NURS 201 Quiz 4 V3 | NURS 201 Medical
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 4) | West Coast
University
1. A patient with Gastroesophageal Reflux Disease (GERD) is being discharged. Which
statement by the patient indicates an understanding of the lifestyle modifications required?
A. I should eat three large meals a day to keep my stomach full.
B. I will lie down flat for 30 minutes after each meal.
C. Drinking orange juice in the morning will help my digestion.
D. I will avoid eating for at least 3 hours before going to bed.
Answer: D
Rationale: Lying down shortly after eating promotes the reflux of gastric contents into the
esophagus due to gravity and increased intra-abdominal pressure. Avoiding food for 3
hours before sleep helps ensure the stomach is empty, reducing the risk of nighttime reflux.
The patient should also avoid trigger foods like citrus, caffeine, and large meals.
2. A nurse is assessing a patient with a suspected Peptic Ulcer. The patient reports pain that is
relieved by eating. Which type of ulcer does the nurse suspect?
A. Gastric ulcer
B. Esophageal ulcer
,C. Curling’s ulcer
D. Duodenal ulcer
Answer: D
Rationale: Duodenal ulcers are characteristically associated with pain occurring 2 to 5
hours after a meal when the stomach is empty, which is often relieved by food or antacids.
In contrast, gastric ulcer pain usually occurs sooner after eating and may be worsened by
food. This clinical distinction is vital for determining the primary location of the peptic
ulceration.
3. The nurse is caring for a patient with Acute Pancreatitis. Which laboratory result should the
nurse prioritize for reporting to the healthcare provider?
A. White blood cell count of 11,000/mm3
B. Serum amylase of 250 U/L
C. Glucose of 130 mg/dL
D. Serum calcium of 6.8 mg/dL
Answer: D
Rationale: Hypocalcemia is a serious complication of acute pancreatitis and can lead to
tetany and cardiac arrhythmias. A calcium level of 6.8 mg/dL is significantly below the
normal range (8.5–10.5 mg/dL) and requires immediate intervention. Amylase and WBC
are expected to be elevated in pancreatitis, but severe hypocalcemia is a priority safety
concern.
,4. A patient with Cirrhosis is experiencing hepatic encephalopathy. Which medication should
the nurse expect to administer to reduce ammonia levels?
A. Lactulose
B. Propranolol
C. Spironolactone
D. Vitamin K
Answer: A
Rationale: Lactulose works by increasing the osmotic pressure in the colon and acidifying
the contents, which converts ammonia to ammonium for excretion in the stool. This
process prevents the absorption of ammonia into the bloodstream, thereby improving
neurological status. The nurse must monitor for frequent soft stools as an indicator of the
medication’s therapeutic effect.
5. A patient is admitted with a diagnosis of Diverticulitis. Which order should the nurse
question during the acute phase of the illness?
A. Intravenous antibiotics
B. NPO status
C. Nasogastric tube to low suction
D. High-fiber diet
Answer: D
, Rationale: During the acute inflammatory phase of diverticulitis, the bowel requires rest to
allow the inflammation to subside, so a high-fiber diet is contraindicated. A low-fiber or
clear liquid diet is initiated once symptoms improve, and high fiber is only recommended
for long-term management after the acute episode. Feeding high fiber during an acute flare
could lead to perforation or bowel obstruction.
6. Which clinical manifestation would the nurse expect to find in a patient with a Small Bowel
Obstruction (SBO)?
A. Projectile vomiting and rapid onset of dehydration
B. Intermittent, lower abdominal cramping
C. Low-grade fever and bloody diarrhea
D. Metabolic acidosis and ribbon-like stools
Answer: A
Rationale: Small bowel obstructions typically present with rapid onset of symptoms,
including upper abdominal pain and projectile vomiting. Because the obstruction prevents
absorption, fluid and electrolyte imbalances occur quickly, leading to dehydration. In
contrast, large bowel obstructions present more slowly and often involve distention
without immediate vomiting.
7. A nurse is providing teaching to a patient with a new ileostomy. What should the patient
be instructed regarding the consistency of the output?
