Peptic ulcer disease

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Question 1: A nurse is explaining the pathophysiology of peptic ulcer disease to a client. Which statement accurately describes the primary mechanism involved in the development of peptic ulcers?

Explanation

A) Correct. Peptic ulcers are most commonly associated with an overproduction of stomach acid, which can erode the protective mucosal lining.

B) Incorrect. Autoimmune reactions are not the primary cause of peptic ulcers. They are more closely linked to factors like acid production and bacterial infection.

C) Incorrect. While bacterial infection with H. pylori can contribute to the development of peptic ulcers, it is not the primary mechanism.

D) Incorrect. Inadequate blood supply to the stomach (ischemia) is not the primary mechanism of peptic ulcers. Acid overproduction and other factors play a more significant role.


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Question 2: A client with peptic ulcer disease asks the nurse about the role of Helicobacter pylori in the development of ulcers. How should the nurse respond?

Explanation

A) Correct. H. pylori is a bacterium that can directly damage the mucosal lining of the stomach, making it more susceptible to ulcers.

B) Incorrect. While H. pylori can lead to increased acid production, its primary mechanism in ulcer development is direct damage to the stomach lining.

C) Incorrect. H. pylori primarily affects the stomach lining, rather than weakening the overall immune system.

D) Incorrect. H. pylori does not primarily disrupt blood flow to the stomach. Its main impact is on the mucosal lining.


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Question 3: A nurse is discussing the role of prostaglandins in the pathophysiology of peptic ulcer disease. What is the nurse's best explanation?

Explanation

A) Incorrect. Prostaglandins do not promote acid production; in fact, they can help regulate acid secretion.

B) Correct. Prostaglandins are protective substances that play a crucial role in maintaining the integrity of the stomach lining and promoting mucosal defense mechanisms.

C) Incorrect. While prostaglandins have various roles in the immune system, they do not primarily stimulate the immune system to fight off bacterial infections in the stomach.

D) Incorrect. Prostaglandins do play a role in regulating blood flow, but their primary function in the stomach is mucosal protection, rather than preventing ischemia.


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Question 4: A client with peptic ulcer disease asks the nurse about the role of NSAIDs (nonsteroidal anti-inflammatory drugs) in ulcer development. How should the nurse respond?

Explanation

A) Incorrect. NSAIDs can lead to increased stomach acid production, but their primary mechanism in ulcer development is direct damage to the stomach lining.

B) Incorrect. NSAIDs do inhibit the action of prostaglandins, but this is not their primary role in ulcer development.

C) Correct. NSAIDs can directly damage the stomach lining, which makes it more vulnerable to the development of ulcers.

D) Incorrect. NSAIDs do not promote the growth of H. pylori. Their mechanism in ulcer development is related to direct damage to the stomach lining.


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Question 5:

A nurse is explaining the role of lifestyle factors in the pathophysiology of peptic ulcer disease. What information should the nurse include?

Explanation

A) Correct. Excessive stress and anxiety can stimulate the release of certain hormones that increase stomach acid production, potentially contributing to the development of peptic ulcers.

B) Incorrect. While spicy foods can exacerbate existing ulcers, they are not a major factor in the development of peptic ulcers.

C) Incorrect. While regular exercise has numerous health benefits, it is not a primary factor in preventing the development of peptic ulcers.

D) Incorrect. Alcohol consumption can contribute to the risk of peptic ulcers, particularly in excessive amounts, due to its potential to irritate the stomach lining and increase acid production.


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Question 6: A client is diagnosed with peptic ulcer disease and asks the nurse about the common risk factors for this condition. Which of the following responses should the nurse provide?

Explanation

A diet high in fiber and low in fat is generally considered healthy, but it is not specifically associated with an increased or decreased risk of peptic ulcer disease.

Choice B reason:

Smoking and alcohol consumption are indeed risk factors for peptic ulcer disease. They can contribute to the development and exacerbation of ulcers.

Choice C reason:

This statement is correct. The use of NSAIDs, such as aspirin and ibuprofen, and Helicobacter pylori infection are well-established risk factors for peptic ulcer disease.

Choice D reason:

While stress and emotional factors may exacerbate peptic ulcer symptoms, they are not the primary cause of the condition. The primary causes are H. pylori infection and the use of NSAIDs.


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Question 7: A client is experiencing epigastric pain, and the nurse suspects peptic ulcer disease. Which of the following should the nurse ask to further assess the client's symptoms?

Explanation

This question is relevant to assess for gastrointestinal symptoms, as changes in bowel movements may indicate issues with digestion or absorption.

Choice B reason:

Family history of heart disease is not directly related to peptic ulcer disease. However, it is essential for overall health assessment and risk factor identification.

