Galen College NUR 170 Exam 4 (pdf) | 2026/2027 | Med-Surg Q&A |
Medical-Surgical Nursing
1. A patient is scheduled for an esophagogastroduodenoscopy (EGD). What is
the priority nursing assessment after the procedure?
A) Checking for a gag reflex before offering fluids
B) Monitoring for a hoarse voice or sore throat
C) Ensuring the patient remains NPO for 12 hours
D) Checking for bruising around the eyes
Correct Answer: Checking for a gag reflex before offering fluids
Rationale: The priority for safety after an EGD is to prevent aspiration. Do not
offer fluids or foods by mouth until you are sure the gag reflex is intact.
Monitoring for signs of perforation, such as pain, bleeding, or fever, is also
important. A hoarse voice or sore throat is normal and may last for several
days.
2. A patient has undergone an ERCP. The nurse should instruct the patient
and family to monitor for which severe post-procedure complications? (Select
all that apply.)
A) Cholangitis
B) Bleeding
C) Perforation
D) Sepsis
E) Pancreatitis
Correct Answer: A, B, C, D, and E
Rationale: Teach the patient and family to monitor for severe post-procedure
complications at home, including cholangitis (gallbladder inflammation),
,bleeding, perforation, sepsis, and pancreatitis. The patient will likely have
severe pain if any of these complications occur. Fever is present in sepsis.
3. A patient is diagnosed with a hiatal hernia. Which of the following is the
most definitive diagnostic test for this condition?
A) EGD
B) Barium swallow
C) Abdominal CT
D) Esophageal manometry
Correct Answer: Barium swallow
Rationale: A hiatal hernia involves the protrusion of the stomach through the
esophageal hiatus of the diaphragm into the chest. It is diagnosed by a
barium swallow, which is the most specific test. EGD and esophageal
manometry are used to assess GERD and esophageal function.
4. A patient is prescribed a proton pump inhibitor (PPI) for GERD. The nurse
should monitor for which potential long-term complication?
A) Hypokalemia
B) Bone fractures
C) Hyperglycemia
D) Hepatotoxicity
Correct Answer: Bone fractures
Rationale: PPIs (e.g., omeprazole) reduce gastric acid and help the
esophagus heal. They can be given long-term, but a long-term use
complication is bone fractures, which are most common in the elderly.
,Patients should be educated on this risk and the importance of calcium and
vitamin D intake.
5. A patient with GERD reports taking calcium carbonate (Tums) for
heartburn. When should the nurse instruct the patient to take this
medication in relation to other medications?
A) With the H2 blocker
B) 1-2 hours before or after taking other medications
C) Immediately before eating
D) Only at bedtime
Correct Answer: 1-2 hours before or after taking other medications
Rationale: When taking calcium carbonate (or other antacids), the patient
should wait 1-2 hours before taking an H2 blocker, antibiotics, or sucralfate.
This ensures that the antacid does not interfere with the absorption of other
medications.
6. The nurse is performing an abdominal assessment. In which order should
the assessment be performed?
A) Inspection, palpation, percussion, auscultation
B) Inspection, auscultation, percussion, palpation
C) Auscultation, inspection, palpation, percussion
D) Palpation, percussion, auscultation, inspection
Correct Answer: Inspection, auscultation, percussion, palpation
Rationale: The correct order for abdominal assessment is inspection,
auscultation, percussion, and palpation. Palpation and percussion should be
, performed last so they do not increase intestinal activity and alter bowel
sounds.
7. During an abdominal assessment, the nurse auscultates a bruit over the
aorta. What is the priority nursing action?
A) Document the finding as normal
B) Palpate the abdomen to determine the size of the mass
C) Notify the healthcare provider immediately
D) Percuss the area to assess for dullness
Correct Answer: Notify the healthcare provider immediately
Rationale: If a bruit is heard over the aorta, it usually indicates the presence
of an abdominal aortic aneurysm. If this sound is heard, the nurse should not
percuss or palpate the abdomen. The healthcare provider should be notified
immediately.
8. The nurse notes a bulging, pulsating mass during an abdominal
assessment. Which action should the nurse take?
A) Palpate the mass to assess its size
B) Auscultate the mass for a bruit
C) Not touch the area and notify the HCP immediately
D) Document the finding as a normal pulsation of the aorta
Correct Answer: Not touch the area and notify the HCP immediately
Rationale: If a bulging, pulsating mass is present during assessment of the
abdomen, the nurse should not touch the area because the patient may have
an abdominal aortic aneurysm, a life-threatening problem. The HCP should
be notified immediately.
