NUR 170 Medical-Surgical Nursing Exam 4
2026 Update
Galen College of Nursing
Gastroesophageal Reflux Disease (GERD) & Hiatal Hernia
1. A nurse is teaching a patient about risk factors for GERD. Which of the following should the nurse
include? (Select all that apply)
a) Underweight
b) Obesity
c) Pregnancy
d) Placement of a nasogastric (NG) tube
e) Regular consumption of peppermint tea
Correct Answer: ✔️✔️✔️💜💜b) Obesity, c) Pregnancy, d) Placement of a nasogastric (NG) tube, e)
Regular consumption of peppermint tea
2. A patient with GERD reports frequent heartburn and indigestion. Which of the following
medications works by reducing gastric acid secretion and is often prescribed for long-term
management?
a) Famotidine (Pepcid)
b) Omeprazole (Prilosec)
c) Calcium carbonate (Tums)
d) Metoclopramide (Reglan)
Correct Answer: ✔️✔️✔️💜💜b) Omeprazole (Prilosec)
3. The nurse is providing discharge teaching to a patient diagnosed with a hiatal hernia. Which patient
statement indicates a need for further teaching?
a) "I will eat small, frequent meals throughout the day."
b) "I plan to lie down for a nap right after I eat lunch."
c) "I will avoid wearing tight clothing around my waist."
d) "I will elevate the head of my bed on 6-inch blocks."
Correct Answer: ✔️✔️✔️💜💜b) "I plan to lie down for a nap right after I eat lunch."
4. A patient is scheduled for a Nissen fundoplication. Post-operatively, what is a priority nursing
assessment?
a) Monitoring for diarrhea
b) Assessing for the ability to belch or vomit
c) Encouraging early ambulation
d) Monitoring for hyperglycemia
Correct Answer: ✔️✔️✔️💜💜b) Assessing for the ability to belch or vomit
,5. A nurse is reviewing the chart of a patient with GERD. Which of the following is a potential
complication of long-term, untreated GERD?
a) Crohn's disease
b) Barrett's esophagus
c) Diverticulitis
d) Cholelithiasis
Correct Answer: ✔️✔️✔️💜💜b) Barrett's esophagus
6. A patient with a hiatal hernia is most likely to experience symptoms of GERD because the hernia:
a) Increases the production of stomach acid.
b) Causes a weakness in the diaphragm, allowing stomach contents to reflux.
c) Blocks the outflow of the stomach, causing bile to back up.
d) Decreases the absorption of nutrients.
Correct Answer: ✔️✔️✔️💜💜b) Causes a weakness in the diaphragm, allowing stomach contents to
reflux.
7. The nurse is teaching a patient about taking H2 receptor antagonists like famotidine (Pepcid).
Which instruction is correct?
a) "Take this medication immediately upon waking to coat your stomach."
b) "Take this 30 minutes before eating to neutralize acid."
c) "This medication works best when taken 1-2 hours after meals to reduce gastric acid."
d) "Chew the tablet thoroughly and follow with a full glass of water."
Correct Answer: ✔️✔️✔️💜💜c) "This medication works best when taken 1-2 hours after meals to
reduce gastric acid." (H2 blockers work best when acid production is stimulated, like after meals)
Peptic Ulcer Disease (PUD)
8. A patient with a history of NSAID use presents with epigastric pain that worsens shortly after
eating. The nurse suspects which type of ulcer?
a) Duodenal ulcer
b) Gastric ulcer
c) Esophageal ulcer
d) Stress ulcer
Correct Answer: ✔️✔️✔️💜💜b) Gastric ulcer
9. A patient with a known peptic ulcer suddenly reports a sharp, severe epigastric pain that radiates to
the shoulder, followed by a rigid, board-like abdomen. The nurse should first:
a) Administer the prescribed pain medication.
b) Place the patient in a supine position.
c) Prepare the patient for emergency surgery.
d) Notify the healthcare provider immediately.