Choice C reason:

Swelling or edema in the legs may be indicative of cardiovascular or circulatory issues, but it is not directly related to peptic ulcer disease.

Choice D reason:

The frequency of consuming high-fiber foods is not specifically related to peptic ulcer disease. However, diet history is essential for overall health assessment.


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Question 8: A client with peptic ulcer disease is prescribed a proton pump inhibitor (PPI) for acid suppression. The client asks the nurse about the best time to take the medication. Which of the following responses should the nurse provide?

Explanation

Taking the PPI with meals is not the most effective timing for acid suppression. PPIs work best when taken on an empty stomach.

Choice B reason:

This statement is correct. PPIs are most effective when taken on an empty stomach, about 30 minutes before a meal. This allows the medication to be absorbed and inhibit acid secretion in the stomach before food intake.

Choice C reason:

While consistency in medication timing is important, taking the PPI at any time of the day may not optimize its effectiveness.

Choice D reason:

Taking the PPI before bedtime may not provide the best acid suppression throughout the day. Taking it on an empty stomach before a meal is a more appropriate approach.


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Question 9: A nurse is caring for a client with peptic ulcer disease who is experiencing severe abdominal pain and vomiting. The healthcare provider orders an endoscopy to evaluate the extent of the ulceration. Which of the following explanations should the nurse provide to the client about the procedure?

Explanation

This statement describes an esophagoscopy, not an endoscopy. An endoscopy examines the upper gastrointestinal tract, including the stomach and duodenum.

Choice B reason:

This statement describes a colonoscopy, not an endoscopy. An endoscopy does not involve the lower gastrointestinal tract.

Choice C reason:

This statement describes an ultrasound, not an endoscopy. An endoscopy is a direct visualization procedure.

Choice D reason:

This statement is correct. An endoscopy involves inserting a fleble tube (endoscope) with a camera on the end through the mouth to examine the stomach and duodenum. It is a commonly used procedure to assess and diagnose peptic ulcer disease.


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Question 10:

A nurse is providing dietary education to a client with peptic ulcer disease. Which of the following dietary modifications should the nurse recommend to the client?

Explanation

Increasing the intake of spicy foods can exacerbate symptoms in a client with peptic ulcer disease, as they can irritate the stomach lining and increase acid production.

Choice B reason:

This statement is correct. Consuming small, frequent meals throughout the day can help reduce stomach distention and pressure, minimizing the symptoms of peptic ulcer disease.

Choice C reason:

Avoiding fluids with meals is not a standard recommendation for peptic ulcer disease. Adequate hydration is important, and drinking fluids with meals should not significantly affect stomach distention.

Choice D reason:

Citrus fruits and juices are acidic and can aggravate the stomach lining in a client with peptic ulcer disease. It is best to avoid or limit their consumption.


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Question 11: A client asks the nurse about the common risk factors for peptic ulcer disease. Which of the following responses should the nurse provide?

Explanation

This statement is correct. Family history and genetic factors are considered significant risk factors for peptic ulcer disease. A positive family history increases the likelihood of developing the condition.

Choice B reason:

Excessive consumption of fresh fruits and vegetables is not a risk factor for peptic ulcer disease. In fact, a diet rich in fruits and vegetables is generally associated with a lower risk of developing peptic ulcers.

Choice C reason:

Regular exercise and maintaining a healthy weight are not considered risk factors for peptic ulcer disease. These factors are essential for overall health but are not directly related to ulcer development.

Choice D reason:

While stress and emotional factors may exacerbate peptic ulcer symptoms, they are not the primary cause of the condition. The primary causes are Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs).


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Question 12: A nurse is providing education to a client recently diagnosed with peptic ulcer disease. Which of the following risk factors should the nurse emphasize as contributing to the development of the client's condition?

Explanation

Consumption of spicy foods and carbonated beverages may exacerbate symptoms in individuals with peptic ulcer disease, but they are not direct risk factors for developing the condition.

Choice B reason:

Regular consumption of yogurt and probiotics may promote gastrointestinal health, but they are not specifically risk factors for peptic ulcer disease.

Choice C reason:

Frequent use of antacids for heartburn relief may indicate underlying acid-related issues, but it is not a risk factor for peptic ulcer disease.

Choice D reason:

This statement is correct. Long-term use of NSAIDs is a well-established risk factor for peptic ulcer disease. NSAIDs can irritate the stomach lining and increase the risk of ulcer formation.


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Question 13: A client with peptic ulcer disease asks the nurse about the role of Helicobacter pylori in the development of the condition. Which of the following responses should the nurse provide?

