A client with peptic ulcer disease (PUD) is admitted to the emergency room complaining of sudden severe upper abdominal pain. Assessment indicates an extremely tender and rigid abdomen, blood pressure 90/60 mmHg, and pulse of 110 beats/minute. Which procedure should the emergency department nurse plan for immediate implementation?

Nasogastric tube insertion.

Iced saline lavage.

Administration pantoprazole (Protonix) IV, a proton pump inhibitor.

Emergency abdominal surgery.

Answer and Explanation

The Correct Answer is D

Choice A: Nasogastric tube insertion may be indicated in the management of a client with peptic ulcer disease (PUD) to assess bleeding, relieve gastric distention, or administer medications. However, in this scenario, the client's presentation with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia suggests a potentially life-threatening condition that requires immediate intervention beyond nasogastric tube insertion.

Choice B: Iced saline lavage is not a standard procedure for managing peptic ulcer disease (PUD) or its complications. It is not the immediate intervention required for the client's presentation.

Choice C: Administration of pantoprazole (Protonix) IV, a proton pump inhibitor, is a relevant intervention for managing peptic ulcer disease (PUD), but it may not be the most immediate action needed for a client with sudden severe abdominal pain, hypotension, and tachycardia. More urgent interventions are required.

Choice D: Emergency abdominal surgery is the most appropriate and immediate intervention for a client with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia. These signs and symptoms may indicate a perforated peptic ulcer, which is a surgical emergency requiring prompt exploration and repair of the perforation to prevent peritonitis and sepsis.

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Correct Answer is D

Explanation

Choice A: Medication teaching concerning thyroid hormones is not directly related to the care of a client with pheochromocytoma. Pheochromocytoma primarily involves the adrenal glands and excessive secretion of catecholamines.

Choice B: Referral to a hospice is not a relevant goal for a client diagnosed with pheochromocytoma. Hospice care is typically provided for clients with advanced, life- limiting illnesses, and pheochromocytoma can often be treated or managed.

Choice C: Psychological counseling to address body image changes is not the primary goal for a client with pheochromocytoma. While psychological support may be beneficial, the primary focus should be on addressing the physiological effects and treatment of pheochromocytoma.

Choice D: Preoperative and postoperative teaching for adrenalectomy is the most relevant goal for a client with pheochromocytoma. Surgical removal of the tumor (adrenalectomy) is the primary treatment for pheochromocytoma, and education about the procedure, preparation, and postoperative care is essential to ensure a successful outcome.

A. "How long has she seemed depressed?" B. "Has she ever attempted suicide before?" C. "Has anything occurred which might have precipitated this suicide attempt?" D. "How did she attempt to kill herself?"

Correct Answer is D

Explanation

Choice A: Inquiring about how long the adolescent has seemed depressed is important for assessing the client's overall mental health history, but it may not provide immediate information about the seriousness of the suicide attempt.

Choice B: Asking about any previous suicide attempts is important for understanding the client's history and risk factors, but it does not directly assess the seriousness of the current attempt.

Choice C: Inquiring about any precipitating events is essential for understanding the context and triggers for the suicide attempt, but it may not be the most immediate question to assess seriousness.

Choice D: Asking "How did she attempt to kill herself?" is the most crucial question to assess the seriousness of the suicide attempt. It provides critical information about the method used, which can help determine the lethality of the attempt and guide immediate interventions and safety measures.

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Naxlex Comprehensive Predictor Exams

When the nurse is designing a plan of care for a client diagnosed with pheochromocytoma, a goal statement should be prepared that relates to which topic?

Correct Answer is D

Explanation

A 16-year-old female client who attempted suicide that morning is admitted to the psychiatric unit. To determine the seriousness of the adolescent's suicide attempt, which question is most important for the nurse to ask the family?

Correct Answer is D

Explanation

A 37-year-old client diagnosed with chronic kidney disease (CKD) is being treated for renal osteodystrophy. Which nursing diagnosis is most likely to be included in this client's plan of care?

The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which finding(s) should alert the nurse that further assessment is needed? (Select all that apply.)

During assessment of a 2-month-old infant, the nurse notices a bluish-black discoloration over the lumbosacral area. Which action should the nurse take?

A client has a serum sodium level of 155 mEq/L (155 mmol/L). The nurse should encourage the client to make which selection from the lunch menu. Reference Range Sodium [Reference Range: Adult 136 to 145 mEq/L or 136 to 145 mmol/L]

An adult client receives a prescription for permethrin (Acticin Cream 5%) to treat an infestation of scabies. The nurse instructs the client to massage the cream into the skin from the head to the soles of the feet, avoiding the eyes. Which additional instruction should the nurse provide?

A client who is receiving antineoplastic chemotherapy has lost 25% of total body weight and is having difficulty eating because of stomatitis. In planning care for this client, which diet should the nurse recommend?

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?