Problem: The client, a 56-year-old Hispanic male, presents with complaints of a four-week history of gradually increasing upper abdominal pain. He describes the pain as "burning" in nature, localized to the epigastrium, and that previously it had been relieved by drinking milk or Mylanta. The pain is much worse now and milk or antacids do not provide any relief. He scores the pain as a "7" on a scale of 1-10. The patient does not feel the pain radiating into his back and has not noticed any blood in his stools. He denies any nausea, vomiting, weight loss, shortness of breath, neurologic symptoms, or chest pain with exercise. He maintains that his appetite is excellent. He has been taking 400 mg ibuprofen almost daily for knee pain for the last 18 months. He injured his right knee in a car accident 15 years ago. He also takes daily doses of 81 mg aspirin "for his heart," although this has not been prescribed. He does not take any other prescribed or OTC medications. The patient smokes 11 ⁄2 packs of cigarettes every day and has done so for 5 years since his wife passed away. He does not drink alcohol or use