An 89-year-old male client complains to the nurse that people are whispering behind his back and mumbling when they talk to him. What age-related condition is likely to be occurring with this client?

Correct Answer: C

Rationale: The correct answer is C: Presbycusis. This age-related condition refers to gradual hearing loss typically seen in older adults. In this case, the client's complaint of people whispering and mumbling suggests difficulty hearing clearly, which aligns with symptoms of presbycusis. Delirium (choice A) is characterized by acute confusion and disorientation, not specifically related to hearing loss. Presbyopia (choice B) is a condition of aging that affects near vision, not hearing. Cerebral dysfunction (choice D) refers to broader cognitive impairment, not specifically related to hearing loss as in presbycusis. Therefore, choice C is the most likely age-related condition in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Risk for injury. The client's symptoms of disorientation, wandering, decreased appetite, and difficulty sleeping indicate an increased risk for falls, accidents, or getting lost. Ensuring the client's safety and preventing any potential harm is the priority. A: Disturbed thought processes may contribute to the client's disorientation but do not pose an immediate threat to their safety. B: Altered sleep pattern is concerning but is secondary to the risk of injury in this scenario. C: Imbalanced nutrition: less than is important, but the immediate priority is addressing the client's safety due to the risk of injury. In summary, the priority nursing problem for this client is the risk for injury due to their disorientation and wandering behavior, which could lead to accidents or harm.

Correct Answer: A

Rationale: Rationale: 1. Given the symptoms of epigastric burning, testing for H. pylori is appropriate as it is a common cause of such symptoms. 2. The serum qualitative test for H. pylori can detect the presence of the bacteria in the patient's system. 3. If positive, treatment for H. pylori (such as antibiotics) would be indicated. 4. Referral for endoscopy or upper GI series is not the initial step as they are more invasive and costly. Summary: - A: Correct, as it targets the potential cause of the symptoms. - B: Not recommended initially, as it is more invasive and not necessary as the first step. - C: Not recommended initially, as it is less specific for H. pylori detection. - D: Premature without confirming the presence of H. pylori.

Correct Answer: C

Rationale: The correct answer is C because the urease breath test is the ideal test to document failure of H. pylori eradication. This test directly measures the presence of the H. pylori bacterium in the stomach by detecting the enzyme urease produced by the bacterium. If the patient still has symptoms after treatment, a positive urease breath test would indicate that the bacterium is still present, leading to treatment failure. Choice A is incorrect because a positive antibody test does not indicate low risk for reinfection. Choice B is incorrect because a positive serum IgG may persist even after successful eradication. Choice D is incorrect because dyspepsia can improve after successful H. pylori eradication rather than worsen.

Correct Answer: B

Rationale: The most likely cause of bleeding in this case is a duodenal ulcer (Choice B). The key clues are severe hematochezia, moderate abdominal cramping, normal barium enema a year ago, and orthostatic changes in blood pressure and pulse. Severe hematochezia suggests a significant upper gastrointestinal bleed. Normal barium enema rules out lower GI sources. Orthostatic changes in blood pressure and pulse are indicative of acute blood loss. Duodenal ulcers are a common cause of upper GI bleeding and can present with hematochezia. In contrast, diverticular bleeds (Choice A) typically present with painless rectal bleeding, inflammatory bowel disease (Choice C) often presents with chronic blood loss and anemia, and vascular ectasia (Choice D) typically causes chronic, slow bleeding.