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1. Question
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer?
Correct
Option 4 is the correct answer:
Rationale: Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding.
Test-Taking Strategy: Focus on the subject, perforation. Option 2 can be eliminated easily because it is not related to perforation. Eliminate option 1 next because tachycardia rather than bradycardia would develop if perforation occurs. From the remaining options, note the strategic words, most likely, to help direct you to the correct option.
Incorrect
Option 4 is the correct answer:
Rationale: Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding.
Test-Taking Strategy: Focus on the subject, perforation. Option 2 can be eliminated easily because it is not related to perforation. Eliminate option 1 next because tachycardia rather than bradycardia would develop if perforation occurs. From the remaining options, note the strategic words, most likely, to help direct you to the correct option.
Peptic Ulcer Disease
A peptic ulcer is an ulceration in the mucosal wall of the stomach, pylorus, duodenum, or esophagus in portions accessible to gastric secretions; erosion may extend through the muscle.
The ulcer may be referred to as gastric, duodenal, or esophageal, depending on its location.
The most common peptic ulcers are gastric ulcers and duodenal ulcers.