Explanation

While Helicobacter pylori is a type of bacteria, it is not typically transmitted through food and does not directly cause peptic ulcer disease.

Choice B reason:

This statement is incorrect. Helicobacter pylori infection is indeed associated with an increased risk of peptic ulcer disease.

Choice C reason:

This statement is correct. Helicobacter pylori infection can weaken the stomach lining by producing substances that can damage the mucous layer, leading to increased vulnerability to acid and contributing to ulcer formation.

Choice D reason:

Helicobacter pylori infection is not caused by excessive consumption of spicy foods. The infection is typically acquired through person-to-person transmission, such as through contaminated water or food, and is unrelated to diet choices.


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Question 14: A client is prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic pain management. The nurse discusses the potential risk of peptic ulcer development with the client. Which of the following instructions should the nurse provide to minimize the risk?

Explanation

Taking NSAIDs with alcohol can increase the risk of gastrointestinal irritation and ulcer development. Alcohol should be avoided while taking NSAIDs.

Choice B reason:

Taking NSAIDs on an empty stomach can increase the risk of irritation and ulcer formation. To minimize this risk, NSAIDs should be taken with food or milk.

Choice C reason:

This statement is correct. Using NSAID patches or creams can provide pain relief without affecting the gastrointestinal tract, reducing the risk of peptic ulcer development.

Choice D reason:

While a high-fiber diet is generally beneficial for digestive health, it does not specifically counteract the effects of NSAIDs on the stomach lining.


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Question 15: A nurse is conducting a health screening for peptic ulcer disease risk factors in a community setting. Which of the following should the nurse include in the assessment?

Explanation

Frequent consumption of spicy foods or citrus fruits can irritate the stomach lining and increase the risk of peptic ulcer development.

Choice B reason:

Family history of lung diseases is not directly related to the risk of peptic ulcer disease. However, family history of peptic ulcers or gastrointestinal conditions is relevant for risk assessment.

Choice C reason:

Experiencing frequent headaches is not a direct risk factor for peptic ulcer disease. However, the nurse should assess for other risk factors and medical history during the health screening.

Choice D reason:

Regular physical exercise is important for overall health, but it is not a direct risk factor for peptic ulcer disease. The nurse should focus on risk factors related to diet, medication use, and other medical conditions.


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Question 16: A nurse is assessing a client suspected to have cholecystitis. Which of the following clinical manifestations should the nurse prioritize as a hallmark symptom of this condition?

Explanation

This statement is correct. Right upper quadrant abdominal pain that radiates to the right shoulder is a hallmark symptom of cholecystitis. The pain is typically sudden, severe, and constant, and it is often triggered by a fatty meal.

Choice B reason:

Left lower quadrant abdominal pain with rebound tenderness is not characteristic of cholecystitis. It may indicate other conditions, such as diverticulitis or appendicitis.

Choice C reason:

Midline epigastric pain aggravated by lying down is more indicative of gastroesophageal reflux disease (GERD) rather than cholecystitis.

Choice D reason:

Diffuse abdominal pain with a low-grade fever may be seen in various conditions, but it does not specifically point to cholecystitis.


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Question 17: A client with suspected cholecystitis presents with jaundice and dark-colored urine. Which of the following clinical manifestations should the nurse associate with these findings?

Explanation

Elevated white blood cell count may indicate inflammation or infection, but it is not directly related to jaundice and dark-colored urine, which are characteristic of increased bilirubin levels.

Choice B reason:

Impaired blood clotting is not directly related to jaundice and dark-colored urine. It may be a concern in liver disease but does not explain the specific manifestations mentioned in the question.

Choice C reason:

This statement is correct. Jaundice and dark-colored urine are indicative of increased bilirubin levels in the blood, which can occur in cholecystitis due to obstruction of the bile ducts.

Choice D reason:

Elevated serum amylase is more associated with pancreatitis rather than cholecystitis. It is not directly related to the clinical manifestations described.


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Question 18: A nurse is caring for a client diagnosed with acute cholecystitis. Which of the following symptoms should the nurse prioritize as a potential sign of a severe complication?

Explanation

Nausea and vomiting after meals are common symptoms in acute cholecystitis, but they do not indicate a severe complication. They are typical manifestations of gallbladder inflammation.

Choice B reason:

Mild right upper quadrant pain may be present in acute cholecystitis, but it does not suggest a severe complication.

Choice C reason:

Referred pain to the left shoulder (Kehr's sign) is a classic symptom of splenic rupture or other conditions involving the spleen, not directly related to cholecystitis.

Choice D reason:

This statement is correct. High fever and chills may indicate the presence of infection and sepsis, which can be severe complications of acute cholecystitis.


