Which dietary advice is most appropriate for a patient with PUD?

Correct Answer: A

Rationale: The correct answer is A: Avoid spicy foods. Spicy foods can irritate the stomach lining and exacerbate symptoms of peptic ulcer disease (PUD). By avoiding spicy foods, the patient can reduce the risk of worsening their condition. B: Increasing caffeine intake can stimulate acid production in the stomach, which can aggravate PUD symptoms. C: Limiting fluid intake is not recommended as staying hydrated is important for overall health and can help with digestion. D: Eating three large meals per day can put a strain on the stomach and increase acid production, potentially worsening PUD symptoms. It is better to eat smaller, more frequent meals to help manage PUD.

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: 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.