A nurse in a provider's office is caring for a client who has a medical history of rheumatoid arthritis and psoriasis, and a family history of heart disease and arthritis. The client has a 60-year smoking history and denies alcohol or other substance use. They are positive for Helicobacter pylori and are on medication for peptic ulcer disease (PUD). Which three findings from the client's medical record increase their risk for peptic ulcer disease?
Family history
Smoking history
Alcohol use
Positive for H. pylori
NSAID use
Correct Answer : B,D,E
Choice A rationale
While family history can contribute to the risk of developing certain conditions, it is not a direct risk factor for peptic ulcer disease.
Choice B rationale
A long-term smoking history is a known risk factor for peptic ulcer disease as it can increase gastric acid secretion and reduce the production of substances that protect the stomach lining.
Choice C rationale
The client denies alcohol use; therefore, it is not a contributing risk factor in this case. However, alcohol use is generally a risk factor for PUD due to its irritating effect on the stomach lining.
Choice D rationale
Being positive for Helicobacter pylori is one of the strongest risk factors for peptic ulcer disease. This bacterium damages the protective mucosal layer of the stomach and duodenum, leading to chronic inflammation and allowing acid to injure the underlying tissue. It is the leading cause of most gastric and duodenal ulcers worldwide.
Choice E rationale
NSAID use is a well-established risk factor for peptic ulcer disease as these medications can disrupt the protective lining of the stomach, leading to ulcers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E","F"]
Explanation
Choice A rationale
Restricting airplane travel is not typically necessary for patients on hemodialysis unless there are specific medical concerns or complications related to their condition.
Choice B rationale
Driving restrictions are not a standard restriction for patients with end-stage kidney disease unless there are other underlying conditions that impair the ability to drive safely.
Choice C rationale
Time constraints are a significant factor for patients on hemodialysis due to the frequent and lengthy treatment sessions, which can limit their availability for other activities.
Choice D rationale
Limiting social activities to twice a week is not a standard recommendation; social interactions are important for mental health and should be encouraged as much as the patient's health allows.
Choice E rationale
Restricting foods high in potassium, sodium, and phosphorus is crucial for patients with end-stage kidney disease to help manage electrolyte levels and prevent complications.
Choice F rationale
Restricting fluid intake is essential for patients on hemodialysis to prevent fluid overload, which can lead to heart failure and other serious health issues.
Correct Answer is D
Explanation
Choice A rationale
Jaundice of the sclera is indicative of hyperbilirubinemia, which can occur in various liver diseases but is not specifically associated with Grey Turner's sign or pancreatitis.
Choice B rationale
Bluish discoloration of the periumbilical area, known as Cullen's sign, is another indicator of severe pancreatitis but is distinct from Grey Turner's sign, which specifically refers to the flank area.
Choice C rationale
Left abdominal pain that occurs with movement may be a symptom experienced by patients with pancreatitis, but it is not referred to as Grey Turner's sign, which is a physical finding rather than a symptom.
Choice D rationale
Grey Turner's sign is characterized by bluish discoloration of the flank area. It is a sign of retroperitoneal hemorrhage, which can occur in severe cases of pancreatitis due to the spread of pancreatic enzymes to surrounding tissues, leading to localized bleeding.
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