A. The output will be liquid to semi-liquid.
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 4) | West Coast
University
1. A patient with Gastroesophageal Reflux Disease (GERD) is being discharged. Which
statement by the patient indicates an understanding of the lifestyle modifications required?
A. I should eat three large meals a day to keep my stomach full.
B. I will lie down flat for 30 minutes after each meal.
C. Drinking orange juice in the morning will help my digestion.
D. I will avoid eating for at least 3 hours before going to bed.
Answer: D
Rationale: Lying down shortly after eating promotes the reflux of gastric contents into the
esophagus due to gravity and increased intra-abdominal pressure. Avoiding food for 3
hours before sleep helps ensure the stomach is empty, reducing the risk of nighttime reflux.
The patient should also avoid trigger foods like citrus, caffeine, and large meals.
2. A nurse is assessing a patient with a suspected Peptic Ulcer. The patient reports pain that is
relieved by eating. Which type of ulcer does the nurse suspect?
A. Gastric ulcer
B. Esophageal ulcer
,C. Curling’s ulcer
D. Duodenal ulcer
Answer: D
Rationale: Duodenal ulcers are characteristically associated with pain occurring 2 to 5
hours after a meal when the stomach is empty, which is often relieved by food or antacids.
In contrast, gastric ulcer pain usually occurs sooner after eating and may be worsened by
food. This clinical distinction is vital for determining the primary location of the peptic
ulceration.
3. The nurse is caring for a patient with Acute Pancreatitis. Which laboratory result should the
nurse prioritize for reporting to the healthcare provider?
A. White blood cell count of 11,000/mm3
B. Serum amylase of 250 U/L
C. Glucose of 130 mg/dL
D. Serum calcium of 6.8 mg/dL
Answer: D
Rationale: Hypocalcemia is a serious complication of acute pancreatitis and can lead to
tetany and cardiac arrhythmias. A calcium level of 6.8 mg/dL is significantly below the
normal range (8.5–10.5 mg/dL) and requires immediate intervention. Amylase and WBC
are expected to be elevated in pancreatitis, but severe hypocalcemia is a priority safety
concern.
,4. A patient with Cirrhosis is experiencing hepatic encephalopathy. Which medication should
the nurse expect to administer to reduce ammonia levels?
A. Lactulose
B. Propranolol
C. Spironolactone
D. Vitamin K
Answer: A
Rationale: Lactulose works by increasing the osmotic pressure in the colon and acidifying
the contents, which converts ammonia to ammonium for excretion in the stool. This
process prevents the absorption of ammonia into the bloodstream, thereby improving
neurological status. The nurse must monitor for frequent soft stools as an indicator of the
medication’s therapeutic effect.
5. A patient is admitted with a diagnosis of Diverticulitis. Which order should the nurse
question during the acute phase of the illness?
A. Intravenous antibiotics
B. NPO status
C. Nasogastric tube to low suction
D. High-fiber diet
Answer: D
, Rationale: During the acute inflammatory phase of diverticulitis, the bowel requires rest to
allow the inflammation to subside, so a high-fiber diet is contraindicated. A low-fiber or
clear liquid diet is initiated once symptoms improve, and high fiber is only recommended
for long-term management after the acute episode. Feeding high fiber during an acute flare
could lead to perforation or bowel obstruction.
6. Which clinical manifestation would the nurse expect to find in a patient with a Small Bowel
Obstruction (SBO)?
A. Projectile vomiting and rapid onset of dehydration
B. Intermittent, lower abdominal cramping
C. Low-grade fever and bloody diarrhea
D. Metabolic acidosis and ribbon-like stools
Answer: A
Rationale: Small bowel obstructions typically present with rapid onset of symptoms,
including upper abdominal pain and projectile vomiting. Because the obstruction prevents
absorption, fluid and electrolyte imbalances occur quickly, leading to dehydration. In
contrast, large bowel obstructions present more slowly and often involve distention
without immediate vomiting.
7. A nurse is providing teaching to a patient with a new ileostomy. What should the patient
be instructed regarding the consistency of the output?
A. The output will be liquid to semi-liquid.
