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?

Chronic pancreatitis.

Peptic ulcer disease (PUD).

Esophagitis.

Gastroesophageal reflux (GERD).

Answer and Explanation

The Correct Answer is B

Choice A Reason:
Chronic pancreatitis is incorrect. Chronic pancreatitis typically presents with persistent, dull abdominal pain that may radiate to the back, often aggravated by eating rather than relieved by it. The pain associated with chronic pancreatitis is not typically described as gnawing or relieved by eating.
Choice B Reason:
Peptic ulcer disease (PUD) is correct. Peptic ulcer disease involves the development of open sores (ulcers) in the lining of the stomach (gastric ulcers) or the upper part of the small intestine (duodenal ulcers). The pain associated with PUD typically occurs in the epigastric region (upper abdomen) and can be described as gnawing, burning, or dull. The pain tends to worsen when the stomach is empty (hunger pains) and is relieved by eating or taking antacids. These symptoms are due to the increase in gastric acid secretion, which exacerbates the ulcer's irritation when the stomach is empty and is neutralized when food buffers the acid. Therefore, the presentation described is consistent with peptic ulcer disease (PUD).
Choice C Reason:
Esophagitis is incorrect. Esophagitis is inflammation of the esophagus and may present with symptoms such as heartburn, difficulty swallowing, or chest pain behind the breastbone. However, the symptoms described, particularly the worsening of pain when hungry and improvement after eating, are not typical of esophagitis.
Choice D Reason:
Gastroesophageal reflux (GERD) is incorrect. While gastroesophageal reflux disease (GERD) can cause epigastric discomfort or heartburn, the symptoms described in the scenario are more indicative of pain related to hunger and relief after eating, which is more characteristic of peptic ulcer disease (PUD). Additionally, GERD symptoms are typically worsened by eating, lying down, or bending over, rather than improved.

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Correct Answer is A

Explanation

Choice A Reason:
Hyperextension and palmar flexion are correct. Hyperextension involves moving the wrist joint backward, testing its ability to extend beyond its neutral position. Palmar flexion involves moving the wrist joint forward, testing its ability to flex toward the palm. These movements collectively assess the range of motion of the wrist joint in both directions, which is essential for identifying any limitations or pain associated with certain movements. Since the client presents with right wrist pain and ecchymosis, assessing both hyperextension and palmar flexion can help determine if there's any injury or impairment affecting the wrist's mobility.
Choice B Reason:
Plantar flexion is incorrect. Plantar flexion refers to a movement of the foot and ankle, not the wrist. Therefore, instructing the client to perform plantar flexion would not assess the wrist's mobility and is not relevant to the presented scenario of right wrist pain with ecchymosis.
Choice C Reason:
Forearm pronation is incorrect. Forearm pronation involves rotating the forearm so that the palm faces downward. This movement primarily assesses the pronation and supination of the forearm, not the wrist's mobility. Since the client's symptoms are specific to the wrist, assessing forearm pronation would not directly evaluate the wrist's range of motion.
Choice D Reason:
Forearm supination is incorrect. Forearm supination involves rotating the forearm so that the palm faces upward. Similar to forearm pronation, this movement primarily assesses the forearm's mobility, not the wrist's mobility. Therefore, instructing the client to perform forearm supination would not be an appropriate method for assessing the wrist's range of motion in the context of right wrist pain with ecchymosis.

A. Send the sample for laboratory evaluation. B. Give the client 8 ounces (236.5 mL) of water to drink. C. Evaluate the client for bladder distention. D. Instruct the client to attempt to urinate again.

Correct Answer is C

Explanation

Choice A Reason:
Sending the sample for laboratory evaluation is incorrect. Sending the urine sample for laboratory evaluation is a standard procedure to assess for any abnormalities, such as urinary tract infections (UTIs), kidney function, or other urinary tract disorders. While laboratory evaluation of the urine sample is important for diagnostic purposes, the client's difficulty providing an adequate urine sample suggests an underlying issue that needs to be addressed before obtaining a sample.
Choice B Reason:
Giving the client 8 ounces (236.5 mL) of water to drink is incorrect. Offering the client water to drink is a common intervention to encourage urine production and facilitate urine sample collection, particularly if the client is dehydrated or has difficulty producing a sample. However, given the client's symptoms of lower abdominal discomfort, frequent urination, and difficulty providing a urine sample despite efforts, simply offering water may not adequately address the underlying issue of potential bladder distention.
Choice C Reason:
Evaluating the client for bladder distention is correct. The client's symptoms of lower abdominal discomfort, frequent urination, and difficulty providing a urine sample after an extended period of time, along with returning with only a few drops of urine, are suggestive of potential bladder distention. Evaluating the client for bladder distention involves assessing for signs such as a visibly enlarged and palpable bladder, suprapubic discomfort or pain, and percussion of the bladder to assess for dullness, indicating fluid accumulation. Addressing bladder distention is essential to ensure the client's comfort and prevent complications associated with urinary retention.
Choice D Reason:
Instructing the client to attempt to urinate again is incorrect. Instructing the client to attempt to urinate again may be a reasonable intervention if the bladder is not distended and the client is simply having difficulty producing a urine sample. However, given the client's symptoms and the difficulty providing an adequate urine sample despite previous attempts, simply instructing the client to try again may not address the underlying issue of potential bladder distention. Evaluating for bladder distention is necessary to determine the appropriate course of action and ensure the client's comfort and safety.

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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

A client is seen in the emergent care clinic for right wrist pain with a pattern of ecchymosis observed on the wrist. Which motion should the nurse instruct the client to perform to assess the wrist mobility?

Correct Answer is A

Explanation

An older adult male arrives at the healthcare center with lower abdominal discomfort and frequent urination. The nurse asks the client to provide a urine sample. After an extended period of time, the client returns with only a few drops of urine. Which action should the nurse implement?

Correct Answer is C

Explanation

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