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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A decrease in the white blood cell count toward normal levels indicates that the infection is responding to antibiotic treatment. A WBC count of 6000/μL is within the normal range for adults (usually 4,000–11,000/μL), which suggests that the body is no longer fighting a significant infection.
B. Bronchial breath sounds heard at the right base indicate consolidation, a sign of ongoing pneumonia or unresolved infection. This would suggest that the infection is not yet controlled, rather than an improvement.
C. Increased tactile fremitus indicates consolidation, which is commonly seen in pneumonia. It suggests that the infection is still present and has not resolved with treatment.
D. Green mucus can indicate the presence of purulent sputum and ongoing infection. Although the color of the mucus may change during the course of pneumonia, the presence of green mucus does not confirm that the infection is resolving, especially after three days of antibiotics.
Correct Answer is D
Explanation
A. Cleaning the stoma site with warm water and mild soap is appropriate and the correct way to maintain stoma hygiene. No harsh chemicals or abrasive materials should be used.
B. It is safe for the client to continue participating in physical activities and exercise, as long as they feel comfortable and take necessary precautions to protect the stoma.
C. Clients with an ileostomy are generally advised to avoid high-fiber foods, especially right after surgery, to reduce the risk of blockages.
D. The ostomy bag should typically be changed every 3 to 7 days, depending on the type of bag used and the amount of output. Changing it every day is unnecessary unless there are signs of leakage or skin irritation.
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