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