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Question 19: A client with chronic cholecystitis reports experiencing indigestion and bloating after meals. The nurse should recognize these symptoms as related to which of the following factors?

Explanation

This statement is correct. Chronic cholecystitis can lead to impaired gallbladder emptying, resulting in difficulties in digesting fats. Indigestion and bloating after meals are common manifestations of this problem.

Choice B reason:

Excessive stomach acid production is more associated with conditions like GERD or peptic ulcer disease, and it is not directly related to chronic cholecystitis.

Choice C reason:

Inflammation of the small intestine may cause abdominal pain, diarrhea, or malabsorption issues, but it is not specifically related to the symptoms described in the question.

Choice D reason:

Decreased production of pancreatic enzymes may lead to malabsorption issues and cause symptoms like diarrhea and steatorrhea. However, it is not the primary cause of indigestion and bloating after meals in chronic cholecystitis.


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Question 20:

A nurse is assessing a client suspected of having acute cholecystitis. Which of the following techniques should the nurse use to elicit Boas' sign?

Explanation

Percussion of the left lower quadrant is not relevant to assess for Boas' sign, which involves the right upper quadrant.

Choice B reason:

Deep palpation of the epigastric region is not associated with Boas' sign. Boas' sign involves palpation of the right subscapular area.

Choice C reason:

This statement is correct. Boas' sign is elicited by palpating the right upper quadrant during inspiration. The client may experience referred pain to the right subscapular area, indicating irritation of the phrenic nerve by the inflamed gallbladder.

Choice D reason:

Auscultation of the left upper quadrant is not relevant to assessing for Boas' sign, which involves the right upper quadrant.


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Question 21: A nurse is caring for a client suspected to have cholecystitis. Which of the following diagnostic tests should the nurse anticipate as the first-line imaging study to confirm the diagnosis?

Explanation

Abdominal CT scan can provide detailed images, but it is not typically the first-line imaging study for diagnosing cholecystitis. It may be used if complications are suspected.

Choice B reason:

MRI of the gallbladder can provide high-resolution images, but it is not the first-line imaging study for diagnosing cholecystitis.

Choice C reason:

This statement is correct. Abdominal ultrasound is the first-line imaging study for diagnosing cholecystitis. It can visualize the gallbladder, detect gallstones, and assess for signs of inflammation, such as gallbladder wall thickening and pericholecystic fluid.

Choice D reason:

ERCP is an invasive procedure used to visualize the biliary and pancreatic ducts, but it is not typically used as a first-line diagnostic test for cholecystitis.


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Question 22: A nurse is preparing a client for an abdominal ultrasound to evaluate suspected cholecystitis. The client asks the nurse about any special preparations needed for the procedure. Which of the following responses should the nurse provide?

Explanation

Fasting for 12 hours before an abdominal ultrasound is not necessary. Abdominal ultrasound does not require an empty stomach.

Choice B reason:

Drinking water is not typically restricted before an abdominal ultrasound. In fact, drinking water can improve image quality in some cases.

Choice C reason:

This statement is correct. There are no special preparations required for an abdominal ultrasound. The procedure is non-invasive and does not involve any special preparation or fasting.

Choice D reason:

Avoiding pain medications is not necessary before an abdominal ultrasound. The client can continue taking prescribed medications as usual.


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Question 23: A nurse is reviewing the laboratory results of a client with suspected cholecystitis. Which of the following findings is consistent with this condition?

Explanation

Elevated serum amylase levels are more indicative of pancreatitis, not cholecystitis.

Choice B reason:

Increased serum creatinine levels are suggestive of kidney dysfunction and are not directly related to cholecystitis.

Choice C reason:

This statement is correct. Cholecystitis is associated with inflammation and infection, which can lead to an elevated white blood cell count (leukocytosis).

Choice D reason:

Low serum bilirubin levels are not consistent with cholecystitis, which can cause obstructive jaundice and elevated bilirubin levels due to bile duct obstruction.


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Question 24: A client with suspected cholecystitis is scheduled for a hepatobiliary iminodiacetic acid (HIDA) scan. The client asks the nurse about the purpose of this test. Which of the following responses should the nurse provide?

Explanation

Visualizing blood flow in the liver is not the purpose of a HIDA scan. This type of scan is primarily used to assess the biliary system.

Choice B reason:

This statement is correct. A HIDA scan is used to assess the function and patency of the bile ducts. It involves injecting a radioactive tracer that is taken up by the liver and excreted into the bile. The scan can visualize the flow of bile and detect any obstruction or abnormality in the biliary system.

Choice C reason:

Evaluating the motility of the small intestine is not the purpose of a HIDA scan. It is used specifically for assessing the biliary system.

