A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the mid epigastric region along with a rigid, board-like abdomen. These clinical manifestations are most likely indicative of which of the following?

The esophagus has become inflamed

An intestinal obstruction has developed

Additional ulcers have developed

The ulcer has perforated

Answer and Explanation

The Correct Answer is D

A. Inflammation of the esophagus (esophagitis) may cause symptoms like heartburn or dysphagia, but it would not explain the sudden, sharp pain or rigid abdomen seen with a perforated ulcer.
B. An intestinal obstruction can cause abdominal pain and distension, but the rigid, board-like abdomen is more characteristic of peritonitis from a perforated ulcer, not an obstruction.
C. Additional ulcers could cause pain and bleeding, but they would not explain the sudden, sharp pain and rigid abdomen that typically result from perforation.
D. The sudden onset of sharp, severe pain in the mid epigastric area, along with a rigid, board-like abdomen, are hallmark signs of a perforated ulcer, which causes peritonitis. This is a medical emergency, as the perforation allows gastric contents to leak into the peritoneal cavity, leading to widespread infection.

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Correct Answer is C

Explanation

A. Encouraging coughing and deep breathing is important for promoting the clearance of respiratory secretions. However, while it aids in mobilizing secretions, it does not directly thin the mucus.
B. Frequent ambulation helps to improve overall lung function and prevent complications like pneumonia, but it does not specifically thin respiratory secretions.
C. Increasing fluid intake helps thin the respiratory secretions by providing hydration, making it easier for the body to expel mucus through coughing. Hydration is critical for reducing the viscosity of sputum, thus promoting its removal.
D. Regular use of the incentive spirometer helps prevent atelectasis and improve lung expansion but does not directly affect the thinning of respiratory secretions.

A. Jaundice B. Anorexia C. Stomatitis D. Pyrosis

Correct Answer is D

Explanation

A. Jaundice is typically related to liver dysfunction and would not be a primary symptom of a hiatal hernia.
B. Anorexia is not a primary symptom of a sliding hiatal hernia, although some patients may experience reduced appetite due to discomfort.
C. Stomatitis (inflammation of the mouth) is not typically associated with a hiatal hernia.
D. Pyrosis, or heartburn, is a primary symptom of a sliding hiatal hernia, which occurs when stomach acid refluxes into the esophagus due to the hernia. This can lead to the sensation of heartburn or acid reflux.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to promote thinning of respiratory secretions?

Correct Answer is C

Explanation

The nurse understands that the primary symptoms of a sliding hiatal hernia are associated with reflux. Therefore, the nurse should assess the client with a hiatal hernia for which of the following symptoms?

Correct Answer is D

Explanation

A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days. Which assessment data obtained by the nurse indicates that the treatment is effective?

A 36-year-old patient with suspected gastrointestinal (GI) bleeding undergoes a diagnostic endoscopy which determines the site of bleeding is a duodenal ulcer. The nurse explains to the patient that bleeding ulcers are commonly related to which of the following:

A client diagnosed with type II diabetes is prescribed prednisone for an acute exacerbation of inflammatory bowel disease. Which management strategy should the nurse discuss with the client?

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

A nurse is caring for a client who has a tracheostomy. Exhibits Drag words from the choices below to fill in each blank in the following sentence. The client has manifestations of dropdownanddropdown

A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

The nurse is preparing a teaching plan for a patient being discharged after an acute episode of upper G.I. bleeding. What important information should the teaching plan include? Select all that apply.

A client comes to the clinic complaining of dysphagia and states that "he feels like food is stuck in his throat." The physician suspects esophageal cancer. Which of the following is a risk factor for esophageal cancer?