What is the primary goal of nursing care for a patient with a bleeding peptic ulcer?

Correct Answer: B

Rationale: The primary goal of nursing care for a patient with a bleeding peptic ulcer is to manage and prevent shock (Choice B). This is because bleeding from the ulcer can lead to hypovolemic shock, a life-threatening condition. Nursing interventions focus on stabilizing the patient's condition by monitoring vital signs, administering IV fluids, and preparing for potential blood transfusions. Decreasing pain (Choice A) is important but not the primary goal in this emergency situation. Similarly, reducing anxiety (Choice C) and educating about dietary restrictions (Choice D) are important aspects of care but are not the immediate priority when the patient is at risk of shock.

Correct Answer: B

Rationale: The correct answer is B: To create a protective barrier in the stomach. Bismuth subsalicylate forms a protective coating on the stomach lining, acting as a barrier to protect against stomach acid and irritants, promoting healing of peptic ulcers. A: To reduce acid production - While some medications like proton pump inhibitors reduce acid production, bismuth subsalicylate does not primarily function in this manner for PUD treatment. C: To increase mucus secretion - Bismuth subsalicylate does not directly increase mucus secretion, although it may indirectly support mucosal protection. D: To eradicate H. pylori - Bismuth subsalicylate does not directly target H. pylori bacteria, which is typically addressed with antibiotics in PUD treatment.

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.