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The nurse is assigned to four clients who were diagnosed with gastric ulcers. Which client should be the nurse’s priority when monitoring for GI bleeding?
- A. The 40-year-old client who is positive for Helicobacter pylori (H. pylori)
- B. The 45-year-old client who drinks 4 ounces of alcohol a day
- C. The 70-year-old client who takes daily baby aspirin of 81 mg
- D. The 30-year-old pregnant client taking acetaminophen prn
Correct Answer: C
Rationale: A. The presence of H. pylori has not been proven to predispose to GI bleeding. B. Although alcohol is associated with gastric mucosal injury, its causative role in bleeding is unclear. C. It is most important for the nurse to monitor the 70-year-old client who is taking aspirin. The client has two risk factors for GI bleeding: age and taking aspirin. D. Pregnancy and acetaminophen usage do not predispose to GI bleeding.
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The client diagnosed with IBD is prescribed sulfasalazine (Asulfidine), a sulfonamide antibiotic. Which statement best describes the rationale for administering this medication?
- A. It is administered rectally to help decrease colon inflammation.
- B. This medication slows gastrointestinal (GI) motility and reduces diarrhea.
- C. This medication kills the bacteria causing the exacerbation.
- D. It acts topically on the colon mucosa to decrease inflammation.
Correct Answer: D
Rationale: Sulfasalazine reduces inflammation in IBD by acting topically on the colon mucosa, delivering its active component (mesalamine) to the inflamed areas. It is not primarily an antibiotic, does not slow motility, and is taken orally, not rectally.
The charge nurse has just received the shift report. Which client should the nurse see first?
- A. The client diagnosed with Crohn's disease who had two (2) semiformed stools on the previous shift.
- B. The elderly client admitted from another facility who is complaining of constipation.
- C. The client diagnosed with AIDS who had a 200-mL diarrhea stool and has elastic skin tissue turgor.
- D. The client diagnosed with hemorrhoids who had some spotting of bright red blood on the toilet tissue.
Correct Answer: C
Rationale: The AIDS client with diarrhea and elastic turgor may still be dehydrated, requiring immediate assessment for electrolyte imbalances. Crohn’s stools, constipation, and hemorrhoid bleeding are less urgent.
The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement?
- A. Provide a low-residue diet.
- B. Rest the client's bowel.
- C. Assess vital signs daily.
- D. Administer antacids orally.
Correct Answer: B
Rationale: During an acute exacerbation of ulcerative colitis, resting the bowel (often via NPO status or clear liquids) reduces inflammation and irritation. A low-residue diet is used in stable phases, daily vital signs are routine, and antacids are irrelevant.
The nurse is performing an admission assessment on a client diagnosed with GERD. Which signs and symptoms would indicate GERD?
- A. Pyrosis, water brash, and flatulence.
- B. Weight loss, dysarthria, and diarrhea.
- C. Decreased abdominal fat, proteinuria, and constipation.
- D. Midepigastric pain, positive H. pylori test, and melena.
Correct Answer: A
Rationale: Pyrosis (heartburn), water brash (regurgitation of sour fluid), and flatulence are classic symptoms of GERD due to acid reflux and gas buildup. The other options include symptoms more associated with other conditions like peptic ulcer disease or systemic disorders.
The client presents to the emergency department experiencing frequent watery, bloody stools after eating some undercooked meat at a fast-food restaurant. Which intervention should be implemented first?
- A. Obtain a stool sample from the client.
- B. Initiate antibiotic therapy intravenously.
- C. Have the laboratory draw a complete blood count.
- D. Administer the antidiarrheal medication Lomotil.
Correct Answer: C
Rationale: Drawing a CBC assesses for infection or anemia due to bloody stools, guiding treatment. Stool samples, antibiotics, and antidiarrheals follow assessment.