NSG 320 Exam 4 V2 | NSG 320 Adult
Health Nursing I | Actual Q&A with
Rationale (NSG320 Exam 4) | Grand
Canyon University
1. A nurse is caring for a patient with a diagnosis of Gastroesophageal Reflux Disease (GERD).
Which of the following lifestyle modifications should the nurse include in the teaching plan?
A. Wait at least 3 hours after eating before lying down.
B. Consume three large meals a day rather than frequent small ones.
C. Drink orange juice or tomato juice daily to increase Vitamin C.
D. Wear a tight-fitting abdominal binder to support the diaphragm.
Correct Answer: A
Explanation: Lying down immediately after eating increases intra-abdominal pressure and
allows gastric contents to reflux into the esophagus. Waiting at least 3 hours ensures that
the stomach has emptied sufficiently to reduce this risk. Patients should also be advised to
eat small, frequent meals and avoid acidic or restrictive clothing.
2. A patient with Chronic Kidney Disease (CKD) is experiencing hyperkalemia. Which clinical
manifestations should the nurse monitor for? (Select All That Apply)
A. Cardiac dysrhythmias
B. Muscle weakness
,C. Hyperactive deep tendon reflexes
D. Tall, peaked T waves on ECG
E. Abdominal cramping
F. Polyuria
Correct Answer: ABDE
Explanation: Hyperkalemia significantly affects cardiac and neuromuscular function,
leading to potentially fatal dysrhythmias and characteristic ECG changes like peaked T
waves. Muscle weakness and abdominal cramping occur as the electrical gradient of the
cell membrane is altered. Hyperactive reflexes and polyuria are not typically associated
with high potassium levels in CKD patients.
3. The nurse is evaluating the laboratory results for a patient suspected of having acute
pancreatitis. Which finding is most specific to this diagnosis?
A. Elevated serum lipase
B. Elevated serum bilirubin
C. Decreased serum calcium
D. Elevated white blood cell count
Correct Answer: A
Explanation: Serum lipase is more specific to the pancreas than amylase and remains
elevated longer, making it a primary diagnostic marker for acute pancreatitis. While
,amylase also rises, it can be elevated in other conditions such as mumps or bowel
obstruction. Hypocalcemia and leukocytosis may occur but are not the primary diagnostic
indicators for the initial identification of pancreatitis.
4. A patient with cirrhosis is prescribed lactulose. The nurse understands that the primary
goal of this medication is to:
A. Promote the excretion of ammonia through the stool.
B. Increase the absorption of fat-soluble vitamins.
C. Reduce portal hypertension and prevent variceal bleeding.
D. Decrease the production of bile salts in the liver.
Correct Answer: A
Explanation: Lactulose works by trapping ammonia in the gut and facilitating its expulsion
through bowel movements, which is critical for patients with hepatic encephalopathy. The
acidic environment created by lactulose converts ammonia into ammonium, which is non-
absorbable. Monitoring for 2-3 soft stools per day is the standard for determining the
efficacy of this therapy.
5. A nurse is assessing a patient with suspected Peptic Ulcer Disease (PUD). Which of the
following assessment findings is most characteristic of a duodenal ulcer?
A. Pain occurring 30 to 60 minutes after a meal.
B. Pain that is worsened by the ingestion of food.
C. Weight loss and malnutrition due to fear of eating.
, D. Pain occurring 2 to 5 hours after a meal, often at night.
Correct Answer: D
Explanation: Duodenal ulcers typically cause pain when the stomach is empty, usually
several hours after eating or during the night, because food acts as a buffer. In contrast,
gastric ulcers often cause pain shortly after eating as gastric acid is secreted. Patients with
duodenal ulcers may actually gain weight because eating relieves their discomfort.
6. Which clinical indicators should the nurse expect to find in a patient during the oliguric
phase of Acute Kidney Injury (AKI)? (Select All That Apply)
A. Urinary output less than 400 mL/day
B. Metabolic alkalosis
C. Hypervolemia and edema
D. Hypokalemia
E. Elevated BUN and Creatinine
F. Neurological changes due to azotemia
Correct Answer: ACEF
Explanation: The oliguric phase is characterized by a significant drop in urine output,
leading to fluid retention, edema, and hypertension. Laboratory results typically show
metabolic acidosis (not alkalosis) and hyperkalemia (not hypokalemia) because the
Health Nursing I | Actual Q&A with
Rationale (NSG320 Exam 4) | Grand
Canyon University
1. A nurse is caring for a patient with a diagnosis of Gastroesophageal Reflux Disease (GERD).
Which of the following lifestyle modifications should the nurse include in the teaching plan?
