NUR 212 Exam 3 | Complete Practice Questions, Correct
Answers & Detailed Rationales (2026/2027)
1. A nurse is caring for a client newly diagnosed with a sliding hiatal
hernia. Which statement by the client indicates an understanding of
the condition?
• A. "Part of my stomach slips up through the diaphragm into my
chest when I bend over."
• B. "My stomach is permanently stuck in my chest cavity and
requires immediate surgery."
• C. "This condition is caused by chronic overuse of nonsteroidal
anti-inflammatory drugs."
• D. "I should avoid lying down for at least four hours after eating."
• Correct Answer: A
• Rationale: A sliding hiatal hernia occurs when the
gastroesophageal junction and a portion of the stomach slide
upward through the esophageal hiatus into the chest cavity, often
precipitated by increased intra-abdominal pressure (bending,
straining). Choice B describes a rolling/fixed hiatal hernia. Choice C
describes gastritis/ulcer causes. Choice D is partially true
regarding reflux precautions, but typically 1–2 hours is
recommended, whereas Choice A directly defines the mechanism
of a sliding hiatal hernia.
2. Which of the following lifestyle modifications should a nurse
include in the discharge teaching plan for a client with a hiatal hernia?
, • A. Eat three large meals daily to stimulate regular peristalsis.
• B. Sleep flat on your back with a pillow under your head.
• C. Wear tight-fitting waist garments to support abdominal
muscles.
• D. Elevate the head of the bed 6 to 8 inches.
• Correct Answer: D
• Rationale: Elevating the head of the bed 6 to 8 inches utilizes
gravity to prevent gastric acid reflux into the esophagus. Large
meals (Choice A) increase gastric distention and pressure. Flat
sleeping positions (Choice B) worsen reflux. Tight clothing (Choice
C) increases intra-abdominal pressure, aggravating symptoms.
3. A client is admitted with acute gastritis. Which of the following risk
factors in the client’s history is most likely the primary cause of this
condition?
• A. Regular use of ibuprofen for chronic arthritis pain
• B. High dietary intake of low-fat dairy products
• C. A sedentary lifestyle with minimal aerobic exercise
• D. Daily consumption of caffeinated green tea
• Correct Answer: A
• Rationale: Regular or high-dose use of nonsteroidal anti-
inflammatory drugs (NSAIDs) like ibuprofen inhibits
prostaglandins, which protect the gastric mucosal barrier, leading
to irritation, inflammation, and erosion (gastritis). Dairy, sedentary
, lifestyle, and moderate green tea are not primary causes of acute
gastritis.
4. Which diagnostic finding is most commonly associated with chronic
gastritis caused by Helicobacter pylori?
• A. Decreased serum amylase and lipase levels
• B. Positive stool occult blood and breath or serology tests for H.
pylori
• C. Elevated red blood cell count and hematocrit
• D. Presence of excess free hydrochloric acid in the gallbladder
• Correct Answer: B
• Rationale: H. pylori infections are diagnosed via urea breath tests,
stool antigen tests, or serology, frequently accompanied by occult
blood loss due to mucosal erosion. Amylase/lipase evaluate
pancreatic function. Anemia (low RBC/Hct), not polycythemia, is
common due to chronic blood loss or impaired B12 absorption.
5. A nurse is providing dietary instructions to a client recovering from
acute gastritis. Which food or beverage should the nurse instruct the
client to avoid?
• A. Boiled white rice
• B. Skim milk
• C. Spicy chili and citrus juices
• D. Baked skinless chicken breast
• Correct Answer: C
, • Rationale: Clients with gastritis must avoid gastric irritants such as
spicy foods, acidic citrus juices, alcohol, and caffeine, as they
stimulate acid secretion and inflame the mucosal barrier. Bland
items like rice, chicken, and moderate dairy are generally well-
tolerated.
6. A client who underwent gastric bypass surgery 24 hours ago reports
severe epigastric pain and pressure. What is the most appropriate
initial nursing action?
• A. Administer a prescribed oral antacid tablet.
• B. Encourage early ambulation to help relieve gas and pressure.
• C. Insert a nasogastric tube immediately to decompress the
stomach pouch.
• D. Provide a clear liquid meal to test bowel tolerance.
• Correct Answer: B
• Rationale: Early ambulation (3–4 times daily) is critical following
bariatric surgery to reduce the risk of deep vein thrombosis (DVT)
and help relieve postoperative gas accumulation and abdominal
pressure. Nasogastric tube insertion is generally contraindicated
post-gastric surgery unless specifically ordered, to protect the
suture line. Oral intake is typically restricted initially.
7. A nurse is monitoring a client who is 3 hours post-op from a Roux-
en-Y gastric bypass. Which finding requires immediate reporting to the
healthcare provider?