Medical-Surgical Nursing
1. A patient is scheduled for an esophagogastroduodenoscopy (EGD). What is
the priority nursing assessment after the procedure?
A) Checking for a gag reflex before offering fluids
B) Monitoring for a hoarse voice or sore throat
C) Ensuring the patient remains NPO for 12 hours
D) Checking for bruising around the eyes
Correct Answer: Checking for a gag reflex before offering fluids
Rationale: The priority for safety after an EGD is to prevent aspiration. Do not
offer fluids or foods by mouth until you are sure the gag reflex is intact.
Monitoring for signs of perforation, such as pain, bleeding, or fever, is also
important. A hoarse voice or sore throat is normal and may last for several
days.
2. A patient has undergone an ERCP. The nurse should instruct the patient
and family to monitor for which severe post-procedure complications? (Select
all that apply.)
A) Cholangitis
B) Bleeding
C) Perforation
D) Sepsis
E) Pancreatitis
Correct Answer: A, B, C, D, and E
Rationale: Teach the patient and family to monitor for severe post-procedure
complications at home, including cholangitis (gallbladder inflammation),
,bleeding, perforation, sepsis, and pancreatitis. The patient will likely have
severe pain if any of these complications occur. Fever is present in sepsis.
3. A patient is diagnosed with a hiatal hernia. Which of the following is the
most definitive diagnostic test for this condition?
A) EGD
B) Barium swallow
C) Abdominal CT
D) Esophageal manometry
Correct Answer: Barium swallow
Rationale: A hiatal hernia involves the protrusion of the stomach through the
esophageal hiatus of the diaphragm into the chest. It is diagnosed by a
barium swallow, which is the most specific test. EGD and esophageal
manometry are used to assess GERD and esophageal function.
4. A patient is prescribed a proton pump inhibitor (PPI) for GERD. The nurse
should monitor for which potential long-term complication?
A) Hypokalemia
B) Bone fractures
C) Hyperglycemia
D) Hepatotoxicity
Correct Answer: Bone fractures
Rationale: PPIs (e.g., omeprazole) reduce gastric acid and help the
esophagus heal. They can be given long-term, but a long-term use
complication is bone fractures, which are most common in the elderly.
,Patients should be educated on this risk and the importance of calcium and
vitamin D intake.
5. A patient with GERD reports taking calcium carbonate (Tums) for
heartburn. When should the nurse instruct the patient to take this
medication in relation to other medications?
A) With the H2 blocker
B) 1-2 hours before or after taking other medications
C) Immediately before eating
D) Only at bedtime
Correct Answer: 1-2 hours before or after taking other medications
Rationale: When taking calcium carbonate (or other antacids), the patient
should wait 1-2 hours before taking an H2 blocker, antibiotics, or sucralfate.
This ensures that the antacid does not interfere with the absorption of other
medications.
6. The nurse is performing an abdominal assessment. In which order should
the assessment be performed?
A) Inspection, palpation, percussion, auscultation
B) Inspection, auscultation, percussion, palpation
C) Auscultation, inspection, palpation, percussion
D) Palpation, percussion, auscultation, inspection
Correct Answer: Inspection, auscultation, percussion, palpation
Rationale: The correct order for abdominal assessment is inspection,
auscultation, percussion, and palpation. Palpation and percussion should be
, performed last so they do not increase intestinal activity and alter bowel
sounds.
7. During an abdominal assessment, the nurse auscultates a bruit over the
aorta. What is the priority nursing action?
A) Document the finding as normal
B) Palpate the abdomen to determine the size of the mass
C) Notify the healthcare provider immediately
D) Percuss the area to assess for dullness
Correct Answer: Notify the healthcare provider immediately
Rationale: If a bruit is heard over the aorta, it usually indicates the presence
of an abdominal aortic aneurysm. If this sound is heard, the nurse should not
percuss or palpate the abdomen. The healthcare provider should be notified
immediately.
8. The nurse notes a bulging, pulsating mass during an abdominal
assessment. Which action should the nurse take?
A) Palpate the mass to assess its size
B) Auscultate the mass for a bruit
C) Not touch the area and notify the HCP immediately
D) Document the finding as a normal pulsation of the aorta
Correct Answer: Not touch the area and notify the HCP immediately
Rationale: If a bulging, pulsating mass is present during assessment of the
abdomen, the nurse should not touch the area because the patient may have
an abdominal aortic aneurysm, a life-threatening problem. The HCP should
be notified immediately.