A. Wait at least 3 hours after eating before lying down.
B. Consume three large meals a day rather than frequent small ones.
C. Drink orange juice or tomato juice daily to increase Vitamin C.
D. Wear a tight-fitting abdominal binder to support the diaphragm.
Correct Answer: A
Explanation: Lying down immediately after eating increases intra-abdominal pressure and
allows gastric contents to reflux into the esophagus. Waiting at least 3 hours ensures that
the stomach has emptied sufficiently to reduce this risk. Patients should also be advised to
eat small, frequent meals and avoid acidic or restrictive clothing.
2. A patient with Chronic Kidney Disease (CKD) is experiencing hyperkalemia. Which clinical
manifestations should the nurse monitor for? (Select All That Apply)
A. Cardiac dysrhythmias
B. Muscle weakness
,C. Hyperactive deep tendon reflexes
D. Tall, peaked T waves on ECG
E. Abdominal cramping
F. Polyuria
Correct Answer: ABDE
Explanation: Hyperkalemia significantly affects cardiac and neuromuscular function,
leading to potentially fatal dysrhythmias and characteristic ECG changes like peaked T
waves. Muscle weakness and abdominal cramping occur as the electrical gradient of the
cell membrane is altered. Hyperactive reflexes and polyuria are not typically associated
with high potassium levels in CKD patients.
3. The nurse is evaluating the laboratory results for a patient suspected of having acute
pancreatitis. Which finding is most specific to this diagnosis?
A. Elevated serum lipase
B. Elevated serum bilirubin
C. Decreased serum calcium
D. Elevated white blood cell count
Correct Answer: A
Explanation: Serum lipase is more specific to the pancreas than amylase and remains
elevated longer, making it a primary diagnostic marker for acute pancreatitis. While
,amylase also rises, it can be elevated in other conditions such as mumps or bowel
obstruction. Hypocalcemia and leukocytosis may occur but are not the primary diagnostic
indicators for the initial identification of pancreatitis.
4. A patient with cirrhosis is prescribed lactulose. The nurse understands that the primary
goal of this medication is to:
A. Promote the excretion of ammonia through the stool.
B. Increase the absorption of fat-soluble vitamins.
C. Reduce portal hypertension and prevent variceal bleeding.
D. Decrease the production of bile salts in the liver.
Correct Answer: A
Explanation: Lactulose works by trapping ammonia in the gut and facilitating its expulsion
through bowel movements, which is critical for patients with hepatic encephalopathy. The
acidic environment created by lactulose converts ammonia into ammonium, which is non-
absorbable. Monitoring for 2-3 soft stools per day is the standard for determining the
efficacy of this therapy.
5. A nurse is assessing a patient with suspected Peptic Ulcer Disease (PUD). Which of the
following assessment findings is most characteristic of a duodenal ulcer?
A. Pain occurring 30 to 60 minutes after a meal.
B. Pain that is worsened by the ingestion of food.
C. Weight loss and malnutrition due to fear of eating.
, D. Pain occurring 2 to 5 hours after a meal, often at night.
Correct Answer: D
Explanation: Duodenal ulcers typically cause pain when the stomach is empty, usually
several hours after eating or during the night, because food acts as a buffer. In contrast,
gastric ulcers often cause pain shortly after eating as gastric acid is secreted. Patients with
duodenal ulcers may actually gain weight because eating relieves their discomfort.
6. Which clinical indicators should the nurse expect to find in a patient during the oliguric
phase of Acute Kidney Injury (AKI)? (Select All That Apply)
A. Urinary output less than 400 mL/day
B. Metabolic alkalosis
C. Hypervolemia and edema
D. Hypokalemia
E. Elevated BUN and Creatinine
F. Neurological changes due to azotemia
Correct Answer: ACEF
Explanation: The oliguric phase is characterized by a significant drop in urine output,
leading to fluid retention, edema, and hypertension. Laboratory results typically show
metabolic acidosis (not alkalosis) and hyperkalemia (not hypokalemia) because the