Choice D reason:

Providing detailed images of the pancreas is not the primary purpose of a HIDA scan, although it can sometimes provide some information about the pancreas if the tracer reaches the duodenum and enters the common bile duct.


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Question 25:

A client is undergoing an abdominal computed tomography (CT) scan to evaluate suspected cholecystitis. The client expresses concern about potential radiation exposure. Which of the following responses should the nurse provide?

Explanation

CT scans use X-rays, not magnetic fields, to create detailed cross-sectional images of the body. They involve radiation exposure.

Choice B reason:

This statement is correct. While CT scans use X-rays, the amount of radiation used in modern CT machines is relatively low and considered safe. The benefits of the diagnostic information obtained from the scan usually outweigh the risks associated with the small amount of radiation exposure.

Choice C reason:

The speed of the scan does not impact the radiation exposure. The amount of radiation used in a CT scan remains the same regardless of the scan duration.

Choice D reason:

CT scans use X-rays, not sound waves. Sound waves are used in ultrasound imaging, not in CT scans.


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Question 26: A nurse is providing discharge instructions to a client diagnosed with peptic ulcer disease. Which of the following statements by the client indicates a need for further teaching?

Explanation

Avoiding NSAIDs is essential for clients with peptic ulcer disease as they can worsen the condition and increase the risk of bleeding.

Choice B reason:

Following a low-fat diet does not directly impact stomach acid production, but it can help prevent irritation to the stomach lining by reducing the intake of potentially irritating foods.

Choice C reason:

This statement is correct. Proton pump inhibitors (PPIs) are commonly prescribed to reduce stomach acid production and promote ulcer healing. It is crucial for the client to continue taking PPIs as directed by their healthcare provider.

Choice D reason:

This statement is incorrect and indicates a need for further teaching. Alcohol can irritate the stomach lining and exacerbate peptic ulcer disease. Clients with peptic ulcers should avoid or minimize alcohol consumption.


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Question 27: A nurse is caring for a client with peptic ulcer disease who is experiencing severe abdominal pain. The healthcare provider orders antacids for pain relief. The nurse should administer the antacids at which of the following times?

Explanation

Administering antacids one hour before meals would be less effective in providing pain relief during mealtime when stomach acid production is increased.

Choice B reason:

This statement is correct. Administering antacids with meals helps neutralize stomach acid during the digestion process and provides pain relief for clients with peptic ulcer disease.

Choice C reason:

Administering antacids two hours after meals may not effectively reduce pain during the mealtime when stomach acid production is at its peak.

Choice D reason:

Administering antacids at bedtime may help with overnight acid reduction, but it may not adequately address pain during meals when acid production is higher.


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Question 28: A client with peptic ulcer disease is prescribed a combination therapy that includes antibiotics and acid-reducing medications. The client asks the nurse about the purpose of the antibiotics in the treatment. Which of the following responses should the nurse provide?

Explanation

Antibiotics do not directly heal the ulcer or reduce stomach acid production. They are prescribed specifically to treat Helicobacter pylori (H. pylori) infection, a common cause of peptic ulcers.

Choice B reason:

This statement is correct. Antibiotics are prescribed to treat H. pylori infection, which is a major cause of peptic ulcers. By eliminating the bacterial infection, the ulcer has a better chance of healing and preventing recurrence.

Choice C reason:

Antibiotics do not promote blood clotting or reduce the risk of bleeding from the ulcer. Other medications may be prescribed to manage bleeding if it occurs.

Choice D reason:

Antibiotics do not relax stomach muscles or alleviate abdominal pain. Pain relief is typically achieved through acid-reducing medications and other pain management strategies.


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Question 29: A nurse is caring for a client who has undergone surgery for a peptic ulcer perforation. The client asks the nurse about the expected recovery time. Which of the following responses should the nurse provide?

Explanation

Recovering fully within 1-2 weeks after surgery for a peptic ulcer perforation may be overly optimistic. The recovery time is typically longer and depends on the individual's health status and the extent of the surgery.

Choice B reason:

This statement is correct. The recovery time after surgery for a peptic ulcer perforation varies depending on factors such as the type of surgery performed, the extent of the perforation, and the client's overall health. It may take several weeks to months for the client to fully recover.

Choice C reason:

Resuming normal activities immediately after surgery for a peptic ulcer perforation is not advisable. Clients usually require a period of rest and limited activity to allow proper healing.

Choice D reason:

Recovering fully in 6 months may be an extended recovery period. While some clients may experience a longer recovery, it is not a standard time frame for everyone.


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Question 30:

A nurse is providing dietary instructions to a client with peptic ulcer disease. Which of the following dietary modifications should the nurse recommend to promote ulcer healing?

