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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Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A: Broccoli is not typically restricted before a gallbladder ultrasound.

Choice B: Instructing the client to avoid consuming a milkshake the night before the test is important because a fatty meal can affect gallbladder contraction and visualization during the ultrasound.

Choice C: A garden salad is not typically restricted before a gallbladder ultrasound.

Choice D: Coffee is not typically restricted before a gallbladder ultrasound.

A. Weight loss history and body surface area (BSA). B. Body mass index (BMI) and serum albumin level. C. Triceps skin fold and mid-arm circumference. D. 24-hour food recall, food preferences, and allergies.

Correct Answer is B

Explanation

Choice A: Weight loss history and body surface area (BSA) are relevant factors to consider when assessing nutritional status, but they are not the most indicative parameters on their own.

Choice B: Body mass index (BMI) and serum albumin level are two of the most indicative parameters for assessing nutritional status. BMI provides information about body weight relative to height, while serum albumin level is a common marker of nutritional status and protein intake.

Choice C: Triceps skinfold and mid-arm circumference are anthropometric measurements that can provide additional information about muscle and fat stores in the body, but they are not as widely used or as indicative as BMI and serum albumin level.

Choice D: 24-hour food recall, food preferences, and allergies are important to assess but do not provide immediate indicators of nutritional status. They are valuable for understanding dietary habits and preferences.

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Naxlex Comprehensive Predictor Exams

The nurse is preparing a client for ultrasonography of the gallbladder. What should the nurse instruct the client to avoid consuming the night before the test?

Correct Answer is B

Explanation

The nurse is admitting an older client with possible malnutrition. Which parameters are most indicative of the client's nutritional status?

Correct Answer is B

Explanation

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