Grand Canyon University NSG 320 Exam 3 (pdf) | 2026/2027 | Adult
Health I Q&A | Nursing
1. A 45-year-old reports a burning epigastric pain that worsens 2 hours after
meals and is relieved by eating. Which condition is most consistent with
these symptoms?
A) Gastric ulcer
B) Duodenal ulcer
C) Gastroesophageal reflux disease
D) Pancreatitis
Correct Answer: Duodenal ulcer
Rationale: Duodenal ulcers typically present with burning epigastric pain that
occurs 2-3 hours after meals and is relieved by food or antacids. Gastric
ulcers cause pain that worsens with eating. GERD pain is typically
retrosternal, and pancreatitis causes severe, radiating upper abdominal pain.
---
2. A patient with peptic ulcer disease is diagnosed with an H. pylori infection.
Which diagnostic test is considered the gold standard for confirming this
infection?
A) Urea breath test
B) Stool antigen test
C) Serology (antibody test)
D) Esophagogastroduodenoscopy (EGD) with biopsy
Correct Answer: Esophagogastroduodenoscopy (EGD) with biopsy
,Rationale: EGD with biopsy is the gold standard for H. pylori testing because
it allows direct visualization of the ulcer and tissue sampling for histology
and culture. The urea breath test is the most accurate noninvasive test, stool
antigen is useful, and serology cannot confirm active infection.
---
3. A patient has just returned from an EGD with biopsy. Which nursing
intervention is the priority immediately following the procedure?
A) Offer the patient a clear liquid diet
B) Assess for the return of the gag reflex before offering oral intake
C) Administer prescribed antibiotics
D) Monitor for signs of gastrointestinal bleeding
Correct Answer: Assess for the return of the gag reflex before offering oral
intake
Rationale: After EGD, the patient's gag reflex may be depressed due to
topical anesthesia. Offering oral intake before the gag reflex returns
increases the risk of aspiration. The nurse must assess the gag reflex before
allowing anything by mouth.
---
4. Which of the following is a classic sign of appendicitis?
A) Left lower quadrant pain with rebound tenderness
B) Periumbilical pain migrating to the right lower quadrant
C) Diffuse abdominal pain with guarding
D) Pain that is relieved by lying still
,Correct Answer: Periumbilical pain migrating to the right lower quadrant
Rationale: Classic appendicitis presents with periumbilical pain that migrates
to the right lower quadrant (McBurney's point). Rebound tenderness,
Rovsing's sign, anorexia, nausea, and low-grade fever are also characteristic.
---
5. A nurse is assessing a patient with suspected appendicitis and performs a
Rovsing's sign test. Which finding indicates a positive Rovsing's sign?
A) Pain in the right lower quadrant when the left lower quadrant is palpated
B) Pain in the left lower quadrant when the right lower quadrant is palpated
C) Pain that is relieved when the patient flexes the right hip
D) Rebound tenderness in the right upper quadrant
Correct Answer: Pain in the right lower quadrant when the left lower
quadrant is palpated
Rationale: Rovsing's sign is positive when palpation of the left lower quadrant
causes pain in the right lower quadrant. This occurs because the pressure
transmits to the inflamed appendix in the right lower quadrant.
---
6. A patient with diverticulitis is in the acute phase. Which dietary
intervention is most appropriate?
A) High-fiber diet
B) Clear liquids or NPO
, C) Low-fiber diet
D) Full liquid diet with protein supplements
Correct Answer: Clear liquids or NPO
Rationale: During the acute phase of diverticulitis, bowel rest is essential.
The patient is typically kept NPO or on clear liquids to allow the inflamed
diverticula to heal. A high-fiber diet is indicated after the acute inflammation
resolves.
---
7. A patient is recovering from an acute diverticulitis episode and asks about
dietary restrictions. Which traditional teaching should the nurse include?
A) "You can resume a regular diet immediately."
B) "Avoid nuts, seeds, and popcorn to prevent recurrence."
C) "Increase your intake of dairy products."
D) "There are no dietary restrictions after recovery."
Correct Answer: "Avoid nuts, seeds, and popcorn to prevent recurrence."
Rationale: Traditional teaching for diverticulitis includes avoiding nuts, seeds,
and popcorn, although this is controversial and some providers no longer
recommend it. Many providers still advise avoidance to prevent diverticular
inflammation.