Correct Answer: ✔️✔️✔️💜💜d) Notify the healthcare provider immediately. (This indicates
perforation)
, 10. Which finding in a patient with PUD would warrant immediate notification of the healthcare
provider?
a) Black, tarry stools that occurred once yesterday
b) Complaints of indigestion after eating
c) Hypoactive bowel sounds and the patient reports feeling dizzy
d) Heartburn that is relieved by an antacid
Correct Answer: ✔️✔️✔️💜💜c) Hypoactive bowel sounds and the patient reports feeling dizzy
11. A patient is diagnosed with an H. pylori infection. The nurse anticipates a treatment plan that
includes:
a) Antacids only
b) Antibiotics and a proton pump inhibitor
c) A barium swallow study
d) Surgery to remove the ulcer
Correct Answer: ✔️✔️✔️💜💜b) Antibiotics and a proton pump inhibitor
12. A patient is admitted with hematemesis. Which description of the emesis is most consistent with a
bleeding ulcer?
a) Bright red blood mixed with food
b) Green, bilious liquid
c) "Coffee-ground" appearance
d) Undigested food from a meal eaten hours ago
Correct Answer: ✔️✔️✔️💜💜c) "Coffee-ground" appearance
13. The nurse is caring for a patient post-gastrectomy. The patient is prescribed medications. Which
type of medication should the nurse question?
a) Proton pump inhibitors
b) Vitamin B12 injections
c) Enteric-coated tablets
d) Antiemetics
Correct Answer: ✔️✔️✔️💜💜c) Enteric-coated tablets
Inflammatory Bowel Disease (IBD): Crohn's & Ulcerative Colitis
14. Which diet is most appropriate for a patient experiencing an acute exacerbation of inflammatory
bowel disease (IBD)?
a) High fiber, low protein
b) Low calorie, low vitamin
c) High protein, high calorie, low fiber
d) Lactose-rich, high residue
Correct Answer: ✔️✔️✔️💜💜c) High protein, high calorie, low fiber
15. A patient with Crohn's disease is likely to have stool that is:
a) Watery and non-bloody
2026 Update
Galen College of Nursing
Gastroesophageal Reflux Disease (GERD) & Hiatal Hernia
1. A nurse is teaching a patient about risk factors for GERD. Which of the following should the nurse
include? (Select all that apply)
a) Underweight
b) Obesity
c) Pregnancy
d) Placement of a nasogastric (NG) tube
e) Regular consumption of peppermint tea
Correct Answer: ✔️✔️✔️💜💜b) Obesity, c) Pregnancy, d) Placement of a nasogastric (NG) tube, e)
Regular consumption of peppermint tea
2. A patient with GERD reports frequent heartburn and indigestion. Which of the following
medications works by reducing gastric acid secretion and is often prescribed for long-term
management?
a) Famotidine (Pepcid)
b) Omeprazole (Prilosec)
c) Calcium carbonate (Tums)
d) Metoclopramide (Reglan)
Correct Answer: ✔️✔️✔️💜💜b) Omeprazole (Prilosec)
3. The nurse is providing discharge teaching to a patient diagnosed with a hiatal hernia. Which patient
statement indicates a need for further teaching?
a) "I will eat small, frequent meals throughout the day."
b) "I plan to lie down for a nap right after I eat lunch."
c) "I will avoid wearing tight clothing around my waist."
d) "I will elevate the head of my bed on 6-inch blocks."
Correct Answer: ✔️✔️✔️💜💜b) "I plan to lie down for a nap right after I eat lunch."
4. A patient is scheduled for a Nissen fundoplication. Post-operatively, what is a priority nursing
assessment?
a) Monitoring for diarrhea
b) Assessing for the ability to belch or vomit
c) Encouraging early ambulation
d) Monitoring for hyperglycemia
Correct Answer: ✔️✔️✔️💜💜b) Assessing for the ability to belch or vomit
,5. A nurse is reviewing the chart of a patient with GERD. Which of the following is a potential
complication of long-term, untreated GERD?
a) Crohn's disease
b) Barrett's esophagus
c) Diverticulitis
d) Cholelithiasis
Correct Answer: ✔️✔️✔️💜💜b) Barrett's esophagus
6. A patient with a hiatal hernia is most likely to experience symptoms of GERD because the hernia:
a) Increases the production of stomach acid.
b) Causes a weakness in the diaphragm, allowing stomach contents to reflux.
c) Blocks the outflow of the stomach, causing bile to back up.
d) Decreases the absorption of nutrients.
