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 ["A","C"]

Explanation

Choice A: Cooked cereal can be used as part of a gastrostomy tube feeding regimen for clients who require enteral nutrition.

Choice B: Lettuce is not typically used in gastrostomy tube feedings as it may not be well-tolerated in liquid form.

Choice C: Clear fat-free broth can be used as part of a gastrostomy tube feeding regimen for clients who require enteral nutrition.

Choice D: Brussels sprouts and nuts are not typically used in gastrostomy tube feedings as they may not be well-tolerated in liquid form.

A. Retract the needle into the syringe. B. Place syringe in a puncture-resistant container. C. Apply an adhesive bandage over the injection site. D. Remove disposable exam gloves.

Correct Answer is A,B,D,C

Explanation

Choice A: Retracting the needle into the syringe should be done before safely disposing of the syringe.

Choice B: Placing the syringe in a puncture-resistant container is the second step to ensure safe disposal of sharp objects.

Choice C: Applying an adhesive bandage over the injection site is the final step to address the bleeding and protect the site.

Choice D: Removing disposable exam gloves is the next step to prevent any contamination.

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Naxlex Comprehensive Predictor Exams

When conducting diet teaching for a client who is on a gastrostomy tube feeding, which foods should the nurse encourage the client use? (Select all that apply.)

Correct Answer is ["A","C"]

Explanation

After administering an injection, the nurse observes bleeding at the site. In what sequence should the nurse perform these actions? (Arrange with the first step on top and the last step on the bottom.)

Correct Answer is A,B,D,C

Explanation

The nurse is reviewing a nutrition plan with a client newly diagnosed with hypertension. Which statement by the client indicates an understanding of the Dietary Approaches to Stop Hypertension (DASH) diet?

The nurse instructs a client with Type 2 diabetes mellitus (DM) to avoid refined sugar and carbohydrates. Choosing which food indicates that the client understands the diet teaching?

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The nurse is caring for an older client with that is exhibiting signs of confusion. Which intervention should the nurse implement?

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