The client with peptic ulcer disease is scheduled for a pyloroplasty. The client asks the nurse about the procedure. The nurse plans to respond knowing that a pyloroplasty involves:
- A. Cutting the vagus nerve
- B. Removing the distal portion of the stomach
- C. Removal of the ulcer and a large portion of the cells that produce hydrochloric acid
- D. An incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The client with ascites is scheduled for a paracentesis. The nurse is assisting the physician in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?
- A. Supine
- B. Left side-lying
- C. Right side-lying
- D. Upright position.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?
- A. Neutralize acid
- B. Reduce acid secretions
- C. Stimulate gastrin release
- D. Protect the mucosal barrier
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The hospitalized client with gastroesophageal reflux disease is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions?
- A. Supine with the head of the bed flat
- B. On the stomach with the head flat
- C. On the left side with the head of the bed elevated 30 degrees
- D. On the right side with the head of the bed elevated 30 degrees
Correct Answer: C
Rationale: The discomfort of reflux is aggravated by positions that compress the abdomen and the stomach. Lying flat on the back (supine) or on the stomach (prone) after a meal can exacerbate symptoms. Similarly, lying on the right side can worsen reflux. The most appropriate position to alleviate discomfort in a client with gastroesophageal reflux disease is lying on the left side with the head of the bed elevated at a 30-degree angle. This position helps prevent the backflow of stomach contents into the esophagus, providing relief to the client.
The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery for 2 hours. The client begins to complain of increases abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen distended and bowel sounds are diminished. Which of the following is the most appropriate nursing intervention?
- A. Administer the prescribed pain medication.
- B. Notify the physician.
- C. Call and ask the operating room team to perform the surgery as soon as possible.
- D. Reposition the client and apply a heating pad on warm setting to the client's abdomen.
Correct Answer: B
Rationale: Based on the signs and symptoms presented in the question, the nurse should suspect peritonitis and should notify the physician. Administering pain medication is not an appropriate intervention. Heat should never be applied to the abdomen of a client with suspected appendicitis. Scheduling surgical time is not within the scope of nursing practice, although the physician probably would perform the surgery earlier than the prescheduled time.
To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine which body areas?
- A. Nail beds
- B. Skin on the back of the hand
- C. Hard palate of the mouth
- D. Soles of the feet
Correct Answer: C
Rationale: To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine the hard palate of the mouth. Jaundice is best assessed in the sclera; however, in dark-skinned patients, normal yellow pigmentation may be present in the sclera, making it difficult to detect jaundice. Inspection of the hard palate for a yellow color can confirm the presence of jaundice. Cyanosis is best observed in the nail beds, not indicative of jaundice. While skin on the palm of the hand can indicate jaundice, the back of the hand is not a typical area for assessment. Jaundice can be assessed on the soles of the feet in dark-skinned patients, but it is better visualized in the hard palate for accurate evaluation.