Which condition(s) would cause the nurse to hold a PRN order for magnesium hydroxide (Milk of Magnesia)?

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.

Choice A reason: The option that the patient "cannot be treated" is incorrect because Pneumocystis carinii pneumonia (PCP) in HIV-positive patients can be treated with medications such as trimethoprim-sulfamethoxazole (TMP-SMX). There are also preventive measures and treatments available for individuals with HIV/AIDS to manage PCP and improve their health outcomes. Thus, this option is not accurate for the scenario described.
Choice B reason: The diagnosis of Pneumocystis carinii pneumonia (PCP) in an HIV-positive patient strongly indicates that the patient has progressed to AIDS. AIDS, or acquired immunodeficiency syndrome, is diagnosed when an individual with HIV develops certain opportunistic infections or their CD4 cell count drops below a critical level. PCP is one of the most common opportunistic infections seen in AIDS patients, signifying severe immune system compromise due to the advanced stage of HIV infection. This makes option B the correct answer.
Choice C reason: The option stating that the patient "has less than 2 years to live" is incorrect because it is not a definitive prognosis for patients with PCP or AIDS. With appropriate medical treatment and adherence to antiretroviral therapy (ART), HIV-positive individuals, even those diagnosed with AIDS, can live longer and healthier lives. Advances in medical care have significantly improved the life expectancy and quality of life for people living with HIV/AIDS. Therefore, this option is not accurate for this scenario.
Choice D reason: The option that the patient "was an intravenous drug user" is incorrect because PCP can affect any HIV-positive individual, regardless of their drug use history. While intravenous drug use is a known risk factor for HIV transmission, it is not directly related to the development of PCP. PCP is caused by a weakened immune system due to HIV progression, not the method of HIV transmission. Thus, this option does not appropriately address the diagnosis of PCP.