Pathophysiological changes associated with peptic ulcer disease may result in:
improved digestion.
decreased abdominal pain.
gastric hemorrhage.
increased production of intrinsic factor.
The Correct Answer is C
A. improved digestion.: The erosion of the protective mucosal layer and subsequent tissue damage actually impair the normal mechanical and chemical processes of the stomach. Ulceration leads to dyspepsia and delayed gastric emptying. It does not enhance the physiological breakdown of nutrients.
B. decreased abdominal pain.: Exposure of the underlying submucosa to gastric acid typically causes significant epigastric distress or burning sensations. While some food may temporarily buffer acid, the disease progression generally increases nociceptive signaling. It is a primary cause of chronic abdominal discomfort.
C. gastric hemorrhage.: Ulcers that erode into the muscularis mucosae can breach the walls of submucosal blood vessels. This results in occult bleeding or massive hematemesis and melena, depending on the vessel size. This represents a frequent and life-threatening complication of the disease.
D. increased production of intrinsic factor.: Chronic inflammation, particularly from H. pylori or autoimmune gastritis, often leads to the atrophy of parietal cells. This causes a decrease in the secretion of this glycoprotein required for Vitamin B12 absorption. It does not stimulate secretory upregulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. gastroesophageal reflux.: This typically presents as retrosternal burning or pyrosis that may worsen when lying supine. While high-fat meals can trigger it, the pain is usually midline and substernal. It does not typically localize to the right upper quadrant.
B. appendicitis.: This inflammatory process begins with periumbilical pain that subsequently migrates to the right lower quadrant at McBurney's point. It is not triggered by the ingestion of fatty foods or biliary stimulation. The anatomical location is inferior to the RUQ.
C. cholecystitis.: Ingestion of lipids triggers cholecystokinin release, causing gallbladder contraction against an obstructing stone. This results in visceral pain in the right upper quadrant that often radiates to the right scapula. Normal cardiac findings support a biliary etiology.
D. a myocardial infarction.: While inferior wall MI can present with epigastric pain, a normal electrocardiogram makes this diagnosis less likely in an acute setting. The specific trigger of high-fat meals and RUQ localization points toward a gallbladder pathology. It is a cardiac emergency.
Correct Answer is D
Explanation
A. Melena. : This refers to the passage of black, tarry stools resulting from the oxidation of hemoglobin. It indicates upper gastrointestinal bleeding where blood has been digested by gastric enzymes. It describes a fecal finding rather than an emetic one.
B. Steatorrhea. : This clinical finding involves the presence of excess fat in the feces due to malabsorption. Stools appear pale, oily, and are typically foul-smelling. It is associated with pancreatic or biliary insufficiency, not the presence of blood.
C. Gastroenteritis. : This is a generalized inflammatory condition of the stomach and intestinal lining. It typically presents with nausea, vomiting, and diarrhea due to infection or irritation. It is a disease state rather than a specific term for blood.
D. Hematemesis. : This term specifically describes the vomiting of blood, which may be bright red or coffee-ground in appearance. Bright red color indicates acute, active bleeding proximal to the ligament of Treitz. This is the correct clinical sign for bloody vomitus.
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