The occupational health nurse is completing an assessment on an employee who has a history of type 2 diabetes, coronary artery disease, unstable angina, and gastroesophageal reflux disease (GERD). Which statement(s) should prompt the nurse to refer the employee for PROMPT evaluation of their cardiac status? (SELECT ALL THAT APPLY)

Most nights I sleep in the family room recliner because I get short of breath lying flat.

I have been waking up at night sweating and wet all over.

Lately, I wake up at night with a burning feeling in my chest.

I have been experiencing headaches immediately after eating.

Immediately after eating I feel sleepy and want to go to bed.

Answer and Explanation

Correct Answer : A,B,C

Choice A rationale

Orthopnea, or shortness of breath when lying flat, is a classic symptom of heart failure. Patients often need to sleep in an elevated position to ease breathing, which indicates a potential worsening of heart function that needs urgent evaluation.

Choice B rationale

Night sweats and overall diaphoresis can be symptoms of myocardial infarction (heart attack) or other acute cardiac conditions. This requires prompt medical assessment to prevent further cardiac events or complications.

Choice C rationale

Nocturnal angina, or chest pain at night, can indicate a severe underlying cardiac issue such as unstable angina or coronary artery disease. This symptom warrants immediate cardiac evaluation to manage and mitigate potential risks.

Choice D rationale

Headaches after eating are not typically associated with cardiac issues but may relate to other conditions such as hypoglycemia or migraines. This symptom alone does not usually prompt immediate cardiac evaluation.

Choice E rationale

Postprandial somnolence, or sleepiness after eating, is generally not linked directly to cardiac status but rather to digestive or metabolic processes. This symptom is less likely to require urgent cardiac assessment. .

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Correct Answer is ["A","D","E"]

Explanation

Choice A rationale

Avoid aspirin products. Aspirin can exacerbate gastrointestinal bleeding and irritation in patients with duodenal ulcers.

Choice B rationale

Choose regular coffee instead of herbal tea. Caffeine, found in regular coffee, can increase stomach acid production and should generally be avoided by those with ulcers.

Choice C rationale

Eat a diet rich in dairy products. Dairy products can increase stomach acid production and may worsen ulcer symptoms.

Choice D rationale

Start a smoking cessation program. Smoking can impair healing and increase stomach acid production, making it important to quit smoking for ulcer management.

Choice E rationale

Avoid ibuprofen for pain. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach lining and exacerbate ulcers.

A. 10-20 liquid, bloody stools daily. B. Hard, rigid abdomen. C. Oral temperature of 99.5°F. D. Urinary stress incontinence.

Correct Answer is A

Explanation

Choice A rationale

Ulcerative colitis commonly presents with 10-20 liquid, bloody stools daily. This is due to inflammation and ulceration of the colon lining, leading to frequent diarrhea mixed with blood and mucus.

Choice B rationale

A hard, rigid abdomen is more indicative of peritonitis, a potential but less common complication of ulcerative colitis. It is not a primary symptom of the disease.

Choice C rationale

An oral temperature of 99.5°F could indicate a low-grade fever, which might occur with ulcerative colitis but is nonspecific and not as characteristic as the frequent bloody stools.

Choice D rationale

Urinary stress incontinence is not a typical symptom of ulcerative colitis. It pertains more to urinary tract issues rather than gastrointestinal conditions.

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Naxlex Comprehensive Predictor Exams

The nurse is planning a teaching session for a patient with a duodenal ulcer. Which instructions are MOST important to include in the teaching? (SELECT ALL THAT APPLY)

Correct Answer is ["A","D","E"]

Explanation

Which sign or symptom would the nurse expect to find in a client diagnosed with ulcerative colitis?

Correct Answer is A

Explanation

Which finding would most concern the nurse when caring for a client diagnosed with a bowel obstruction?

The nurse is assessing the status of a post-operative client in the PACU. The nurse should be most concerned with which assessment finding?

A client asks a nurse about the use of vitamin C to prevent urinary tract infection. The nurse states that the function of vitamin C is to:

During an intake assessment, a client with antisocial personality disorder uses profanity, sexual orientation slurs, and threatens to spit at the nurse. What is the MOST appropriate statement or querry for the nurse to make about the client's behavior?

The nurse has discussed activity as a way to lose weight with a group of overweight clients. Which is the BEST cardiovascular exercise plan for weight loss?

The nurse understands that the most complete explanation of obesity is that it is the result of:

The client, hospitalized with an exacerbation of ulcerative colitis, is prescribed mesalamine rectally via enema. The client states that an enema is disgusting and wants to know why the medication can't be given orally. The nurse's best response would be:

The nurse is assessing an alert and independent older client for the risk of malnutrition. What item is most appropriate to assess?