NUR 254 - MEDICAL-SURGICAL NURSING II - EXAM 2
2026/2027 – 70 Questions & Answers 100% Pass
OVERVIEW :
Exam 2 covers Units 4-6: Gastrointestinal disorders - GERD, PUD, GI bleed, bowel
obstruction, appendicitis, hepatitis, cirrhosis, pancreatitis; Endocrine disorders -
diabetes mellitus type 1 & 2, DKA, HHS, thyroid and parathyroid disorders; Renal
system - acute kidney injury, chronic kidney disease, dialysis, electrolytes. Emphasis on
fluid-electrolyte balance, glucose control, nutrition, bleeding precautions, infection
prevention, and patient education for chronic disease management. Correct answers
bold Green.
TOPICS COVERED:
Unit 4: GI & Liver Q1-26
Unit 5: Endocrine Q27-50
Unit 6: Renal & Electrolytes Q51-70
UNIT 4: GASTROINTESTINAL & LIVER Q1-26
1. GERD teaching includes:
A. Avoid lying flat after meals, small meals, avoid spicy/fatty foods, caffeine,
alcohol, no smoking, HOB elevated 30 deg
B. Eat large meals before bed
C. Lie flat immediately
D. No diet changes
Rationale: Prevents reflux.
2. PUD - duodenal ulcer pain pattern is:
A. Pain immediately after eating
B. No pain pattern
C. Only during sleep no relation to food
D. Pain 2-5 hrs after meals, nocturnal, relieved by food and antacids, worse when
stomach empty
Rationale: Acid without food buffer causes pain.
3. Gastric ulcer pain is:
A. Relieved by food
B. No pain
C. Pain 30-60 min after eating, aggravated by food, may cause weight loss
D. Only at night
Rationale: Food irritates gastric ulcer.
4. GI bleed - upper vs lower difference:
A. Same presentation
, B. No difference
C. Upper = bright red only
D. Upper - hematemesis, melena black tarry; Lower - hematochezia bright red
Rationale: Blood digested in upper tract = black.
5. Priority for upper GI bleed:
A. ABCs, 2 large bore IVs, NS or LR, type & crossmatch, NG tube as ordered,
monitor Hgb/Hct, VS for shock
B. Give food immediately
C. Lay flat without monitoring
D. No IV needed
Rationale: Hemorrhage can cause hypovolemic shock.
6. Bowel obstruction signs:
A. No pain
B. Normal bowel sounds
C. Diarrhea only
D. Crampy abdominal pain, vomiting, distention, absent bowel sounds later, no
flatus/stool
Rationale: Obstruction blocks passage.
7. Appendicitis classic sign is:
A. Left lower pain
B. No fever
C. RLQ pain at McBurney's point, rebound tenderness, anorexia, nausea, low-
grade fever - Rovsing's sign
D. No pain
Rationale: Inflamed appendix at RLQ.
8. Appendicitis - what NOT to do:
A. NPO status
B. Monitor VS
C. Assess pain
D. Do NOT give laxatives, enemas, or heat to abdomen - may cause rupture
Rationale: Increases pressure causing perforation.
9. Hepatitis - mode of transmission Hep A is:
A. Fecal-oral via contaminated food/water
B. Blood only
C. Sexual only
D. Airborne
Rationale: Hep A fecal-oral.
10. Hepatitis B & C transmission:
A. Fecal-oral only
B. Airborne
C. Casual contact
D. Blood, sexual, perinatal - Hep B vaccine available, no vaccine for C
Rationale: Bloodborne.
11. Cirrhosis signs include:
A. No jaundice
B. Only leg pain
2026/2027 – 70 Questions & Answers 100% Pass
OVERVIEW :
Exam 2 covers Units 4-6: Gastrointestinal disorders - GERD, PUD, GI bleed, bowel
obstruction, appendicitis, hepatitis, cirrhosis, pancreatitis; Endocrine disorders -
diabetes mellitus type 1 & 2, DKA, HHS, thyroid and parathyroid disorders; Renal
system - acute kidney injury, chronic kidney disease, dialysis, electrolytes. Emphasis on
fluid-electrolyte balance, glucose control, nutrition, bleeding precautions, infection
prevention, and patient education for chronic disease management. Correct answers
bold Green.
TOPICS COVERED:
Unit 4: GI & Liver Q1-26
Unit 5: Endocrine Q27-50
Unit 6: Renal & Electrolytes Q51-70
UNIT 4: GASTROINTESTINAL & LIVER Q1-26
1. GERD teaching includes:
A. Avoid lying flat after meals, small meals, avoid spicy/fatty foods, caffeine,
alcohol, no smoking, HOB elevated 30 deg
B. Eat large meals before bed
C. Lie flat immediately
D. No diet changes
Rationale: Prevents reflux.
2. PUD - duodenal ulcer pain pattern is:
A. Pain immediately after eating
B. No pain pattern
C. Only during sleep no relation to food
D. Pain 2-5 hrs after meals, nocturnal, relieved by food and antacids, worse when
stomach empty
Rationale: Acid without food buffer causes pain.
3. Gastric ulcer pain is:
A. Relieved by food
B. No pain
C. Pain 30-60 min after eating, aggravated by food, may cause weight loss
D. Only at night
Rationale: Food irritates gastric ulcer.
4. GI bleed - upper vs lower difference:
A. Same presentation
, B. No difference
C. Upper = bright red only
D. Upper - hematemesis, melena black tarry; Lower - hematochezia bright red
Rationale: Blood digested in upper tract = black.
5. Priority for upper GI bleed:
A. ABCs, 2 large bore IVs, NS or LR, type & crossmatch, NG tube as ordered,
monitor Hgb/Hct, VS for shock
B. Give food immediately
C. Lay flat without monitoring
D. No IV needed
Rationale: Hemorrhage can cause hypovolemic shock.
6. Bowel obstruction signs:
A. No pain
B. Normal bowel sounds
C. Diarrhea only
D. Crampy abdominal pain, vomiting, distention, absent bowel sounds later, no
flatus/stool
Rationale: Obstruction blocks passage.
7. Appendicitis classic sign is:
A. Left lower pain
B. No fever
C. RLQ pain at McBurney's point, rebound tenderness, anorexia, nausea, low-
grade fever - Rovsing's sign
D. No pain
Rationale: Inflamed appendix at RLQ.
8. Appendicitis - what NOT to do:
A. NPO status
B. Monitor VS
C. Assess pain
D. Do NOT give laxatives, enemas, or heat to abdomen - may cause rupture
Rationale: Increases pressure causing perforation.
9. Hepatitis - mode of transmission Hep A is:
A. Fecal-oral via contaminated food/water
B. Blood only
C. Sexual only
D. Airborne
Rationale: Hep A fecal-oral.
10. Hepatitis B & C transmission:
A. Fecal-oral only
B. Airborne
C. Casual contact
D. Blood, sexual, perinatal - Hep B vaccine available, no vaccine for C
Rationale: Bloodborne.
11. Cirrhosis signs include:
A. No jaundice
B. Only leg pain
