NU 185 Exam 3 Medical-Surgical Nursing II 2026 Galen College
1. A nurse is providing discharge teaching to a patient with GERD. Which
instruction should the nurse include?
A. Eat three large meals a day to prevent hunger.
B. Elevate the head of the bed 6 to 12 inches using blocks.
C. Lie down for 30 minutes immediately after eating.
D. Drink orange juice daily to increase vitamin C intake.
Answer: B
Rationale: Elevating the head of the bed helps prevent gastric acid from refluxing into the
esophagus. Patients should also avoid lying down after meals and eat small, frequent meals.
2. A patient with a history of Peptic Ulcer Disease (PUD) suddenly develops a
rigid, board-like abdomen and severe pain. What is the priority nursing action?
A. Administer an antacid as ordered.
B. Place the patient in a prone position.
C. Notify the healthcare provider immediately.
D. Start a bolus of IV fluids.
Answer: C
Rationale: A rigid, board-like abdomen is a classic sign of perforation, a medical
emergency that requires immediate surgical consultation.
,3. Which clinical manifestation is more commonly associated with Ulcerative
Colitis than Crohn’s disease?
A. Bloody stools (rectal bleeding)
B. Skip lesions
C. Malabsorption in the small intestine
D. Fistula formation
Answer: A
Rationale: Ulcerative Colitis primarily involves the mucosa of the rectum and colon,
leading to frequent bloody diarrhea. Crohn’s is characterized by transmural inflammation
and skip lesions.
4. A patient with cirrhosis is prescribed Lactulose. What is the primary purpose
of this medication?
A. To reduce abdominal ascites.
B. To treat esophageal varices.
C. To lower blood ammonia levels.
D. To prevent vitamin K deficiency.
Answer: C
Rationale: Lactulose promotes the excretion of ammonia through the stool to prevent or
treat hepatic encephalopathy.
5. The nurse is assessing a patient with acute pancreatitis. Which finding should
be reported to the provider as a sign of retroperitoneal hemorrhage?
A. Positive Murphy’s sign
B. Cullen’s sign (bluish periumbilical discoloration)
C. Steatorrhea
D. Rebound tenderness in the LLQ
Answer: B
, Rationale: Cullen’s sign (bruising around the navel) and Turner’s sign (flank bruising)
indicate retroperitoneal bleeding associated with severe pancreatitis.
6. What is the goal for a patient receiving medical management for hepatic
encephalopathy regarding bowel movements?
A. One firm stool every other day.
B. Five to six watery stools per day.
C. Two to three soft stools per day.
D. Total cessation of bowel movements.
Answer: C
Rationale: The therapeutic goal of lactulose is to achieve 2-3 soft stools daily, indicating
the ammonia is being effectively cleared without causing dehydration.
7. A patient presents with RUQ pain that radiates to the right shoulder after
eating a high-fat meal. Which condition does the nurse suspect?
A. Appendicitis
B. Cholecystitis
C. Diverticulitis
D. Pancreatitis
Answer: B
Rationale: Cholecystitis (inflammation of the gallbladder) typically causes RUQ pain
radiating to the scapula or shoulder, often triggered by fatty foods.
8. Which diagnostic laboratory test is the most specific for diagnosing acute
pancreatitis?
A. Serum Amylase
B. White Blood Cell Count
C. Serum Lipase
D. Serum Bilirubin
Answer: C
1. A nurse is providing discharge teaching to a patient with GERD. Which
instruction should the nurse include?
A. Eat three large meals a day to prevent hunger.
B. Elevate the head of the bed 6 to 12 inches using blocks.
C. Lie down for 30 minutes immediately after eating.
D. Drink orange juice daily to increase vitamin C intake.
Answer: B
Rationale: Elevating the head of the bed helps prevent gastric acid from refluxing into the
esophagus. Patients should also avoid lying down after meals and eat small, frequent meals.
2. A patient with a history of Peptic Ulcer Disease (PUD) suddenly develops a
rigid, board-like abdomen and severe pain. What is the priority nursing action?
A. Administer an antacid as ordered.
B. Place the patient in a prone position.
C. Notify the healthcare provider immediately.
D. Start a bolus of IV fluids.
Answer: C
Rationale: A rigid, board-like abdomen is a classic sign of perforation, a medical
emergency that requires immediate surgical consultation.
,3. Which clinical manifestation is more commonly associated with Ulcerative
Colitis than Crohn’s disease?
A. Bloody stools (rectal bleeding)
B. Skip lesions
C. Malabsorption in the small intestine
D. Fistula formation
Answer: A
Rationale: Ulcerative Colitis primarily involves the mucosa of the rectum and colon,
leading to frequent bloody diarrhea. Crohn’s is characterized by transmural inflammation
and skip lesions.
4. A patient with cirrhosis is prescribed Lactulose. What is the primary purpose
of this medication?
A. To reduce abdominal ascites.
B. To treat esophageal varices.
C. To lower blood ammonia levels.
D. To prevent vitamin K deficiency.
Answer: C
Rationale: Lactulose promotes the excretion of ammonia through the stool to prevent or
treat hepatic encephalopathy.
5. The nurse is assessing a patient with acute pancreatitis. Which finding should
be reported to the provider as a sign of retroperitoneal hemorrhage?
A. Positive Murphy’s sign
B. Cullen’s sign (bluish periumbilical discoloration)
C. Steatorrhea
D. Rebound tenderness in the LLQ
Answer: B
, Rationale: Cullen’s sign (bruising around the navel) and Turner’s sign (flank bruising)
indicate retroperitoneal bleeding associated with severe pancreatitis.
6. What is the goal for a patient receiving medical management for hepatic
encephalopathy regarding bowel movements?
A. One firm stool every other day.
B. Five to six watery stools per day.
C. Two to three soft stools per day.
D. Total cessation of bowel movements.
Answer: C
Rationale: The therapeutic goal of lactulose is to achieve 2-3 soft stools daily, indicating
the ammonia is being effectively cleared without causing dehydration.
7. A patient presents with RUQ pain that radiates to the right shoulder after
eating a high-fat meal. Which condition does the nurse suspect?
A. Appendicitis
B. Cholecystitis
C. Diverticulitis
D. Pancreatitis
Answer: B
Rationale: Cholecystitis (inflammation of the gallbladder) typically causes RUQ pain
radiating to the scapula or shoulder, often triggered by fatty foods.
8. Which diagnostic laboratory test is the most specific for diagnosing acute
pancreatitis?
A. Serum Amylase
B. White Blood Cell Count
C. Serum Lipase
D. Serum Bilirubin
Answer: C
