A 72-year-old patient was admitted with epigastric pain caused by a peptic ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?
Chest pain relieved with eating or drinking water
Burning epigastric pain 90 minutes after breakfast
Back pain three or four hours after eating a meal
Rigid abdomen and vomiting following indigestion
The Correct Answer is D
Choice A rationale
Chest pain that is relieved with eating or drinking water is not typically indicative of a complication from a peptic ulcer. This symptom may be related to conditions like gastroesophageal reflux disease (GERD).
Choice B rationale
Burning epigastric pain after eating is a common symptom of a peptic ulcer and, while uncomfortable, does not usually require an urgent change in the plan of care unless it significantly worsens or is accompanied by other concerning symptoms.
Choice C rationale
Back pain after eating can be associated with a peptic ulcer if the ulcer is located at the back of the stomach or the pain radiates; however, it does not typically warrant an urgent change in care without other symptoms.
Choice D rationale
A rigid abdomen and vomiting following indigestion can indicate a perforated ulcer, which is a medical emergency. This requires immediate intervention and possibly surgical consultation, thus warranting an urgent change in the nursing plan of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E","F"]
Explanation
Choice A rationale
Restricting airplane travel is not typically necessary for patients on hemodialysis unless there are specific medical concerns or complications related to their condition.
Choice B rationale
Driving restrictions are not a standard restriction for patients with end-stage kidney disease unless there are other underlying conditions that impair the ability to drive safely.
Choice C rationale
Time constraints are a significant factor for patients on hemodialysis due to the frequent and lengthy treatment sessions, which can limit their availability for other activities.
Choice D rationale
Limiting social activities to twice a week is not a standard recommendation; social interactions are important for mental health and should be encouraged as much as the patient's health allows.
Choice E rationale
Restricting foods high in potassium, sodium, and phosphorus is crucial for patients with end-stage kidney disease to help manage electrolyte levels and prevent complications.
Choice F rationale
Restricting fluid intake is essential for patients on hemodialysis to prevent fluid overload, which can lead to heart failure and other serious health issues.
Correct Answer is B
Explanation
Choice A rationale
Storing the medication at room temperature is a practical instruction but does not explain the therapeutic purpose of the medication, which is essential for patient understanding.
Choice B rationale
Epoetin alfa (Procrit) is used to treat anemia associated with chronic kidney disease by supplementing erythropoietin, a hormone the damaged kidneys can no longer produce effectively. This is the most informative statement for the patient's understanding of the medication's purpose.
Choice C rationale
While epoetin alfa can improve anemia and potentially improve quality of life, it does not directly delay the need for dialysis, which is determined by overall kidney function and not solely by the presence of anemia.
Choice D rationale
Epoetin alfa does not have a role in preventing AV fistula clotting. It is specifically used to stimulate red blood cell production and has no direct effect on clotting mechanisms.
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