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1. A patient with a history of peptic ulcer disease presents with abdominal
pain, nausea, and vomiting. The nurse suspects that the patient may have a
perforated ulcer. Which of the following signs would support this
diagnosis?
A) Decreased bowel sounds
B) Rigid, board-like abdomen
C) Rebound tenderness
D) All of the above
Answer: D) All of the above. A perforated ulcer is a medical emergency
that occurs when the ulcer erodes through the wall of the stomach or
duodenum, causing leakage of gastric contents into the peritoneal cavity.
This can lead to peritonitis, which is inflammation and infection of the
peritoneum. Peritonitis causes abdominal pain, nausea, vomiting,
decreased bowel sounds, rigid abdomen, and rebound tenderness.
2. A pregnant woman in her third trimester visits the prenatal clinic for a
routine check-up. The nurse performs a Leopold's maneuver to assess the
fetal position and finds that the fetus is in a breech presentation. What
does this mean and what are the implications for delivery?
A) The fetus is lying horizontally across the uterus and will require a
cesarean section.
B) The fetus is lying vertically with the head down and will have a normal
vaginal delivery.
C) The fetus is lying vertically with the buttocks or feet down and may
require a cesarean section or external cephalic version.
D) The fetus is lying obliquely with the shoulder presenting and will
require a cesarean section or internal podalic version.
Answer: C) The fetus is lying vertically with the buttocks or feet down
and may require a cesarean section or external cephalic version. A breech
presentation is when the fetus is not in the optimal vertex position for
delivery, which is head down. A breech presentation can increase the risk
of complications such as cord prolapse, fetal distress, birth trauma, and
neonatal asphyxia. A cesarean section may be indicated if the fetus cannot
be turned to a vertex position by external cephalic version, which is a
manual manipulation of the abdomen to rotate the fetus.
3. A patient with Crohn's disease undergoes an ileostomy, which is a
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