---
Health I Q&A | Nursing
1. A 45-year-old reports a burning epigastric pain that worsens 2 hours after
meals and is relieved by eating. Which condition is most consistent with
these symptoms?
A) Gastric ulcer
B) Duodenal ulcer
C) Gastroesophageal reflux disease
D) Pancreatitis
Correct Answer: Duodenal ulcer
Rationale: Duodenal ulcers typically present with burning epigastric pain that
occurs 2-3 hours after meals and is relieved by food or antacids. Gastric
ulcers cause pain that worsens with eating. GERD pain is typically
retrosternal, and pancreatitis causes severe, radiating upper abdominal pain.
---
2. A patient with peptic ulcer disease is diagnosed with an H. pylori infection.
Which diagnostic test is considered the gold standard for confirming this
infection?
A) Urea breath test
B) Stool antigen test
C) Serology (antibody test)
D) Esophagogastroduodenoscopy (EGD) with biopsy
Correct Answer: Esophagogastroduodenoscopy (EGD) with biopsy
,Rationale: EGD with biopsy is the gold standard for H. pylori testing because
it allows direct visualization of the ulcer and tissue sampling for histology
and culture. The urea breath test is the most accurate noninvasive test, stool
antigen is useful, and serology cannot confirm active infection.
---
3. A patient has just returned from an EGD with biopsy. Which nursing
intervention is the priority immediately following the procedure?
A) Offer the patient a clear liquid diet
B) Assess for the return of the gag reflex before offering oral intake
C) Administer prescribed antibiotics
D) Monitor for signs of gastrointestinal bleeding
Correct Answer: Assess for the return of the gag reflex before offering oral
intake
Rationale: After EGD, the patient's gag reflex may be depressed due to
topical anesthesia. Offering oral intake before the gag reflex returns
increases the risk of aspiration. The nurse must assess the gag reflex before
allowing anything by mouth.
---
4. Which of the following is a classic sign of appendicitis?
A) Left lower quadrant pain with rebound tenderness
B) Periumbilical pain migrating to the right lower quadrant
C) Diffuse abdominal pain with guarding
D) Pain that is relieved by lying still
,Correct Answer: Periumbilical pain migrating to the right lower quadrant
Rationale: Classic appendicitis presents with periumbilical pain that migrates
to the right lower quadrant (McBurney's point). Rebound tenderness,
Rovsing's sign, anorexia, nausea, and low-grade fever are also characteristic.
---
5. A nurse is assessing a patient with suspected appendicitis and performs a
Rovsing's sign test. Which finding indicates a positive Rovsing's sign?
A) Pain in the right lower quadrant when the left lower quadrant is palpated
B) Pain in the left lower quadrant when the right lower quadrant is palpated
C) Pain that is relieved when the patient flexes the right hip
D) Rebound tenderness in the right upper quadrant
Correct Answer: Pain in the right lower quadrant when the left lower
quadrant is palpated
Rationale: Rovsing's sign is positive when palpation of the left lower quadrant
causes pain in the right lower quadrant. This occurs because the pressure
transmits to the inflamed appendix in the right lower quadrant.
---
6. A patient with diverticulitis is in the acute phase. Which dietary
intervention is most appropriate?
A) High-fiber diet
B) Clear liquids or NPO
, C) Low-fiber diet
D) Full liquid diet with protein supplements
Correct Answer: Clear liquids or NPO
Rationale: During the acute phase of diverticulitis, bowel rest is essential.
The patient is typically kept NPO or on clear liquids to allow the inflamed
diverticula to heal. A high-fiber diet is indicated after the acute inflammation
resolves.
---
7. A patient is recovering from an acute diverticulitis episode and asks about
dietary restrictions. Which traditional teaching should the nurse include?
A) "You can resume a regular diet immediately."
B) "Avoid nuts, seeds, and popcorn to prevent recurrence."
C) "Increase your intake of dairy products."
D) "There are no dietary restrictions after recovery."
Correct Answer: "Avoid nuts, seeds, and popcorn to prevent recurrence."
Rationale: Traditional teaching for diverticulitis includes avoiding nuts, seeds,
and popcorn, although this is controversial and some providers no longer
recommend it. Many providers still advise avoidance to prevent diverticular
inflammation.
---