Explanation

Increasing intake of spicy foods is not recommended for clients with peptic ulcer disease, as they can irritate the stomach lining and exacerbate symptoms.

Choice B reason:

This statement is correct. Consuming frequent, small meals throughout the day helps prevent prolonged periods of fasting, which can reduce stomach acid production and irritation to the stomach lining. It also aids in maintaining steady blood sugar levels.

Choice C reason:

Drinking caffeinated beverages can increase stomach acid production and may worsen symptoms in clients with peptic ulcer disease. It is best to avoid or limit caffeinated drinks.

Choice D reason:

High-fiber foods can be beneficial for overall digestive health, but they are not specifically recommended for promoting ulcer healing. In some cases, high-fiber foods may need to be avoided if they cause discomfort.


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Question 31: A nurse is providing discharge instructions to a client with a history of peptic ulcer disease. The client asks the nurse about warning signs of potential complications. Which of the following responses should the nurse provide?

Explanation

Mild bloating and gas after meals may be common gastrointestinal symptoms but are not specific warning signs of complications related to peptic ulcer disease.

Choice B reason:

This statement is correct. Black, tarry stools (melena) or vomiting blood (hematemesis) are potential signs of gastrointestinal bleeding, a serious complication of peptic ulcer disease. Clients should seek immediate medical attention if they experience these symptoms.

Choice C reason:

Occasional heartburn may occur during the course of ulcer healing but is not considered a warning sign of complications.

Choice D reason:

Feeling fatigued and sleepy after meals is not typically associated with peptic ulcer disease or its complications.


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Question 32: A nurse is caring for a client admitted with a perforated peptic ulcer. Which of the following findings should the nurse anticipate in the client's physical assessment?

Explanation

A perforated peptic ulcer can lead to localized peritonitis, which may cause abdominal rigidity and guarding, rather than hypoactive bowel sounds.

Choice B reason:

Reduced abdominal tenderness is not expected in a client with a perforated peptic ulcer. Abdominal tenderness is likely to be present due to inflammation and irritation of the peritoneal lining.

Choice C reason:

Elevated blood pressure is not a typical finding in a client with a perforated peptic ulcer. The client may experience hypotension due to fluid loss and hemorrhage.

Choice D reason:

This statement is correct. A perforated peptic ulcer can cause increased abdominal rigidity due to the inflammation and irritation of the peritoneal lining. The abdomen may feel tense and rigid upon palpation.


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Question 33: A nurse is caring for a client with peptic ulcer disease who is prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis. Which of the following statements by the client indicates a need for further education?

Explanation

Taking NSAIDs with food can help reduce stomach irritation and the risk of developing peptic ulcers.

Choice B reason:

This statement is correct. Dark, tarry stools may indicate gastrointestinal bleeding, a potential complication of peptic ulcer disease. The client should promptly notify their healthcare provider if they experience this symptom.

Choice C reason:

This statement is incorrect and indicates a need for further education. While antacids can provide temporary relief from heartburn, they do not address the underlying issue of stomach irritation caused by NSAIDs. The client should avoid NSAIDs or discuss alternative pain management strategies with their healthcare provider.

Choice D reason:

Avoiding alcohol is advisable while on NSAIDs as alcohol can increase the risk of gastrointestinal bleeding and worsen peptic ulcer disease.


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Question 34: A nurse is caring for a client with peptic ulcer disease who is receiving intravenous proton pump inhibitors (PPIs) to reduce stomach acid production. Which of the following nursing actions is a priority when administering PPIs to this client?

Explanation

Assessing for signs of fluid overload is a priority when administering PPIs intravenously, as these medications can increase the risk of fluid retention in some clients.

Choice B reason:

Monitoring liver function test results is important for clients taking certain medications, but it is not the priority when administering PPIs to this client.

Choice C reason:

Elevating the head of the client's bed is a standard measure to prevent aspiration and improve digestion, but it is not the priority in this scenario.

Choice D reason:

Checking for drug interactions with other medications is essential for safe medication administration, but it is not the priority when administering PPIs intravenously to this client.


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Question 35:

A client with peptic ulcer disease is scheduled for an upper gastrointestinal endoscopy. The client asks the nurse about the purpose of the procedure. Which of the following responses should the nurse provide?

Explanation

Choice A Reason:
This statement is correct. An upper gastrointestinal endoscopy is a diagnostic procedure that uses a fleble tube with a camera (endoscope) to visualize the esophagus, stomach, and duodenum. It helps identify abnormalities, such as peptic ulcers, inflammation, or tumors.

Choice B reason:

Assessing blood flow to the intestines and colon is not the purpose of an upper gastrointestinal endoscopy. This procedure focuses on the upper digestive tract.

