Exam Final: NUR209/ NUR 209 (2026/ 2027
Update) Medical Surgical Nursing II| Review
with Questions and Verified Answers| 100%
Correct| Grade A – Fortis
A patient has just returned to the nursing unit after an
esophagogastroduodenoscopy (EGD). Which action by assistive personnel (AP)
requires that the registered nurse (RN) intervene?
a. Offering the patient a pitcher of water
b. Positioning the patient on the right side
c. Checking the vital signs every 30 minutes
d. Swabbing the patient's mouth with a wet cloth - ANSWER A.
Immediately after EGD, the patient will have a decreased gag reflex and is at risk
for aspiration. Assessment for return of the gag reflex should be done by the RN.
The other actions by the AP are appropriate.
Which area of the abdomen shown in the accompanying figure will the nurse
palpate to assess for splenomegaly?
a. 1
b. 2
c. 3
d. 4 - ANSWER B.
The spleen is usually not palpable, but when palpated, it is located in left upper
quadrant of abdomen.
A patient who has just been started on enteral nutrition of full-strength formula at
100 mL/hr has 6 liquid stools the first day. Which action would the nurse plan to
take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
,c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube. - ANSWER
A.
Loose stools indicate poor absorption of nutrients and indicate a need to slow the
feeding rate or decrease the concentration of the feeding. Water should be given
when patients receive enteral feedings to prevent dehydration. When a closed
enteral feeding system is used, the tubing and formula are changed every 24 hours.
High residual volumes do not contribute to diarrhea.
A young adult with extensive facial injuries from a motor vehicle crash is receiving
continuous enteral nutrition through a percutaneous endoscopic gastrostomy
(PEG). Which action will the nurse include in the plan of care?
a. Keep the patient positioned lying on the left side.
b. Flush the tube with 30 mL of water every 4 hours.
c. Crush and mix medications in with the feeding formula.
d. Obtain a daily abdominal radiograph to verify tube placement. - ANSWER
B.
The tube is flushed every 4 hours during continuous feedings to avoid tube
obstruction. The patient should be positioned with the head of the bed elevated.
Crushed medications mixed in with the formula are likely to clog the tube. An x-
ray is obtained immediately after placement of the PEG tube to check position, but
daily x-rays are not needed.
A malnourished patient is receiving a parenteral nutrition (PN) infusion containing
amino acids and dextrose from a bag that was hung with a new tubing and filter 24
hours ago. The nurse observes that about 50 mL remain in the PN container.
Which action would the nurse take?
a. Add a new container of PN using the current tubing and filter.
b. Hang a new container of PN and change the IV tubing and filter.
c. Infuse the remaining 50 mL and then hang a new container of PN.
d. Ask the health care provider to clarify the written PN prescription. -
ANSWER B.
All PN solutions and tubings are changed at 24 hours. Infusion of the additional 50
mL will increase patient risk for infection. The nurse (not the health care provider)
is responsible for knowing the indicated times for tubing and filter changes.
, What action would the nurse take when caring for a patient with a soft, silicone
nasogastric tube in place for enteral nutrition?
a. Avoid giving medications through the feeding tube.
b. Keep head of bed elevated to 30- to 45-degree angle.
c. Replace the tube every 3 days to avoid mucosal damage.
d. Administer medications mixed with enteral feeding formula. - ANSWER
B.
Elevate the head of the bed to decrease the risk of aspiration. The tubes are less
likely to cause mucosal damage than the stiffer polyvinyl chloride tubes used for
nasogastric suction and do not need to be replaced at certain intervals. Medications
can be given through these tubes but flushing before and after medication
administration is important to avoid clogging. Do not mix medications with
formula, as the combination can clog the tube.
After change-of-shift report, which patient will the nurse assess first?
a. A 40-yr-old woman whose parenteral nutrition infusion bag has 30 minutes of
solution left
b. A 40-yr-old man with continuous enteral feedings who has developed
pulmonary
crackles
c. A 30-yr-old man with 4+ generalized pitting edema and severe protein-calorie
malnutrition
d. A 30-yr-old woman whose gastrostomy tube is plugged after crushed
medications
were administered - ANSWER B
The patient data suggest aspiration may have occurred, and rapid assessment and
intervention are needed. The other patients should also be assessed soon, but the
data about them do not suggest any immediately life-threatening complications.
After sleeve gastrectomy, a 42-yr-old male patient returns to the surgical nursing
unit with a nasogastric tube to low, intermittent suction and a patient-controlled
analgesia (PCA) machine for pain control. Which nursing action would be
included in the postoperative plan of care?
a. Offer sips of fruit juices at frequent intervals.
