A client with a history of peptic ulcer disease reports epigastric pain. Which action should the nurse take first?

Administer an antacid as prescribed

Assess the characteristics of the pain

Check for recent NSAID use

Obtain a stool sample for occult blood

Answer and Explanation

The Correct Answer is B

Choice A reason: Administering an antacid relieves epigastric pain but is premature without assessing pain characteristics. Pain in peptic ulcer disease may indicate complications like perforation, requiring urgent evaluation. Assessment guides whether antacids or other interventions are appropriate, prioritizing patient safety.

Choice B reason: Assessing pain characteristics (e.g., location, intensity, radiation) is the first step, as epigastric pain in peptic ulcer disease may signal complications like bleeding or perforation. This data guides interventions, ensuring timely management of potentially life-threatening conditions, making it the priority action.

Choice C reason: Checking NSAID use identifies ulcer triggers but is secondary to pain assessment. Pain characteristics determine urgency, as severe or radiating pain may indicate perforation, requiring immediate action. Assessment provides critical data before investigating contributing factors like medication history.

Choice D reason: Obtaining a stool sample for occult blood detects gastrointestinal bleeding but is not the first step. Assessing pain characteristics identifies urgent complications like perforation, guiding whether diagnostic tests or interventions are needed, making pain assessment the initial priority.

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Correct Answer is A

Explanation

Choice A reason: Avoiding alcohol is critical with phenytoin, as it increases seizure risk and alters drug metabolism, reducing efficacy or causing toxicity. Alcohol’s CNS depressant effects exacerbate epilepsy, making this the priority teaching point to ensure seizure control and medication safety.

Choice B reason: Increasing calcium intake is unrelated to phenytoin or epilepsy management. While phenytoin may affect bone health long-term, alcohol avoidance is more urgent, as it directly impacts seizure control and drug pharmacokinetics, making it the priority teaching focus.

Choice C reason: Limiting physical activity is unnecessary for epilepsy unless seizures are poorly controlled. Alcohol avoidance is critical, as it lowers the seizure threshold and interferes with phenytoin metabolism, posing immediate risks to seizure control, making it the primary teaching point.

Choice D reason: Reducing fluid intake is irrelevant to phenytoin or epilepsy. Proper hydration supports health, but alcohol avoidance is the priority, as it directly affects seizure risk and phenytoin’s effectiveness, ensuring therapeutic levels and preventing breakthrough seizures in epilepsy management.

A. Obtain an arterial blood gas prior to the procedure B. Perform the drainage immediately after meals C. Instruct the client to breathe shallow and fast D. Explain that the client may be placed in five positions

Correct Answer is D

Explanation

Choice A reason: Obtaining an arterial blood gas assesses oxygenation and acid-base status, useful in COPD management, but is not required before postural drainage. This invasive procedure is unnecessary for routine drainage, which mobilizes secretions. Explaining positions prepares the client, enhancing cooperation and effectiveness.

Choice B reason: Performing drainage after meals risks aspiration or vomiting, as a full stomach increases intra-abdominal pressure in COPD patients. Postural drainage is most effective when performed on an empty stomach, making this approach incorrect. Patient education on positioning is the priority.

Choice C reason: Shallow, fast breathing is counterproductive in COPD, as it reduces tidal volume and worsens hypercapnia. Postural drainage requires slow, deep breaths to mobilize secretions and improve ventilation. Explaining positions ensures proper technique, making this breathing instruction incorrect.

Choice D reason: Explaining that the client may be placed in five positions (e.g., prone, supine, lateral) prepares them for postural drainage, which uses gravity to mobilize lung secretions in COPD. This education enhances compliance and effectiveness, as proper positioning is critical for therapeutic success, making it the correct approach.

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A client with a history of peptic ulcer disease reports epigastric pain. Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with a new diagnosis of epilepsy who is prescribed phenytoin. Which teaching point should the nurse emphasize?

Correct Answer is A

Explanation

When performing postural drainage on a client with chronic obstructive pulmonary disease, which approach should the nurse use?

Correct Answer is D

Explanation

The nurse is reviewing risk factors for cholelithiasis in a client’s history. Which factor most significantly increases the client’s risk for developing gallstones?

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The nurse is caring for a client with a new diagnosis of hyperthyroidism. Which intervention should the nurse prioritize?

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The nurse is caring for a client with a history of chronic obstructive pulmonary disease who is receiving oxygen therapy. Which assessment should the nurse prioritize?

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