What is the primary clinical manifestation of greatest concern with a peptic ulcer?

pulmonary embolism

bleeding

bowel obstruction

hepatomegaly

Answer and Explanation

The Correct Answer is B

Choice A reason:
Pulmonary embolism is not a typical complication of a peptic ulcer. While serious, pulmonary embolism is unrelated to the gastrointestinal tract and would not arise from ulceration of the stomach or duodenum. It is therefore not the correct answer to the question posed.
Choice B reason:
Bleeding is the primary clinical manifestation of greatest concern with a peptic ulcer. Ulcers can erode into blood vessels, leading to gastrointestinal hemorrhage, which may present as hematemesis (vomiting blood) or melena (black, tarry stools). Severe bleeding can result in hypovolemic shock and requires immediate medical intervention, such as endoscopic hemostasis, blood transfusions, or surgery. This makes bleeding the most critical concern among the options listed.
Choice C reason:
Bowel obstruction can occur as a complication of peptic ulcer disease but is less common compared to bleeding. It arises from scarring or swelling near the pylorus, leading to gastric outlet obstruction. While serious, it is not the most frequent or immediate concern in the context of peptic ulcers.
Choice D reason:
Hepatomegaly, or enlargement of the liver, is unrelated to peptic ulcer disease. This symptom is typically associated with liver conditions such as cirrhosis, hepatitis, or cancer, and does not result from ulcer pathology.

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Correct Answer is C

Explanation

Choice A reason:
Left ventricular heart failure can cause severe chest pain and elevated cardiac enzymes but is not as directly associated with elevated cardiac troponin levels as a myocardial infarction. The presence of elevated troponin levels specifically indicates myocardial cell injury, which is most consistent with an MI.

Choice B reason:
Unstable angina involves chest pain that is not relieved by rest and may indicate a higher risk for an MI. However, it typically does not result in elevated cardiac troponin levels unless there is actual myocardial damage. Elevated troponin is a marker for myocardial infarction rather than just unstable angina.

Choice C reason:
Myocardial infarction (MI) is the correct answer. Elevated levels of cardiac troponin are a key indicator of myocardial infarction as they reflect heart muscle damage. The patient's severe chest pain and elevated troponin levels strongly suggest that an MI has occurred.

Choice D reason:
Prinzmetal angina, or variant angina, is characterized by chest pain caused by coronary artery spasms. While it can cause significant pain, it does not typically lead to elevated cardiac troponin levels unless it results in myocardial damage, which is less common than in an MI.

A. Nifedipine is a dihydropyridine and therefore only affects the movement of calcium into the cells of vascular smooth muscle. B. Verapamil and Diltiazem affect the movement of calcium into the cells of both the heart and blood vessels. C. All three medications have antidysrhythmic properties. D. Nifedipine affects the movement of calcium into the cells of both the heart and blood vessels.

Correct Answer is B

Explanation

Choice A reason:
Nifedipine is a dihydropyridine calcium channel blocker that primarily affects vascular smooth muscle, leading to vasodilation. While it can lower blood pressure, it does not significantly affect cardiac conduction or rhythm, which is why it is not used as an antidysrhythmic.

Choice B reason:
Verapamil and Diltiazem are calcium channel blockers that affect the movement of calcium into the cells of both the heart and blood vessels. They have a significant impact on cardiac conduction and can be used to treat arrhythmias by slowing down the heart rate and reducing the conduction through the atrioventricular node.

Choice C reason:
Not all three medications have antidysrhythmic properties. Only Verapamil and Diltiazem are effective as antidysrhythmic agents due to their effects on cardiac conduction. Nifedipine does not share these properties and is therefore not used to manage arrhythmias.

Choice D reason:
Nifedipine primarily affects the movement of calcium into the cells of vascular smooth muscle, not the heart. Its main use is in the treatment of hypertension and angina, where its vasodilatory effects are beneficial. It does not significantly impact cardiac rhythm or conduction like Verapamil and Diltiazem do.

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What is the primary clinical manifestation of greatest concern with a peptic ulcer?

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Naxlex Comprehensive Predictor Exams

A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of cardiac troponin. Based upon the lab findings, the nurse suspects which of the following has occurred:

Correct Answer is C

Explanation

Why are Verapamil and Diltiazem considered to be antidysrhythmic medications but Nifedipine is not, if all three medications are calcium channel blockers?

Correct Answer is B

Explanation

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