A 35-year-old patient with a history of PUD presents with a sudden, sharp, and persistent pain in the upper abdomen that is worse with movement. What should the nurse suspect?

Correct Answer: C

Rationale: The correct answer is C: Perforated ulcer. The sudden, sharp, and persistent pain in the upper abdomen that worsens with movement is indicative of a perforated ulcer, where the stomach acid has eaten through the ulcer and leaked into the abdominal cavity. This can lead to severe pain and tenderness. Gastritis (choice A) typically presents with dull, aching pain. Intestinal obstruction (choice B) usually causes cramping abdominal pain with distension and vomiting. Pancreatitis (choice D) presents with severe, steady pain in the upper abdomen that may radiate to the back. Therefore, based on the sudden onset of sharp pain that worsens with movement in a patient with a history of PUD, the nurse should suspect a perforated ulcer.

Correct Answer: C

Rationale: The correct answer is C: Eradicate H. pylori and reduce acid secretion. This combination therapy is commonly used to treat peptic ulcer disease caused by H. pylori infection. Amoxicillin and clarithromycin target and eradicate the H. pylori bacteria, while the PPI helps reduce acid secretion to promote ulcer healing. Choice A is incorrect because the regimen is focused on treating existing ulcers rather than preventing new ones. Choice B is incorrect because the primary goal of the therapy is not just pain relief but rather treating the underlying cause of the ulcers. Choice D is incorrect because the therapy does not directly promote healing by increasing mucus production but rather by targeting H. pylori and reducing acid secretion.

Correct Answer: B

Rationale: The correct answer is B: Notify the physician immediately. This is the priority action because the patient is showing signs of a perforated peptic ulcer, a medical emergency that requires immediate surgical intervention to prevent complications like sepsis. Contacting the physician promptly allows for quick decision-making and coordination of emergency surgery. Administering pain medication (A) can mask symptoms and delay proper diagnosis and treatment. Emergency surgery (C) is necessary, but physician notification should come first. Inserting a nasogastric tube (D) may be indicated later for decompression, but it is not the immediate priority in this critical situation.

Correct Answer: B

Rationale: The correct answer is B: Endoscopy with biopsy. This is the most commonly used test to confirm gastritis as it allows direct visualization of the stomach lining and collection of tissue samples for biopsy. Barium swallow (A) is used to diagnose structural abnormalities, not gastritis. Abdominal ultrasound (C) is more useful for evaluating organs like the liver and gallbladder. Stool culture (D) is used to identify bacterial infections in the stool, not diagnose gastritis.

Correct Answer: B

Rationale: The correct answer is B: Co-trimoxazole. Co-trimoxazole is primarily eliminated through the kidneys and does not have prominent hepatic or gastrointestinal effects in overdose. In contrast, A (Co-phenotrope), C (Co-proxamol), and D (Co-codamol) can cause significant hepatic and gastrointestinal effects in overdose due to the presence of opioids or paracetamol. Co-phenotrope contains diphenoxylate (an opioid), Co-proxamol contains dextropropoxyphene (an opioid), and Co-codamol contains codeine and paracetamol. Therefore, B is the correct answer as it does not apply to drugs with significant hepatic and gastrointestinal effects in overdose.