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Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBC's.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Your patient with peritonitis is NPO and complaining of thirst. What is your priority?
- A. Increase the I.V. infusion rate.
- B. Use diversion activities.
- C. Provide frequent mouth care.
- D. Give ice chips every 15 minutes.
Correct Answer: C
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Your patient Maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?
- A. Calcium carbonate (Tums)
- B. Famotidine (Pepcid)
- C. Misoprostol (Cytotec)
- D. Sucralfate (Carafate)
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Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?
- A. Peristalsis.
- B. Gastric acidity.
- C. Gastric motility.
- D. Gastric pH.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You're patient, post-op drainage of a pelvic abscess secondary to diverticulitis, begins to cough violently after drinking water. His wound has ruptured and a small segment of the bowel is protruding. What's your priority?
- A. Ask the patient what happened, call the doctor, and cover the area with a water-soaked bedsheet.
- B. Obtain vital signs, call the doctor, and obtain emergency orders.
- C. Have a CAN hold the wound together while you obtain vital signs, call the doctor and flex the patient's knees.
- D. Have the doctor called while you remain with the patient, flex the patient's knees, and cover the wound with sterile towels soaked in sterile saline solution.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBCs.
Correct Answer: C
Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.