Which assessment data would indicate to the nurse that pharmacologic treatment with antibiotics and antacids has been effective for the patient diagnosed with peptic ulcer disease (PUD) secondary to H. pylori?
Absence of burning epigastric pain after eating.
Two episodes of coffee-ground emesis.
A decrease in the patient’s alcohol intake.
Normalization of the patient’s hemoglobin levels.
The Correct Answer is A
Choice A rationale
The absence of burning epigastric pain after eating indicates that the treatment for peptic ulcer disease (PUD) secondary to H. pylori has been effective. This suggests that the ulcer has healed and the inflammation has subsided.
Choice B rationale
Coffee-ground emesis indicates the presence of blood in the vomit, which suggests ongoing bleeding and is not a sign of effective treatment for PUD.
Choice C rationale
A decrease in alcohol intake is beneficial for overall health but does not directly indicate the effectiveness of treatment for PUD secondary to H. pylori.
Choice D rationale
Normalization of hemoglobin levels is important but does not specifically indicate the effectiveness of treatment for PUD secondary to H. pylori. The primary indicator would be the resolution of symptoms such as burning epigastric pain.
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Correct Answer is B
Explanation
Choice A rationale
Decreased breath sounds in the lower lobes can indicate areas of the lung that are not ventilating well, but this finding alone does not specifically indicate an exacerbation of COPD. It could be due to other conditions such as pleural effusion or atelectasis.
Choice B rationale
Increased respiratory rate and use of accessory muscles are signs of respiratory distress and indicate that the patient is working harder to breathe. These findings are consistent with an exacerbation of COPD, where the airways are more obstructed, and the patient has difficulty maintaining adequate ventilation.
Choice C rationale
Elevated blood pressure and heart rate can occur in many conditions and are not specific indicators of a COPD exacerbation. These vital sign changes can be due to pain, anxiety, or other stressors.
Choice D rationale
Presence of wheezing and cyanosis are also indicators of a COPD exacerbation. Wheezing indicates airway obstruction, and cyanosis indicates hypoxemia, both of which are common during an exacerbation.
Correct Answer is D
Explanation
ChoiceArationale
Post-renalacute kidneyinjury(AKI)iscausedbyobstructionofurineflow,leadingto decreased urine output, but it does not typically cause crackles in the lungs.
ChoiceBrationale
Diabetesinsipidus(DI)ischaracterizedbyexcessiveurinationandthirstduetoadeficiencyof antidiuretic hormone (ADH), but it does not cause crackles in the lungs.
ChoiceCrationale
Syndromeofinappropriateantidiuretichormone(SIADH)involvesexcessivereleaseofADH, leading to water retention and hyponatremia, but it does not cause crackles in the lungs.
ChoiceDrationale
Congestiveheartfailure(CHF)canleadtofluidaccumulationinthelungs(crackles)and decreased urine output due to poor cardiac function and renal perfusion.