Galen College NUR 242 Exam 3 (pdf) | 2026/2027 | Med-Surg Q&A |
Medical-Surgical Nursing
1. A nurse is caring for a client with acute respiratory distress syndrome
(ARDS) who is on a mechanical ventilator. The nurse notes a sudden
decrease in oxygen saturation and absent breath sounds on the left side.
Which action should the nurse take first?
A) Call a code blue
B) Increase the FiO2 on the ventilator
C) Prepare for emergency needle decompression
D) Assess the client's endotracheal tube placement
Correct Answer: Prepare for emergency needle decompression
Rationale: A sudden decrease in SpO2 with absent breath sounds on one side
in a mechanically ventilated client is highly suspicious for a tension
pneumothorax. The priority is to prepare for emergency needle
decompression or chest tube insertion. This is a life-threatening complication
of positive pressure ventilation.
2. A client is admitted with an upper GI bleed. Which is the priority nursing
intervention?
A) Apply oxygen by nasal cannula
B) Insert a nasogastric tube
C) Administer IV fluids
D) Draw blood for type and crossmatch
Correct Answer: Apply oxygen by nasal cannula
Rationale: In an active upper GI bleed, applying oxygen is the priority
intervention. Hypoxia can occur rapidly due to blood loss and decreased
,oxygen-carrying capacity. Maintaining oxygenation is the first step before
other interventions.
3. A client reports chest pain that worsens when lying flat and is relieved by
sitting up. The nurse suspects which condition?
A) Hiatal hernia
B) Peptic ulcer disease
C) Gastritis
D) Cholecystitis
Correct Answer: Hiatal hernia
Rationale: Hiatal hernia symptoms often worsen after meals and when lying
flat, and may resolve with sitting up or walking. The recumbent position
allows stomach acid to reflux more easily into the esophagus, causing pain.
This positional nature is a key clinical feature.
4. A client with a history of chronic gastritis is being monitored for
complications. Which laboratory finding is most important for the nurse to
monitor?
A) Serum potassium
B) Complete blood count (CBC)
C) Serum lipase
D) Liver function tests
Correct Answer: Complete blood count (CBC)
Rationale: Chronic gastritis can lead to occult GI bleeding and impaired
vitamin B12 absorption. A CBC helps monitor for anemia from chronic blood
loss. This is a key complication of long-standing gastritis.
,5. A client is scheduled for an esophagogastroduodenoscopy (EGD). Which
assessment finding after the procedure requires immediate intervention?
A) Blood pressure 82/48 mm Hg with a rapid pulse
B) Mild sore throat when swallowing
C) Drowsiness from the sedative medication
D) Complaints of mild nausea
Correct Answer: Blood pressure 82/48 mm Hg with a rapid pulse
Rationale: After an EGD, sudden hypotension with tachycardia may indicate
perforation or significant internal bleeding, which can rapidly progress to
shock and requires immediate intervention. A mild sore throat, drowsiness,
and nausea are expected effects.
6. Which nursing action is a priority after an EGD to evaluate readiness for
oral intake?
A) Offering ice chips for comfort
B) Checking the gag reflex and swallowing ability
C) Asking the client if they feel hungry
D) Measuring abdominal girth
Correct Answer: Checking the gag reflex and swallowing ability
Rationale: After an EGD, the gag reflex must be assessed before the client is
allowed to take anything by mouth to prevent aspiration. This is a critical
safety check following sedation and instrumentation.
, 7. A client is scheduled for an ERCP. Which nursing teaching is most
important before this procedure?
A) "You will need to remain NPO for 4 to 6 hours before the procedure."
B) "You will be awake during the entire procedure."
C) "You can eat a light meal 2 hours before the procedure."
D) "You will need to drink a bowel preparation solution."
Correct Answer: "You will need to remain NPO for 4 to 6 hours before the
procedure."
Rationale: For an ERCP, the client should be NPO for 4 to 6 hours before the
procedure. This reduces the risk of aspiration during sedation and allows for
clear visualization. The client is typically sedated, not awake.
8. A client is diagnosed with a duodenal ulcer. Which characteristic finding
should the nurse expect?
A) Pain that is worsened by eating
B) Pain that is relieved by eating
C) Pain that occurs immediately after meals
D) Pain that is constant and unrelieved
Correct Answer: Pain that is relieved by eating
Rationale: Duodenal ulcers are characterized by pain that occurs when the
stomach is empty and is typically relieved by eating. Gastric ulcers typically
have pain that is worsened by eating.
