The nurse should advise a patient with PUD to avoid which of the following medications due to the risk of exacerbating the condition?

Correct Answer: D

Rationale: The correct answer is D (Both B and C). NSAIDs and aspirin are known to irritate the stomach lining and increase the risk of developing peptic ulcers. Acetaminophen, on the other hand, does not have the same effect on the stomach lining and is considered safer for patients with PUD. Therefore, advising a patient with PUD to avoid NSAIDs and aspirin is crucial to prevent exacerbation of the condition. Additionally, selecting option D is appropriate as it covers both medications that should be avoided, providing a comprehensive approach to managing PUD.

Correct Answer: B

Rationale: The correct answer is B, a CT scan of the abdomen. This diagnostic test would be ordered first because it can quickly visualize the abdominal organs and help identify any potential perforations or complications associated with PUD. A CT scan is non-invasive and provides detailed images to assist in making an accurate diagnosis promptly. A: Abdominal ultrasound may not provide as detailed information as a CT scan and may not be as effective in detecting certain complications related to PUD. C: Upper GI endoscopy is more invasive and may not be the initial choice for a patient with severe abdominal pain unless there is a clear indication. D: Barium swallow is not typically used as a first-line diagnostic test for acute abdominal pain in a patient with a history of PUD.

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.