Correct Answer: ✔️✔️✔️💜💜b) Causes a weakness in the diaphragm, allowing stomach contents to
reflux.
7. The nurse is teaching a patient about taking H2 receptor antagonists like famotidine (Pepcid).
Which instruction is correct?
a) "Take this medication immediately upon waking to coat your stomach."
b) "Take this 30 minutes before eating to neutralize acid."
c) "This medication works best when taken 1-2 hours after meals to reduce gastric acid."
d) "Chew the tablet thoroughly and follow with a full glass of water."
Correct Answer: ✔️✔️✔️💜💜c) "This medication works best when taken 1-2 hours after meals to
reduce gastric acid." (H2 blockers work best when acid production is stimulated, like after meals)
Peptic Ulcer Disease (PUD)
8. A patient with a history of NSAID use presents with epigastric pain that worsens shortly after
eating. The nurse suspects which type of ulcer?
a) Duodenal ulcer
b) Gastric ulcer
c) Esophageal ulcer
d) Stress ulcer
Correct Answer: ✔️✔️✔️💜💜b) Gastric ulcer
9. A patient with a known peptic ulcer suddenly reports a sharp, severe epigastric pain that radiates to
the shoulder, followed by a rigid, board-like abdomen. The nurse should first:
a) Administer the prescribed pain medication.
b) Place the patient in a supine position.
c) Prepare the patient for emergency surgery.
d) Notify the healthcare provider immediately.
Correct Answer: ✔️✔️✔️💜💜d) Notify the healthcare provider immediately. (This indicates
perforation)
, 10. Which finding in a patient with PUD would warrant immediate notification of the healthcare
provider?
a) Black, tarry stools that occurred once yesterday
b) Complaints of indigestion after eating
c) Hypoactive bowel sounds and the patient reports feeling dizzy
d) Heartburn that is relieved by an antacid
Correct Answer: ✔️✔️✔️💜💜c) Hypoactive bowel sounds and the patient reports feeling dizzy
11. A patient is diagnosed with an H. pylori infection. The nurse anticipates a treatment plan that
includes:
a) Antacids only
b) Antibiotics and a proton pump inhibitor
c) A barium swallow study
d) Surgery to remove the ulcer
Correct Answer: ✔️✔️✔️💜💜b) Antibiotics and a proton pump inhibitor
12. A patient is admitted with hematemesis. Which description of the emesis is most consistent with a
bleeding ulcer?
a) Bright red blood mixed with food
b) Green, bilious liquid
c) "Coffee-ground" appearance
d) Undigested food from a meal eaten hours ago
Correct Answer: ✔️✔️✔️💜💜c) "Coffee-ground" appearance
13. The nurse is caring for a patient post-gastrectomy. The patient is prescribed medications. Which
type of medication should the nurse question?
a) Proton pump inhibitors
b) Vitamin B12 injections
c) Enteric-coated tablets
d) Antiemetics
Correct Answer: ✔️✔️✔️💜💜c) Enteric-coated tablets
Inflammatory Bowel Disease (IBD): Crohn's & Ulcerative Colitis
14. Which diet is most appropriate for a patient experiencing an acute exacerbation of inflammatory
bowel disease (IBD)?
a) High fiber, low protein
b) Low calorie, low vitamin
c) High protein, high calorie, low fiber
d) Lactose-rich, high residue
Correct Answer: ✔️✔️✔️💜💜c) High protein, high calorie, low fiber
15. A patient with Crohn's disease is likely to have stool that is:
a) Watery and non-bloody
