line.

C) Benign variation:
A benign variation would not typically cause such a significant change in the area of cardiac dullness. This finding is more concerning for pathology, such as cardiomegaly, than a harmless variation.

D) Expected finding:
The normal borders of the heart should not extend upward to the 2nd left intercostal space during percussion. This finding is not within normal limits and suggests an abnormal enlargement of the heart, rather than an expected physiological outcome.

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An adult client presents with gnawing epigastric pain. The pain is worse when the client is hungry and abates after eating something. Which problem do these symptoms suggest?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which skill should the nurse have an older client demonstrate to evaluate the ability to perform activities of daily living (ADL)?

Correct Answer is B

Explanation

Rationale:

While percussing the borders of the heart, the nurse picks up an area of dullness beginning at the 5th left intercostal space and moving upward to the 2nd left intercostal space at the sternal border. What do these findings indicate?

Correct Answer is B

Explanation

Rationale:

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