Your patient Maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?

Correct Answer: C

Rationale: In the context of Maria developing peptic ulcer disease due to NSAID use, the correct answer is C) Misoprostol (Cytotec). Misoprostol is a prostaglandin analog that helps prevent NSAID-induced ulcers by promoting mucus production in the stomach, enhancing mucosal defense, and reducing acid secretion. This drug is particularly effective in patients like Maria who require NSAIDs for pain management but are at risk for developing ulcers. Option A) Calcium carbonate (Tums) is an antacid that provides symptomatic relief but does not prevent NSAID-induced ulcers. Option B) Famotidine (Pepcid) is an H2 receptor antagonist that reduces acid production but does not address the underlying issue of mucosal protection. Option D) Sucralfate (Carafate) is a cytoprotective agent that forms a protective barrier over ulcers but does not specifically prevent NSAID-induced ulcers like Misoprostol does. In an educational context, understanding the mechanism of action of drugs used to prevent and treat gastrointestinal issues related to NSAID use is crucial for nursing practice. Nurses need to know the rationale behind selecting Misoprostol in this scenario to provide optimal care for patients like Maria and prevent complications associated with NSAID therapy.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Have the doctor called while you remain with the patient, flex the patient's knees, and cover the wound with sterile towels soaked in sterile saline solution. The priority in this situation is to protect the exposed bowel to prevent infection and further complications. By covering the wound with sterile towels soaked in sterile saline solution, you create a barrier against contamination. Flexing the patient's knees helps reduce tension on the abdominal muscles, which can decrease the risk of further bowel protrusion. Option A is incorrect because covering the area with a water-soaked bedsheet is not an appropriate intervention for protecting the exposed bowel. Option B is not the best choice as obtaining vital signs alone does not address the immediate risk of infection and further injury. Option C is also incorrect as having a CAN hold the wound together is not as effective as covering it with sterile towels and calling the doctor for immediate intervention. This scenario emphasizes the importance of rapid assessment and implementation of appropriate interventions to manage post-operative complications effectively in patients with gastrointestinal issues. It highlights the critical thinking skills and quick decision-making required in emergency situations in medical-surgical nursing.

Correct Answer: C

Rationale: In the context of a patient with peritonitis who is NPO and complaining of thirst, the priority action is to provide frequent mouth care, as indicated by the correct answer C. Providing frequent mouth care helps to maintain oral hygiene, reduce dryness, and alleviate the sensation of thirst without compromising the patient's NPO status. It also promotes comfort and prevents complications such as oral mucosal breakdown and infection. Addressing the patient's thirst through mouth care is a non-invasive and safe approach that aligns with the patient's dietary restrictions. The other options are not the priority in this situation: - Option A (Increase the I.V. infusion rate) may not be necessary solely for thirst relief and could potentially lead to fluid overload or other complications. - Option B (Use diversion activities) is not the most appropriate intervention when the patient's primary concern is thirst related to NPO status and peritonitis. - Option D (Give ice chips every 15 minutes) is contraindicated for a patient who is NPO due to the risk of aspiration and potential worsening of the underlying condition. Understanding the rationale behind prioritizing mouth care in this scenario reinforces the importance of individualized patient care, critical thinking, and evidence-based practice in the field of medical-surgical nursing.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) His gastric bleeding occurred 2 hours earlier. This indicates that the coffee-ground emesis is a result of bleeding that happened some time ago. When blood stays in the stomach for a period of time, it undergoes partial digestion by gastric acid, leading to the coffee-ground appearance. Option A is incorrect because coffee-ground emesis typically indicates older bleeding rather than fresh, active bleeding. Option B is also incorrect because saline gastric lavage is not indicated in this situation and can be harmful. Option D is incorrect as the immediate need is not for a transfusion but rather for further assessment and management of the underlying cause of bleeding. From an educational perspective, understanding the significance of coffee-ground emesis in a patient with a history of peptic ulcer disease is crucial for nursing practice. It helps nurses recognize the timing of bleeding events and guides appropriate interventions. This knowledge empowers nurses to provide timely and effective care to patients experiencing gastrointestinal bleeding, ultimately improving outcomes and patient safety.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Red. After a partial gastrectomy for adenocarcinoma of the stomach, the gastric secretions are expected to be red due to blood in the stomach. This finding is significant as it indicates the presence of bleeding, which could be a complication postoperatively and requires immediate attention. Option A) Brown is incorrect because brown gastric secretions are not typically expected after this type of surgery. Brown color may indicate the presence of old blood or bile. Option B) Clear is incorrect as clear gastric secretions are not typical post-partial gastrectomy and would not be expected in this context. Option D) Yellow is also incorrect because yellow gastric secretions are more commonly associated with issues like bile reflux rather than immediate postoperative findings after a partial gastrectomy. Educationally, understanding the color and significance of gastric secretions post-gastrectomy is crucial for nurses caring for surgical patients. Recognizing abnormal findings like red gastric secretions can help prompt timely interventions and prevent complications, highlighting the importance of thorough assessment and clinical judgment in postoperative care.