Choice C reason:

Evaluating kidney function and the urinary system is unrelated to an upper gastrointestinal endoscopy, which focuses on the upper digestive tract.

Choice D reason:

Diagnosing conditions in the lower digestive tract is not the purpose of an upper gastrointestinal endoscopy. Lower digestive tract evaluations are typically done using colonoscopy or sigmoidoscopy.


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Question 36: A nurse is caring for a client with peptic ulcer disease who is prescribed sucralfate. Which of the following instructions should the nurse provide to the client about taking sucralfate?

Explanation

Choice A reason:

This statement is correct. Sucralfate is best taken on an empty stomach at least 1 hour before meals to allow it to form a protective barrier over the ulcer and provide optimal therapeutic effects.

Choice B reason:

Crushing sucralfate tablets is not recommended, as it may interfere with the medication's ability to adhere to the ulcer site and provide protection.

Choice C reason:

Taking sucralfate with antacids may reduce its effectiveness, as antacids can interfere with its therapeutic actions. It is best to take sucralfate separately from antacids.

Choice D reason:

It is essential to avoid taking sucralfate with other medications, especially those that require an acidic environment for absorption. This is because sucralfate can decrease the absorption of certain drugs.


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Question 37: A client with peptic ulcer disease reports experiencing frequent abdominal pain, especially during mealtimes. Which of the following nursing interventions should the nurse implement to alleviate the client's pain?

Explanation

Choice A reason:

Eating a large, well-balanced meal during mealtimes may exacerbate abdominal pain for the client with peptic ulcer disease. Instead, the client should be encouraged to eat smaller, more frequent meals to reduce stomach acid production.

Choice B reason:

This statement is correct. Administering prescribed antacids 30 minutes before meals can help reduce stomach acid levels during digestion and alleviate the client's pain.

Choice C reason:

Instructing the client to lie flat immediately after eating is not recommended, as it may increase the risk of reflux and worsen the client's symptoms.

Choice D reason:

Providing the client with spicy foods is not advisable, as they can irritate the stomach lining and worsen symptoms for the client with peptic ulcer disease.


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Question 38: A nurse is caring for a client with a peptic ulcer who is prescribed histamine-2 (H2) receptor blockers. Which of the following laboratory values should the nurse monitor closely while the client is taking H2 receptor blockers?

Explanation

Choice A reason:

This statement is correct. H2 receptor blockers can sometimes cause an increase in serum potassium levels. The nurse should monitor the client's potassium levels closely to detect any abnormalities.

Choice B reason:

H2 receptor blockers do not typically affect blood glucose levels, so monitoring blood glucose is not the priority in this scenario.

Choice C reason:

H2 receptor blockers are not known to have a significant impact on serum creatinine levels, so monitoring creatinine is not the priority in this case.

Choice D reason:

H2 receptor blockers are not known to affect the CBC, so monitoring the complete blood count is not the priority for this client.


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Question 39: A client with peptic ulcer disease is at risk of developing a gastrointestinal bleed. The nurse should assess the client for which of the following early signs of bleeding?

Explanation

Choice A reason:

Hypertension and increased heart rate are not early signs of gastrointestinal bleeding. In fact, hypotension and tachycardia are more common signs of significant blood loss.

Choice B reason:

Abdominal distention and bloating are not typical early signs of gastrointestinal bleeding. These symptoms may occur due to other gastrointestinal issues but are not specific to bleeding.

Choice C reason:

This statement is correct. Melena, or black, tarry stools, is a classic sign of upper gastrointestinal bleeding and indicates the presence of partially digested blood in the stool.

Choice D reason:

Hyperactive bowel sounds are not early signs of gastrointestinal bleeding. Bowel sounds may be hyperactive or hypoactive depending on the severity of the bleeding and associated factors.


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Question 40:

A client with peptic ulcer disease is prescribed misoprostol. Which of the following information should the nurse include in the client's medication education?

Explanation

Choice A reason:

Misoprostol is not an antibiotic. It is a synthetic prostaglandin used to protect the stomach lining and prevent peptic ulcers, particularly in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs).

Choice B reason:

Misoprostol should be taken with meals to minimize gastrointestinal side effects. Taking it on an empty stomach may increase the risk of adverse effects.

Choice C reason:

This statement is correct. Misoprostol is contraindicated during pregnancy and can cause uterine contractions and birth defects. Clients taking misoprostol should use effective contraception to prevent pregnancy.

Choice D reason:

Misoprostol is not used to reduce stomach acid production. Instead, it helps protect the stomach lining by increasing mucus production and promoting bicarbonate secretion.


