Which patient should the nurse assess first after receiving a change-of-shift report?

A patient with a scheduled physical therapy session in 1 hour.

A patient with a routine follow-up appointment for a non-urgent condition.

A patient with altered mental status and confusion.

A patient with moderate pleuritis and requesting pain medication.

Answer and Explanation

The Correct Answer is C

A. While this patient is scheduled for a physical therapy session, it is not an urgent concern that would require immediate attention.
B. A routine follow-up appointment for a non-urgent condition can be managed at a later time and does not take priority over more acute concerns.
C. A patient with altered mental status and confusion should be assessed first. This could indicate a serious underlying issue such as infection, hypoxia, or a neurological condition. Altered mental status in any patient warrants immediate attention to prevent further complications.
D. Although the patient with pleuritis is in pain, moderate pleuritis is typically not an urgent condition, and pain management can be provided after more pressing concerns are addressed.

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Correct Answer is D

Explanation

A. Chronic alcohol consumption can contribute to ulcers but is not the primary cause of duodenal ulcers. It can increase stomach acid and irritate the mucosal lining.
B. High intake of spicy foods is often blamed for ulcers, but it is not a direct cause. Spicy foods may exacerbate symptoms but do not cause ulcers.
C. Inadequate fiber intake is not a significant factor in the development of duodenal ulcers. Diet can influence overall digestive health but is not the main cause.
D. Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen, are a leading cause of duodenal ulcers. They inhibit prostaglandin production, which protects the mucosal lining of the stomach and duodenum, leading to ulcer formation and increased risk of bleeding.

A. "I will try not to gain weight." B. "I will sleep with the head of my bed elevated." C. "I will drink less fluid." D. "I will consume less caffeine and fewer spicy foods." E. "I will lie down for one half hour after meals."

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

Explanation

A. Maintaining a healthy weight is important in managing a hiatal hernia. Excess weight can increase abdominal pressure, which may worsen symptoms of acid reflux.
B. Sleeping with the head of the bed elevated helps prevent acid reflux and symptoms of heartburn associated with a hiatal hernia. Elevation reduces the risk of stomach contents moving into the esophagus during sleep.
C. Drinking less fluid is not a necessary dietary change for hiatal hernia management. However, clients should avoid consuming large amounts of fluid with meals, as this may exacerbate reflux symptoms.
D. Consuming less caffeine and fewer spicy foods is appropriate because both can irritate the esophagus and increase acid reflux. Caffeine and spicy foods are known to trigger symptoms in individuals with a hiatal hernia.
E. Lying down for one-half hour after meals is not recommended for clients with a hiatal hernia, as it can worsen symptoms of reflux. The client should be advised to wait at least 2–3 hours before lying down after eating.

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Which patient should the nurse assess first after receiving a change-of-shift report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 36-year-old patient with suspected gastrointestinal (GI) bleeding undergoes a diagnostic endoscopy which determines the site of bleeding is a duodenal ulcer. The nurse explains to the patient that bleeding ulcers are commonly related to which of the following:

Correct Answer is D

Explanation

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

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

Explanation

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The nurse is changing the subclavian dressing of a client who is receiving total parenteral nutrition. When assessing the catheter insertion site, the nurse noticed the presence of a yellow drainage from around the sutures that are anchoring the catheter. Which actions should the nurse take first?

A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

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The nurse is preparing a teaching plan for a patient being discharged after an acute episode of upper G.I. bleeding. What important information should the teaching plan include? Select all that apply.