• A. Mild serosanguineous drainage on the abdominal dressing
• B. Client report of mild incisional pain managed with PCA
Answers & Detailed Rationales (2026/2027)
1. A nurse is caring for a client newly diagnosed with a sliding hiatal
hernia. Which statement by the client indicates an understanding of
the condition?
• A. "Part of my stomach slips up through the diaphragm into my
chest when I bend over."
• B. "My stomach is permanently stuck in my chest cavity and
requires immediate surgery."
• C. "This condition is caused by chronic overuse of nonsteroidal
anti-inflammatory drugs."
• D. "I should avoid lying down for at least four hours after eating."
• Correct Answer: A
• Rationale: A sliding hiatal hernia occurs when the
gastroesophageal junction and a portion of the stomach slide
upward through the esophageal hiatus into the chest cavity, often
precipitated by increased intra-abdominal pressure (bending,
straining). Choice B describes a rolling/fixed hiatal hernia. Choice C
describes gastritis/ulcer causes. Choice D is partially true
regarding reflux precautions, but typically 1–2 hours is
recommended, whereas Choice A directly defines the mechanism
of a sliding hiatal hernia.
2. Which of the following lifestyle modifications should a nurse
include in the discharge teaching plan for a client with a hiatal hernia?
, • A. Eat three large meals daily to stimulate regular peristalsis.
• B. Sleep flat on your back with a pillow under your head.
• C. Wear tight-fitting waist garments to support abdominal
muscles.
• D. Elevate the head of the bed 6 to 8 inches.
• Correct Answer: D
• Rationale: Elevating the head of the bed 6 to 8 inches utilizes
gravity to prevent gastric acid reflux into the esophagus. Large
meals (Choice A) increase gastric distention and pressure. Flat
sleeping positions (Choice B) worsen reflux. Tight clothing (Choice
C) increases intra-abdominal pressure, aggravating symptoms.
3. A client is admitted with acute gastritis. Which of the following risk
factors in the client’s history is most likely the primary cause of this
condition?
• A. Regular use of ibuprofen for chronic arthritis pain
• B. High dietary intake of low-fat dairy products
• C. A sedentary lifestyle with minimal aerobic exercise
• D. Daily consumption of caffeinated green tea
• Correct Answer: A
• Rationale: Regular or high-dose use of nonsteroidal anti-
inflammatory drugs (NSAIDs) like ibuprofen inhibits
prostaglandins, which protect the gastric mucosal barrier, leading
to irritation, inflammation, and erosion (gastritis). Dairy, sedentary
, lifestyle, and moderate green tea are not primary causes of acute
gastritis.
4. Which diagnostic finding is most commonly associated with chronic
gastritis caused by Helicobacter pylori?
• A. Decreased serum amylase and lipase levels
• B. Positive stool occult blood and breath or serology tests for H.
pylori
• C. Elevated red blood cell count and hematocrit
• D. Presence of excess free hydrochloric acid in the gallbladder
• Correct Answer: B
• Rationale: H. pylori infections are diagnosed via urea breath tests,
stool antigen tests, or serology, frequently accompanied by occult
blood loss due to mucosal erosion. Amylase/lipase evaluate
pancreatic function. Anemia (low RBC/Hct), not polycythemia, is
common due to chronic blood loss or impaired B12 absorption.
5. A nurse is providing dietary instructions to a client recovering from
acute gastritis. Which food or beverage should the nurse instruct the
client to avoid?
• A. Boiled white rice
• B. Skim milk
• C. Spicy chili and citrus juices
• D. Baked skinless chicken breast
• Correct Answer: C
, • Rationale: Clients with gastritis must avoid gastric irritants such as
spicy foods, acidic citrus juices, alcohol, and caffeine, as they
stimulate acid secretion and inflame the mucosal barrier. Bland
items like rice, chicken, and moderate dairy are generally well-
tolerated.
6. A client who underwent gastric bypass surgery 24 hours ago reports
severe epigastric pain and pressure. What is the most appropriate
initial nursing action?
• A. Administer a prescribed oral antacid tablet.
• B. Encourage early ambulation to help relieve gas and pressure.
• C. Insert a nasogastric tube immediately to decompress the
stomach pouch.
• D. Provide a clear liquid meal to test bowel tolerance.
• Correct Answer: B
• Rationale: Early ambulation (3–4 times daily) is critical following
bariatric surgery to reduce the risk of deep vein thrombosis (DVT)
and help relieve postoperative gas accumulation and abdominal
pressure. Nasogastric tube insertion is generally contraindicated
post-gastric surgery unless specifically ordered, to protect the
suture line. Oral intake is typically restricted initially.
7. A nurse is monitoring a client who is 3 hours post-op from a Roux-
en-Y gastric bypass. Which finding requires immediate reporting to the
healthcare provider?
• A. Mild serosanguineous drainage on the abdominal dressing
• B. Client report of mild incisional pain managed with PCA