Update) Medical Surgical Nursing II| Review
with Questions and Verified Answers| 100%
Correct| Grade A – Fortis
A patient has just returned to the nursing unit after an
esophagogastroduodenoscopy (EGD). Which action by assistive personnel (AP)
requires that the registered nurse (RN) intervene?
a. Offering the patient a pitcher of water
b. Positioning the patient on the right side
c. Checking the vital signs every 30 minutes
d. Swabbing the patient's mouth with a wet cloth - ANSWER A.
Immediately after EGD, the patient will have a decreased gag reflex and is at risk
for aspiration. Assessment for return of the gag reflex should be done by the RN.
The other actions by the AP are appropriate.
Which area of the abdomen shown in the accompanying figure will the nurse
palpate to assess for splenomegaly?
a. 1
b. 2
c. 3
d. 4 - ANSWER B.
The spleen is usually not palpable, but when palpated, it is located in left upper
quadrant of abdomen.
A patient who has just been started on enteral nutrition of full-strength formula at
100 mL/hr has 6 liquid stools the first day. Which action would the nurse plan to
take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
,c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube. - ANSWER
A.
Loose stools indicate poor absorption of nutrients and indicate a need to slow the
feeding rate or decrease the concentration of the feeding. Water should be given
when patients receive enteral feedings to prevent dehydration. When a closed
enteral feeding system is used, the tubing and formula are changed every 24 hours.
High residual volumes do not contribute to diarrhea.
A young adult with extensive facial injuries from a motor vehicle crash is receiving
continuous enteral nutrition through a percutaneous endoscopic gastrostomy
(PEG). Which action will the nurse include in the plan of care?
a. Keep the patient positioned lying on the left side.
b. Flush the tube with 30 mL of water every 4 hours.
c. Crush and mix medications in with the feeding formula.
d. Obtain a daily abdominal radiograph to verify tube placement. - ANSWER
B.
The tube is flushed every 4 hours during continuous feedings to avoid tube
obstruction. The patient should be positioned with the head of the bed elevated.
Crushed medications mixed in with the formula are likely to clog the tube. An x-
ray is obtained immediately after placement of the PEG tube to check position, but
daily x-rays are not needed.
A malnourished patient is receiving a parenteral nutrition (PN) infusion containing
amino acids and dextrose from a bag that was hung with a new tubing and filter 24
hours ago. The nurse observes that about 50 mL remain in the PN container.
Which action would the nurse take?
a. Add a new container of PN using the current tubing and filter.
b. Hang a new container of PN and change the IV tubing and filter.
c. Infuse the remaining 50 mL and then hang a new container of PN.
d. Ask the health care provider to clarify the written PN prescription. -
ANSWER B.
All PN solutions and tubings are changed at 24 hours. Infusion of the additional 50
mL will increase patient risk for infection. The nurse (not the health care provider)
is responsible for knowing the indicated times for tubing and filter changes.
, What action would the nurse take when caring for a patient with a soft, silicone
nasogastric tube in place for enteral nutrition?
a. Avoid giving medications through the feeding tube.
b. Keep head of bed elevated to 30- to 45-degree angle.
c. Replace the tube every 3 days to avoid mucosal damage.
d. Administer medications mixed with enteral feeding formula. - ANSWER
B.
Elevate the head of the bed to decrease the risk of aspiration. The tubes are less
likely to cause mucosal damage than the stiffer polyvinyl chloride tubes used for
nasogastric suction and do not need to be replaced at certain intervals. Medications
can be given through these tubes but flushing before and after medication
administration is important to avoid clogging. Do not mix medications with
formula, as the combination can clog the tube.
After change-of-shift report, which patient will the nurse assess first?
a. A 40-yr-old woman whose parenteral nutrition infusion bag has 30 minutes of
solution left
b. A 40-yr-old man with continuous enteral feedings who has developed
pulmonary
crackles
c. A 30-yr-old man with 4+ generalized pitting edema and severe protein-calorie
malnutrition
d. A 30-yr-old woman whose gastrostomy tube is plugged after crushed
medications
were administered - ANSWER B
The patient data suggest aspiration may have occurred, and rapid assessment and
intervention are needed. The other patients should also be assessed soon, but the
data about them do not suggest any immediately life-threatening complications.
After sleeve gastrectomy, a 42-yr-old male patient returns to the surgical nursing
unit with a nasogastric tube to low, intermittent suction and a patient-controlled
analgesia (PCA) machine for pain control. Which nursing action would be
included in the postoperative plan of care?
a. Offer sips of fruit juices at frequent intervals.
