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
Explanation
Choice A rationale
Elevated blood pressure is a common finding in cardiovascular conditions but is not specifically indicated by the presence of crackles, dyspnea on exertion, or an S3 gallop.
Choice B rationale
A decreased respiratory rate is not typically associated with the presence of crackles and dyspnea; these symptoms are more indicative of increased work of breathing and potential fluid overload.
Choice C rationale
Pitting edema is a classic sign of fluid retention, which can be associated with heart failure. The presence of crackles, dyspnea on exertion, and an S3 gallop are clinical indicators that suggest heart failure, making pitting edema a likely finding.
Choice D rationale
An irregular pulse may be found in various cardiac conditions but is not directly suggested by the symptoms described. The presence of an S3 gallop is more indicative of heart failure, which is commonly associated with fluid overload signs such as pitting edema.
Correct Answer is ["B","C","E","F"]
Explanation
Choice A rationale
Hypertension is not a typical manifestation of pyelonephritis. While it can be present due to other underlying conditions, it is not directly related to pyelonephritis.
Choice B rationale
Frequency, or the need to urinate more often, is a common symptom of pyelonephritis as the infection can irritate the bladder and urinary tract.
Choice C rationale
Flank pain is a classic symptom of pyelonephritis. It is usually located on the side of the affected kidney and can be quite severe.
Choice D rationale
Neck pain is not associated with pyelonephritis. It is more likely related to musculoskeletal issues or other non-urinary tract conditions.
Choice E rationale
Costovertebral tenderness, which is tenderness felt on tapping the back where the ribs meet the spine, is indicative of kidney infection and is expected in pyelonephritis.
Choice F rationale
Urgency, or a sudden, strong need to urinate, is another symptom of pyelonephritis due to inflammation and irritation in the urinary system.
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