Points Awarded 18.00
Points Missed 7.00
Percentage 72.0%
Assessment
Ms. Lewis arrives at her HCP's office, and the nurse escorts her to the
... [Show More] examination room. The nurse performs the initial assessment. During the initial interview, Ms. Lewis requests that the nurse call her Gail.
1.
Which information is most significant when assessing a client suspected of having a peptic ulcer? A) Amount of stress at work and in personal life.
INCORRECT
In the past, stress and emotions were thought to be a major cause of ulcers, but stress rarely causes an ulcer although it probably can aggravate the symptoms.
B) Frequent use of aspirin or products containing aspirin.
CORRECT
Longterm use of antiinflammatory medications (NSAIDs) damages the stomach lining and causes ulcers. NSAIDs inhibit the production of an enzyme (cyclooxygenase) that produces prostaglandins which help protect
the stomach lining from chemical and physical injury.
Gail reports that she occasionally takes aspirin or ibuprofen for low back pain and joint pains. During the interview, Gail tells the nurse that she frequently has a gnawing, burning pain in her stomach. The nurse asks Gail to explain the pain in more detail.
C) History of cigarette smoking and/or current cigarette smoking.
INCORRECT
Nicotine delays the healing of an ulcer, but it does not cause the development of a peptic ulcer.
D) Daily consumption of coffee or other caffeinated drinks.
INCORRECT
Although caffeine stimulates the secretion of gastric acid, ingestion of caffeine is not considered a risk factor in developing gastric ulcers.
Points Earned: 1.0/1.0
Correct Answer(s): B
2.
Which response by Gail supports a peptic ulcer?
A) "The pain usually does not bother me at night."
INCORRECT
Because gastric acid production at night can cause extreme abdominal pain, individuals with ulcers may wake up during the night.
B) "My pain is temporarily relieved when I drink milk."
CORRECT
Although antacids and milk usually provide temporary relief for the pain since they neutralize the gastric acid in the stomach, milk can make an ulcer worse because it stimulates the stomach to produce more acid and digestive juices that can aggravate an ulcer.
C) "My pain seems to be worse just before I eat a meal."
INCORRECT
The gnawing, burning pain frequently occurs several hours following a meal after the food leaves the stomach but while acid production is still high.
D) "The pain is worse in the morning when I first wake up."
INCORRECT
Pain upon awakening is not a symptom experienced by clients diagnosed with PUD.
Points Earned: 1.0/1.0
Correct Answer(s): B
Diagnostic Tests
The HCP suspects that Gail has a peptic ulcer and schedules her for a Helicobacter pylori (H. pylori) breath test. The nurse explains that this is a simple and safe test used to detect an active H. pylori infection which is often the cause of PUD. The nurse discusses the preprocedure guidelines for the test. [Show Less]