9. A client is diagnosed with a gastric ulcer. Which characteristic finding
should the nurse expect?
Medical-Surgical Nursing
1. A nurse is caring for a client with acute respiratory distress syndrome
(ARDS) who is on a mechanical ventilator. The nurse notes a sudden
decrease in oxygen saturation and absent breath sounds on the left side.
Which action should the nurse take first?
A) Call a code blue
B) Increase the FiO2 on the ventilator
C) Prepare for emergency needle decompression
D) Assess the client's endotracheal tube placement
Correct Answer: Prepare for emergency needle decompression
Rationale: A sudden decrease in SpO2 with absent breath sounds on one side
in a mechanically ventilated client is highly suspicious for a tension
pneumothorax. The priority is to prepare for emergency needle
decompression or chest tube insertion. This is a life-threatening complication
of positive pressure ventilation.
2. A client is admitted with an upper GI bleed. Which is the priority nursing
intervention?
A) Apply oxygen by nasal cannula
B) Insert a nasogastric tube
C) Administer IV fluids
D) Draw blood for type and crossmatch
Correct Answer: Apply oxygen by nasal cannula
Rationale: In an active upper GI bleed, applying oxygen is the priority
intervention. Hypoxia can occur rapidly due to blood loss and decreased
,oxygen-carrying capacity. Maintaining oxygenation is the first step before
other interventions.
3. A client reports chest pain that worsens when lying flat and is relieved by
sitting up. The nurse suspects which condition?
A) Hiatal hernia
B) Peptic ulcer disease
C) Gastritis
D) Cholecystitis
Correct Answer: Hiatal hernia
Rationale: Hiatal hernia symptoms often worsen after meals and when lying
flat, and may resolve with sitting up or walking. The recumbent position
allows stomach acid to reflux more easily into the esophagus, causing pain.
This positional nature is a key clinical feature.
4. A client with a history of chronic gastritis is being monitored for
complications. Which laboratory finding is most important for the nurse to
monitor?
A) Serum potassium
B) Complete blood count (CBC)
C) Serum lipase
D) Liver function tests
Correct Answer: Complete blood count (CBC)
Rationale: Chronic gastritis can lead to occult GI bleeding and impaired
vitamin B12 absorption. A CBC helps monitor for anemia from chronic blood
loss. This is a key complication of long-standing gastritis.
,5. A client is scheduled for an esophagogastroduodenoscopy (EGD). Which
assessment finding after the procedure requires immediate intervention?
A) Blood pressure 82/48 mm Hg with a rapid pulse
B) Mild sore throat when swallowing
C) Drowsiness from the sedative medication
D) Complaints of mild nausea
Correct Answer: Blood pressure 82/48 mm Hg with a rapid pulse
Rationale: After an EGD, sudden hypotension with tachycardia may indicate
perforation or significant internal bleeding, which can rapidly progress to
shock and requires immediate intervention. A mild sore throat, drowsiness,
and nausea are expected effects.
6. Which nursing action is a priority after an EGD to evaluate readiness for
oral intake?
A) Offering ice chips for comfort
B) Checking the gag reflex and swallowing ability
C) Asking the client if they feel hungry
D) Measuring abdominal girth
Correct Answer: Checking the gag reflex and swallowing ability
Rationale: After an EGD, the gag reflex must be assessed before the client is
allowed to take anything by mouth to prevent aspiration. This is a critical
safety check following sedation and instrumentation.
, 7. A client is scheduled for an ERCP. Which nursing teaching is most
important before this procedure?
A) "You will need to remain NPO for 4 to 6 hours before the procedure."
B) "You will be awake during the entire procedure."
C) "You can eat a light meal 2 hours before the procedure."
D) "You will need to drink a bowel preparation solution."
Correct Answer: "You will need to remain NPO for 4 to 6 hours before the
procedure."
Rationale: For an ERCP, the client should be NPO for 4 to 6 hours before the
procedure. This reduces the risk of aspiration during sedation and allows for
clear visualization. The client is typically sedated, not awake.
8. A client is diagnosed with a duodenal ulcer. Which characteristic finding
should the nurse expect?
A) Pain that is worsened by eating
B) Pain that is relieved by eating
C) Pain that occurs immediately after meals
D) Pain that is constant and unrelieved
Correct Answer: Pain that is relieved by eating
Rationale: Duodenal ulcers are characterized by pain that occurs when the
stomach is empty and is typically relieved by eating. Gastric ulcers typically
have pain that is worsened by eating.
9. A client is diagnosed with a gastric ulcer. Which characteristic finding
should the nurse expect?
