A client shares with the nurse concerns of a possible stomach ulcer. The client is experiencing heartburn and a dull gnawing pain that is relieved with eating. Which is the best response by the nurse?

Encourage the client to obtain a complete physical exam, since these symptoms are consistent with an ulcer.

Advise the client that he needs to seek immediate medical evaluation and treatment of these symptoms.

Assure the client that his symptoms may only reflect reflux, since ulcer pain is not relieved with food.

Instruct the client that these mild symptoms can generally be controlled with changes in his diet.

Answer and Explanation

The Correct Answer is A

Rationale:

A. Encourage the client to obtain a complete physical exam, since these symptoms are consistent with an ulcer: The client’s symptoms are typical of a duodenal ulcer. A full evaluation allows for appropriate diagnosis and treatment without causing alarm.

B. Advise the client that he needs to seek immediate medical evaluation and treatment of these symptoms: Immediate evaluation is not warranted unless the client has signs of bleeding, perforation, or severe distress. A timely but routine follow-up is appropriate for stable symptoms.

C. Assure the client that his symptoms may only reflect reflux, since ulcer pain is not relieved with food: Duodenal ulcer pain is classically relieved by eating, while gastric ulcer pain may worsen with food. Dismissing the symptoms as reflux could delay interventions.

D. Instruct the client that these mild symptoms can generally be controlled with changes in his diet: While diet can influence ulcer symptoms, assuming dietary change alone is sufficient may delay proper medical evaluation and necessary pharmacologic treatment.

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Correct Answer is B

Explanation

Rationale:
A. Report the COVID-19 result to the local health department according to the Center for Disease Control (CDC) guidelines: Reporting is important for public health surveillance but is not the nurse’s most immediate priority. Isolation should occur first to prevent the spread of infection, especially before confirmatory test results are available.

B. Isolate the client from other clients, family, and healthcare workers not wearing proper personal protective equipment (PPE): Prompt isolation is the highest priority to prevent transmission of COVID-19. Even with a previous negative test, current symptoms suggest active infection, and precautions must be implemented immediately to protect others.

C. Notify the charge nurse the client will need assignment to the COVID-19 specified area of the facility: While communication with the charge nurse is necessary for client placement, it should follow immediate implementation of infection control measures.

D. Place the nasal swab specimen for COVID-19 directly into a biohazard bag: Proper specimen handling is critical for safety and test integrity but does not take precedence over isolating a potentially infectious client.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

Rationale for Correct Choices:

Rupture: Aneurysm rupture is the most serious and immediate complication of an abdominal aortic aneurysm (AAA). The client’s gnawing back and abdominal pain, along with a pulsatile abdominal mass and bruit, suggest that the aneurysm is unstable.
Hypertension: Chronic high blood pressure exerts continuous force on arterial walls, weakening the aortic structure and promoting aneurysm formation and progression. It significantly increases the likelihood of rupture once an aneurysm is present.

Rationale for Incorrect Choices:

Dissection: Dissection involves a tear in the intimal layer of the artery, creating a false lumen. Although serious, it is more commonly associated with thoracic aortic aneurysms rather than abdominal ones. The client's symptoms and findings are more consistent with rupture.
Occlusion: Aneurysm-related occlusion refers to blockage of blood flow, which is less common in abdominal aneurysms. The client’s peripheral pulses are normal (2+), indicating adequate distal perfusion. There’s no sign of limb ischemia or thrombotic complications.
Smoking: Smoking is a known risk factor for developing aneurysms but is not the most direct or strongest predictor of rupture. Its role is more associated with aneurysm formation and progression. Hypertension more specifically correlates with increased rupture risk.
Hyperlipidemia: High lipid levels contribute to atherosclerosis, which can lead to aneurysm development over time. However, like smoking, it is not as strongly associated with aneurysm rupture as hypertension.

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A client shares with the nurse concerns of a possible stomach ulcer. The client is experiencing heartburn and a dull gnawing pain that is relieved with eating. Which is the best response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Four days after exposure to COVID-19 a client has a negative COVID-19 test result. Eight days after the negative test result, the client presents with fever, fatigue, and cough and the nurse performs a second COVID-19 test. Which action is most important for the nurse to take?

Correct Answer is B

Explanation

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

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