A nurse assessing a client determines that he is in the compensatory stage of shock. Which of the following findings support this conclusion?

Choice A reason: Checking blood glucose is important in stroke management to rule out hypoglycemia mimicking stroke symptoms, but it is not the first action. A neurological exam identifies stroke signs like weakness or speech deficits, guiding urgent interventions like thrombolytics. Glucose testing follows to ensure metabolic causes are addressed after confirming neurological deficits.

Choice B reason: Performing a neurological exam is the first priority in suspected stroke to identify focal deficits, such as hemiparesis, aphasia, or altered consciousness. This confirms the diagnosis and determines eligibility for time-sensitive treatments like thrombolytics or thrombectomy. Rapid assessment using tools like the NIH Stroke Scale ensures timely intervention to minimize brain damage.

Choice C reason: Obtaining a CT scan is critical to differentiate ischemic from hemorrhagic stroke but follows a neurological exam. The exam confirms stroke symptoms, ensuring the scan is warranted. CT scans guide treatment decisions but are not the first step, as clinical assessment drives the urgency and direction of diagnostic imaging.

Choice D reason: Monitoring blood pressure is important in stroke, as hypertension can worsen outcomes, but it is not the first action. A neurological exam identifies stroke symptoms, prioritizing rapid diagnosis and treatment. Blood pressure management follows to optimize cerebral perfusion, especially if thrombolytics are considered, but initial assessment takes precedence.

Choice A reason: Helicobacter pylori infection is a major risk factor for peptic ulcer disease. It damages the gastric mucosa by producing urease, which neutralizes stomach acid, and toxins that cause inflammation and ulceration. Chronic infection leads to gastritis and weakens the mucosal barrier, increasing susceptibility to acid-induced damage and ulcer formation in the stomach or duodenum.

Choice B reason: Spicy foods and a laid-back lifestyle are not established risk factors for peptic ulcer disease. Spicy foods may irritate existing ulcers but do not cause them. A laid-back lifestyle, implying low stress, does not contribute to ulceration, as stress is a minor factor compared to H. pylori or NSAIDs. These are myths not supported by scientific evidence.

Choice C reason: An active lifestyle does not increase the risk of peptic ulcer disease and may even promote overall health. Smoking, however, is a risk factor, as it impairs mucosal blood flow and healing, but this option pairs it with an active lifestyle, which dilutes its relevance. Smoking alone would be a stronger risk factor, making this combination less accurate.

Choice D reason: Alcohol abuse and smoking are significant risk factors for peptic ulcer disease. Alcohol irritates the gastric mucosa, increasing acid production and weakening the mucosal barrier. Smoking reduces mucosal blood flow, impairs healing, and enhances H. pylori-related damage. Together, they synergistically increase the risk of developing gastric or duodenal ulcers over time.