A 60-year-old patient with a history of peptic ulcer disease is admitted to the hospital with complaints of coffee-ground emesis and melena. What is the nurse's most appropriate initial action?

Encourage the patient to take deep breaths and relax.

Prepare the patient for an abdominal ultrasound.

Administer oral proton pump inhibitors as prescribed.

Initiate intravenous (IV) access and administer fluids as prescribed.

Answer and Explanation

The Correct Answer is D

A.   Encouraging the patient to relax and breathe deeply does not address the immediate concerns of potential hemorrhage.
B.   An abdominal ultrasound is not the first step in managing potential GI bleeding; stabilization is the priority.
C.   Proton pump inhibitors are important for managing peptic ulcer disease, but the immediate priority is
stabilizing the patient’s condition.
D.   Initiating IV access and administering fluids as prescribed is essential to stabilize the patient, manage shock, and address potential blood loss from gastrointestinal bleeding.

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Correct Answer is D

Explanation

A. Using mouthwash may reduce tartar and plaque, but it does not address the severe risks associated with tobacco use, such as oral cancer.
B. The 5-year survival rate for oral cancer is low, but it is not specifically tied to the year 2020 and should be emphasized in a broader context.
C. Brushing and flossing are essential for oral health, but they do not directly relate to cardiovascular disease prevention.
D. Tobacco use can significantly increase the risk of caries, tooth loss, and other oral health problems, negatively affecting the client's quality of life.

A. Iron deficiency anemia B. Vitamin B12 deficiency anemia C. Thalassemia minor D. Anemia of chronic disease

Correct Answer is B

Explanation

A. Iron deficiency anemia typically presents with a low MCV, not an elevated MCV, and it is less likely to be associated with the symptoms of glossitis and peripheral neuropathy.
B. Vitamin B12 deficiency anemia is a likely diagnosis in this patient. Chronic alcohol use can lead to malabsorption of vitamin B12, which contributes to macrocytic anemia (high MCV). Symptoms like glossitis and peripheral neuropathy are common in B12 deficiency.
C. Thalassemia minor usually presents with microcytic anemia and would not typically cause the elevated MCV or neurological symptoms seen in this patient.
D. Anemia of chronic disease typically presents with a normal or low MCV and is not associated with elevated MCV or the neurological symptoms seen in this patient.

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A 60-year-old patient with a history of peptic ulcer disease is admitted to the hospital with complaints of coffee-ground emesis and melena. What is the nurse's most appropriate initial action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing preventative health care education material to a new client who chews tobacco. Which of the following statements should the nurse underline as an important reminder in the pamphlet that highlights oral health for this client?

Correct Answer is D

Explanation

A 50-year-old male patient with a history of chronic alcoholism presents with fatigue, glossitis, and peripheral neuropathy. Laboratory findings show a hemoglobin level of 9.0 g/dL and mean corpuscular volume (MCV) of 110 fL. What type of anemia is most likely in this patient?

Correct Answer is B

Explanation

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