Mucosal barrier fortifiers are used in peptic ulcer disease management for which of the following indications?

Correct Answer: C

Rationale: In the management of peptic ulcer disease, mucosal barrier fortifiers are used to stimulate mucus production (Option C). The correct answer is C because these medications help enhance the protective mucus layer in the stomach and duodenum, which acts as a physical barrier against gastric acid and digestive enzymes. By increasing mucus production, these fortifiers promote mucosal healing and protect the gastrointestinal lining. Option A (To inhibit mucus production) is incorrect because inhibiting mucus production would worsen the condition by reducing the protective barrier against stomach acid. Option B (To neutralize acid production) is incorrect as mucosal barrier fortifiers do not work by directly neutralizing acid but rather by strengthening the mucosal defense mechanisms. Option D (To stimulate hydrogen ion diffusion back into the mucosa) is also incorrect as this process would not contribute to mucosal protection and ulcer healing. Educationally, understanding the rationale behind using mucosal barrier fortifiers in peptic ulcer disease is crucial for nursing students to grasp the principles of ulcer management. By comprehending how these medications work to enhance mucosal protection, students can provide effective care to patients with peptic ulcers and promote optimal healing outcomes.

Correct Answer: C

Rationale: In the context of medical surgical nursing, understanding Murphy's sign is crucial as it is a clinical indicator for cholecystitis, inflammation of the gallbladder. Choice C, "On deep inspiration, pain is elicited and breathing stops," best describes Murphy's sign. This sign is elicited during physical examination when pressure is applied to the right upper quadrant of the abdomen just below the rib cage while the patient takes a deep breath. The cessation of inspiration or the "stopping" of breathing due to pain indicates a positive Murphy's sign, suggesting gallbladder inflammation. Option A, periumbilical ecchymosis, is not related to Murphy's sign but may be indicative of other conditions like pancreatitis. Option B, pain on deep palpation and release, is more characteristic of rebound tenderness seen in peritonitis. Option D, abdominal muscle tightening in anticipation of palpation, is known as guarding and is seen in conditions like acute abdomen. For nursing students, recognizing and understanding clinical signs like Murphy's sign is essential for accurate assessment and timely intervention in patients with gastrointestinal issues. By differentiating between the options and understanding the specific characteristics of each sign, nurses can effectively contribute to the diagnosis and management of patients with abdominal pathologies.

Correct Answer: B

Rationale: The most commonly used test to diagnose cholecystitis is an abdominal ultrasound. This imaging study is preferred due to its high sensitivity and specificity in identifying gallstones, inflammation, and other abnormalities in the gallbladder. Abdominal CT scan (Option A) is not the first-line diagnostic test for cholecystitis because it is less sensitive in detecting gallstones compared to ultrasound. Barium swallow (Option C) is used to visualize the esophagus and upper gastrointestinal tract, not the gallbladder, making it an inappropriate choice for diagnosing cholecystitis. Endoscopy (Option D) is used to visualize the upper gastrointestinal tract and is not the indicated test for assessing the gallbladder and diagnosing cholecystitis. In an educational context, understanding the appropriate diagnostic tests for specific conditions is crucial for nursing practice. By knowing the rationale behind choosing the right test, nurses can provide optimal care to patients with suspected cholecystitis, ensuring timely and accurate diagnosis and treatment.

Correct Answer: B

Rationale: In the case of a client hospitalized for cholecystitis, the main focus of nursing management should be on option B) Assessment for complications. This is the correct answer because cholecystitis involves inflammation of the gallbladder, which can lead to serious complications such as infection, abscess formation, or even perforation of the gallbladder. Therefore, closely monitoring the client for any signs of worsening condition or complications is crucial for timely intervention and optimal patient outcomes. Option A) Administration of antibiotics may be a component of the treatment for cholecystitis, especially if it is caused by an infectious process. However, the primary focus should be on assessing for complications to prevent deterioration of the client's condition. Option C) Preparation for lithotripsy is not typically indicated for cholecystitis. Lithotripsy is a procedure used to break down gallstones, which may be a consideration for clients with gallstones but not necessarily for those with cholecystitis. Option D) Preparation for surgery may be necessary in some cases of cholecystitis, particularly if complications arise or if conservative management is not effective. However, the immediate priority is to assess for complications and stabilize the client's condition before considering surgical intervention. In an educational context, understanding the priority of nursing management in conditions like cholecystitis is essential for providing safe and effective care to patients. By focusing on assessing for complications, nurses can intervene promptly and prevent potential adverse outcomes, ultimately promoting the best possible patient care and recovery.

Correct Answer: D

Rationale: In the context of a client being treated for chronic cholecystitis, the correct instruction is to use anticholinergics as prescribed (Option D). Anticholinergics help to decrease the spasms in the smooth muscle of the gastrointestinal tract, including the gallbladder, which can be beneficial in managing the symptoms associated with cholecystitis. Option A, increasing rest, while important for overall health, does not directly address the treatment of cholecystitis. Option B, avoiding antacids, is not specifically indicated for cholecystitis treatment and may not have a direct impact on the condition. Option C, increasing protein in the diet, is not the priority in the management of cholecystitis as dietary modifications typically focus on reducing fat intake to decrease gallbladder stimulation. From an educational standpoint, understanding the rationale behind the correct answer helps students grasp the pharmacological management of gastrointestinal conditions. It reinforces the importance of tailored interventions for specific conditions and highlights the role of medications in symptom management. This question also emphasizes the need for critical thinking in selecting the most appropriate intervention based on the client's condition.