Nokea
The nurse is administering morning medications at 0730. Which medication should have priority?
- A. A proton pump inhibitor.
- B. A nonnarcotic analgesic.
- C. A histamine receptor antagonist.
- D. A mucosal barrier agent.
Correct Answer: A
Rationale: Proton pump inhibitors (PPIs) are the mainstay treatment for GERD, reducing acid production and preventing esophageal damage. They should be prioritized over analgesics, histamine receptor antagonists, or mucosal barrier agents, which are less critical for immediate symptom control and healing.
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The client is two (2) hours post colonoscopy. Which assessment data warrant immediate intervention by the nurse?
- A. The client has a soft, nontender abdomen.
- B. The client has a loose, watery stool.
- C. The client has hyperactive bowel sounds.
- D. The client's pulse is 104 and BP is 98/60.
Correct Answer: D
Rationale: Tachycardia (pulse 104) and low BP (98/60) suggest possible bleeding or hypovolemia post-colonoscopy, requiring immediate intervention. A soft abdomen, watery stool, and hyperactive bowel sounds are expected.
Which oral medication should the nurse question before administering to the client with peptic ulcer disease?
- A. E-mycin, an antibiotic.
- B. Prilosec, a proton pump inhibitor.
- C. Flagyl, an antimicrobial agent.
- D. Tylenol, a nonnarcotic analgesic.
Correct Answer: A
Rationale: E-mycin (erythromycin) can irritate the gastric mucosa and exacerbate peptic ulcer disease, so it should be questioned. Prilosec and Flagyl treat ulcers (especially H. pylori-related), and Tylenol is safe for pain relief.
Which data should the nurse report to the healthcare provider when assessing the oral cavity of an elderly client?
- A. The client's tongue is rough and beefy red.
- B. The client's tonsils are +1 on a grading scale.
- C. The client's mucosa is pink and moist.
- D. The client's uvula rises with the mouth open.
Correct Answer: A
Rationale: A rough, beefy red tongue may indicate vitamin B12 deficiency or glossitis, warranting HCP notification. Normal tonsil size, pink/moist mucosa, and uvula movement are expected findings.
The client with appendicitis asks the nurse for a laxative to help relieve her constipation. The nurse explains to her that laxatives are not given to persons with possible appendicitis. What is the primary reason for this?
- A. Laxatives will decrease the spread of infection.
- B. Laxatives are not given prior to any type of surgery.
- C. The client does not have true constipation. She only has pressure.
- D. Laxatives could cause a rupture of the appendix.
Correct Answer: D
Rationale: Laxatives increase peristalsis, which could rupture an inflamed appendix, leading to peritonitis.
The nurse is taking a hospital admission history for the 40-year-old client. The nurse is concerned about possible acute pancreatitis when the client makes which statement?
- A. “I have sudden-onset intense pain in my upper left abdomen that goes to my back.”
- B. “I had persistent lower abdominal pain that now shifted to the lower right quadrant.”
- C. “My stools are loose and bloody, and I have cramping abdominal pain with spasms.”
- D. “I have this mild pain in my upper abdomen, but I have been vomiting forcefully a lot.”
Correct Answer: A
Rationale: A. The predominant symptom of acute pancreatitis is severe, deep or piercing, continuous or steady abdominal pain in the upper left quadrant. The pain may radiate to the back because of the retroperitoneal location of the pancreas. Middle-aged individuals are at increased risk for developing acute pancreatitis. B. Abdominal pain located mainly in the right lower quadrant may be a symptom of appendicitis (not pancreatitis). Appendicitis is more common in younger adults. C. Bloody diarrhea and colicky abdominal pain are symptoms of IBD, also more common in young adults. D. Upper abdominal pain and projectile vomiting are symptoms of gastric outlet obstruction or another GI disorder and not pancreatitis.