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. Total loss of gastric enzymes is not a primary cause of dumping syndrome. While gastric enzymes may be reduced following gastric surgery, the syndrome is primarily related to the way food moves through the digestive tract.
B. Excess secretion of digestive enzymes in the intestines does not directly cause dumping syndrome. Although enzyme levels can be affected by surgery, dumping syndrome is more about the timing and volume of food delivery to the intestines.
C. Rapid emptying of stomach contents into the small intestine is the primary cause of dumping syndrome. This occurs because the normal regulatory mechanisms of the stomach are bypassed or disrupted after gastric resection, leading to a quick shift of food into the small intestine, which causes symptoms like nausea, diarrhea, and dizziness.
D. Excess glycogen production by the liver is not related to dumping syndrome. This would be more relevant to conditions affecting glucose metabolism, not gastrointestinal emptying.

A. "Cytotec helps to enhance the pain-relieving effects of the NSAIDs." B. "Cytotec helps to protect the stomach lining from damage caused by NSAIDs." C. "Cytotec helps to decrease inflammation in the joints." D. "Cytotec helps to reduce the risk of developing blood clots from the NSAIDs."

Correct Answer is B

Explanation

A. Cytotec does not enhance the pain-relieving effects of NSAIDs. Instead, it works to protect the stomach lining from the harmful effects of NSAIDs, which can cause gastrointestinal ulcers and bleeding.
B. Misoprostol (Cytotec) is used to protect the stomach lining from damage caused by NSAIDs, which can increase the production of stomach acid and decrease the protective mucus lining. Cytotec helps prevent gastric ulcers and other GI complications associated with long-term NSAID use.
C. Cytotec does not directly decrease inflammation in the joints. NSAIDs are the primary medications for reducing joint inflammation in conditions like arthritis.
D. Cytotec does not reduce the risk of developing blood clots from NSAIDs. It is primarily used for its protective effect on the gastrointestinal system.

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Naxlex Comprehensive Predictor Exams

As a result of gastric resection, the client is at risk for developing dumping syndrome. The nurse should prepare a plan of care for this client based on knowledge that this problem stems primarily from which of the following gastrointestinal changes?

Correct Answer is C

Explanation

A patient who is taking NSAIDs to treat arthritis asks the nurse why Cytotec (misoprostol) has also been prescribed. Which explanation by the nurse is accurate?

Correct Answer is B

Explanation

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Which patient should the nurse assess first after receiving a change-of-shift report?

A nurse is caring for a client who is being admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse take first?

A patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

A nurse is caring for a client who has an endotracheal tube and is receiving mechanical ventilation. Which of the following actions should the nurse take to reduce the risk of ventilator-associated pneumonia?

A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?

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?