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).
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Observing chest and upper neck for a rash is correct. This assessment is unrelated to tinnitus. Observing the chest and upper neck for a rash may be relevant in the context of other conditions, such as skin disorders or infectious diseases, but it does not provide information about the effects of tinnitus.
Choice B Reason:
Performing a hearing test is correct. Tinnitus is the perception of noise or ringing in the ears when no external sound is present. It can affect a person's hearing and overall quality of life. Therefore, the most appropriate assessment to evaluate the effects of tinnitus is to perform a hearing test. This test can assess the client's auditory function, including their ability to hear different frequencies and intensities of sound. By conducting a hearing test, the nurse can gather objective data on the client's hearing abilities and determine the extent to which tinnitus may be impacting their hearing sensitivity and perception.
Choice C Reason:
Evaluating for a loss of peripheral vision is incorrect. Loss of peripheral vision is not a typical effect of tinnitus. While tinnitus can affect auditory perception, it does not directly impact visual function, particularly peripheral vision. Therefore, evaluating for loss of peripheral vision is not relevant to assessing the effects of tinnitus.
Choice D Reason:
Assessing deep tendon reflexes is incorrect. Assessing deep tendon reflexes is unrelated to evaluating the effects of tinnitus. Deep tendon reflexes are assessed to evaluate the integrity of the neurological system and are typically tested in the context of assessing motor function and nerve responses. This assessment does not provide information about the auditory effects of tinnitus.
Correct Answer is A
Explanation
Choice A Reason:
Palpating the client's dorsalis pedis pulses is appropriate because shiny lower legs with no hair growth are characteristic findings of peripheral arterial disease (PAD), which commonly occurs in individuals with diabetes mellitus. Palpating the client's dorsalis pedis pulses allows the nurse to assess peripheral arterial perfusion. Weak or absent dorsalis pedis pulses may indicate decreased blood flow to the feet and lower extremities, supporting the diagnosis of PAD.
Choice B Reason:
Asking if the client often feels weak or hungry is less relevant to the assessment findings of shiny lower legs with no hair growth. While it is important to assess for symptoms of hypoglycemia in clients with diabetes mellitus, such as weakness or hunger, these symptoms do not directly correlate with the observed peripheral vascular changes.
Choice C Reason:
Comparing the range of motion of both legs is less relevant to the assessment findings of shiny lower legs with no hair growth. Range of motion assessment is important for assessing joint function and mobility but does not provide information specifically related to peripheral vascular status.
Choice D Reason:
Measuring the client's capillary glucose is less relevant to the assessment findings of shiny lower legs with no hair growth. While it is important to monitor blood glucose levels in clients with diabetes mellitus, capillary glucose measurement does not provide information specifically related to peripheral vascular status or the observed findings of PAD.
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