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Question 41: A nurse is providing education to a client with a history of peptic ulcer disease on preventive strategies. Which of the following instructions should the nurse include to help prevent ulcer recurrence?

Explanation

Choice A reason:

This statement is correct. Smoking and excessive alcohol intake can irritate the stomach lining and increase the risk of peptic ulcer recurrence. Avoiding these substances is important for promoting healing and preventing further damage.

Choice B reason:

Consuming a high-fat diet is not recommended for peptic ulcer prevention. High-fat foods can stimulate acid production and worsen symptoms for clients with peptic ulcers.

Choice C reason:

Engaging in strenuous exercise immediately after meals is not advisable, as it can increase the risk of acid reflux and worsen symptoms for clients with peptic ulcers.

Choice D reason:

Regular use of NSAIDs can increase the risk of developing peptic ulcers and is not a preventive strategy for clients with a history of peptic ulcer disease.


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Question 42: A client with peptic ulcer disease is prescribed a proton pump inhibitor (PPI) as part of the preventive treatment plan. Which of the following statements by the client indicates a need for further education about PPIs?

Explanation

Choice A reason:

This statement is incorrect and indicates a need for further education. PPIs should be taken on an empty stomach, at least 30 minutes before meals, to allow for optimal absorption and effectiveness.

Choice B reason:

This statement is correct. Clients should continue taking the PPI for the full duration as prescribed, even if they start to feel better, to prevent ulcer recurrence.

Choice C reason:

This statement is correct. PPIs can decrease calcium absorption and increase the risk of osteoporosis in some clients. Increasing calcium intake or taking calcium supplements may be necessary for clients on long-term PPI therapy.

Choice D reason:

This statement is correct. Antacids can interfere with the action of PPIs, and clients should avoid taking them together. If needed, antacids should be taken at least 1 hour before or after the PPI.


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Question 43: A client with peptic ulcer disease asks the nurse about dietary recommendations to prevent ulcer recurrence. Which of the following statements should the nurse include in the client's education?

Explanation

Choice A reason:

Limiting fiber-rich foods is not a recommended preventive strategy for peptic ulcer disease. In fact, fiber can aid digestion and promote bowel regularity, which may be beneficial for some clients with peptic ulcers.

Choice B reason:

This statement is correct. Spicy and acidic foods can irritate the stomach lining and increase stomach acid production, potentially worsening symptoms for clients with peptic ulcers.

Choice C reason:

Increasing consumption of carbonated beverages is not advised, as they can cause bloating and increased gas production, which may exacerbate symptoms for clients with peptic ulcers.

Choice D reason:

Caffeine-containing beverages should be limited or avoided, as caffeine can stimulate gastric acid secretion and may worsen symptoms for clients with peptic ulcers.


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Question 44: A nurse is caring for a client who recently underwent Helicobacter pylori eradication therapy for peptic ulcer disease. Which of the following instructions should the nurse provide to the client to prevent H. pylori reinfection?

Explanation

Choice A reason:

Avoiding all dairy products is not a preventive measure for H. pylori reinfection. Dairy consumption does not play a significant role in H. pylori colonization or infection.

Choice B reason:

This statement is correct. H. pylori is primarily transmitted through the oral-oral or fecal-oral route. Practicing strict hand hygiene, especially after using the restroom and before eating, can help reduce the risk of transmission and reinfection.

Choice C reason:

Including raw vegetables in the diet is not a specific preventive measure for H. pylori reinfection. A balanced diet that promotes overall gut health may be beneficial, but raw vegetables alone do not prevent H. pylori reinfection.

Choice D reason:

Taking over-the-counter antacids regularly is not a preventive strategy for H. pylori reinfection. Antacids do not target the bacterium and are not effective in eradicating H. pylori.


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Question 45:

A client with a history of peptic ulcer disease is prescribed sucralfate as part of the preventive treatment plan. Which of the following instructions should the nurse provide to the client about taking sucralfate?

Explanation

Choice A reason:

Taking sucralfate with meals is not recommended, as it can reduce its effectiveness. Sucralfate should be taken on an empty stomach, at least 1 hour before meals, to allow it to form a protective barrier over the ulcerated areas.

Choice B reason:

Crushing sucralfate tablets is not advised, as it can interfere with the medication's ability to adhere to the ulcer site and provide protection.

Choice C reason:

This statement is correct. Taking antacids with sucralfate can reduce its effectiveness, as antacids can interfere with its therapeutic actions. Clients should avoid taking antacids together with sucralfate.

Choice D reason:

Sucralfate does not typically cause drowsiness, so taking it before bedtime is not necessary for this medication. It should be taken at regular intervals during the day as prescribed.


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