A nurse is educating a patient with PUD about avoiding foods that may exacerbate symptoms. Which of the following should be included?

Correct Answer: B

Rationale: The correct answer is B: Caffeinated beverages. Caffeine can stimulate acid production in the stomach, leading to increased irritation and worsening of symptoms in patients with peptic ulcer disease (PUD). Avoiding caffeinated beverages helps reduce gastric acid secretion, promoting healing and symptom relief. Incorrect choices: A: Whole grains - Whole grains are generally recommended for PUD patients as they provide fiber and nutrients without irritating the stomach. C: Fresh fruits - Fresh fruits are typically well-tolerated by PUD patients and provide essential vitamins and minerals. D: Lean meats - Lean meats are a good source of protein and are generally safe for PUD patients, as long as they are not fried or heavily seasoned.

Correct Answer: B

Rationale: The correct answer is B. Gastric outlet obstruction requires immediate decompression to relieve pressure and prevent complications. Inserting a nasogastric tube allows for drainage of gastric contents and relieves the obstruction. Administering an antiemetic (Choice A) may provide temporary relief but does not address the underlying issue. Offering clear liquids (Choice C) can worsen the obstruction. Encouraging ambulation (Choice D) is not appropriate as the patient needs immediate intervention for the obstruction.

Correct Answer: B

Rationale: The correct answer is B: Avoid pregnancy while taking this medication. Misoprostol is contraindicated in pregnancy due to its potential to cause miscarriage or birth defects. It is important for the nurse to educate the patient on the risks associated with pregnancy while taking this medication. Explanation of why other choices are incorrect: A: Taking misoprostol with antacids may reduce its effectiveness as antacids can neutralize stomach acid, affecting the drug's action. C: Misoprostol should be taken with food to minimize gastrointestinal side effects, not on an empty stomach. D: Misoprostol is not a cure for PUD; it helps in treating and preventing ulcers but does not eliminate the underlying cause of the ulcer.

Correct Answer: B

Rationale: The correct answer is B: Osteoporosis. Long-term PPI use can lead to decreased calcium absorption, increasing the risk of osteoporosis. PPIs suppress stomach acid, which is essential for calcium absorption. Monitoring for bone density changes is crucial. A: Hypertension is not a common side effect of PPI use. PPIs do not directly affect blood pressure regulation. C: Hyperkalemia is not typically associated with PPI use. PPIs do not directly impact potassium levels. D: Anemia is not a common side effect of PPI use. PPIs do not directly cause decreased red blood cell production. In summary, monitoring for osteoporosis is important in patients on long-term PPI therapy due to potential calcium absorption issues.

Correct Answer: D

Rationale: The correct answer is D: CT scan of the abdomen. A CT scan is the most appropriate immediate diagnostic test for suspected perforated peptic ulcer disease (PUD). It provides detailed images to confirm the presence of perforation, assess extent of damage, and guide surgical intervention. Upper GI endoscopy (choice A) may delay diagnosis and treatment in a perforation scenario due to the risk of causing further injury. Abdominal X-ray (choice B) may show free air under the diaphragm, but CT scan is more sensitive and specific. Barium swallow (choice C) is contraindicated in suspected perforation as it can lead to barium leakage into the abdominal cavity, causing further complications.