,NUR170/NUR 170 Exam 4 |
Medical-Surgical Nursing | Galen College |
26 /27Updated (PDF)
1. The pancreas is located in which abdominal quadrant?
A) Right upper quadrant
B) Left upper quadrant
C) Right lower quadrant
D) Left lower quadrant
Correct Answer: Left upper quadrant
Rationale: The pancreas is a retroperitoneal organ located in the left upper quadrant (LUQ) of the
abdomen, extending horizontally across the posterior abdominal wall. The right upper quadrant
contains the liver and gallbladder. The lower quadrants contain intestinal structures. This anatomical
knowledge is foundational for understanding pancreatic function in digestion and metabolism.
2. A client with acute pancreatitis reports severe epigastric pain that radiates to the back. Which
laboratory finding most strongly supports this diagnosis?
A) Elevated serum amylase and lipase
B) Elevated serum bilirubin
C) Decreased serum calcium
D) Elevated serum glucose
Correct Answer: Elevated serum amylase and lipase
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase, with lipase being
more specific to the pancreas. Elevated bilirubin suggests biliary obstruction. Decreased calcium can
occur but is not diagnostic. Elevated glucose may occur but is not specific. Early recognition of
pancreatitis is essential to prevent complications.
,3. A client with ulcerative colitis is experiencing an acute exacerbation with 15–20 bloody stools per
day. Which provider order should the nurse prioritize first?
A) Administer 0.9% Normal Saline at 125 mL/hr
B) Obtain a stool culture for Clostridium difficile
C) Administer the prescribed dose of sulfasalazine
D) Initiate a referral for a dietary consult
Correct Answer: Administer 0.9% Normal Saline at 125 mL/hr
Rationale: In an acute exacerbation of ulcerative colitis with frequent bloody stools, the client is at
high risk for fluid volume deficit and electrolyte imbalances. Intravenous fluid resuscitation is the
priority to maintain hemodynamic stability and prevent hypovolemic shock. While diagnostics and
medications are important, stabilizing the client's circulatory status takes precedence according to the
ABC (Airway, Breathing, Circulation) framework.
4. A client with Crohn's disease is at risk for which complication due to chronic inflammation?
A) Stricture formation and bowel obstruction
B) Toxic megacolon
C) Perforation of the colon
D) Liver cirrhosis
Correct Answer: Stricture formation and bowel obstruction
Rationale: Crohn's disease is a transmural inflammatory process that can lead to fibrosis, stricture
formation, and bowel obstruction. Toxic megacolon and perforation are more commonly associated
with ulcerative colitis. Liver cirrhosis is not a direct complication of Crohn's disease. Recognizing the
differences between Crohn's disease and ulcerative colitis is essential for nursing care.
5. A client is diagnosed with irritable bowel syndrome (IBS). Which statement accurately describes this
disorder?
, A) It is characterized by chronic or recurrent diarrhea, constipation, or both, with abdominal pain and
bloating
B) It is an autoimmune disorder causing inflammation of the intestinal lining
C) It is caused by a bacterial infection of the gastrointestinal tract
D) It is a structural abnormality of the colon
Correct Answer: It is characterized by chronic or recurrent diarrhea, constipation, or both, with
abdominal pain and bloating
Rationale: IBS is a functional GI disorder that causes chronic or recurrent diarrhea, constipation, or
both, along with abdominal pain and bloating. It is not autoimmune, infectious, or structural. It is the
most common digestive disorder and is often associated with psychological factors such as depression
and anxiety.
6. A client with cirrhosis is at risk for bleeding. Which laboratory value should the nurse monitor
closely?
A) Serum albumin
B) Prothrombin time (PT) and INR
C) Serum bilirubin
D) Serum ammonia
Correct Answer: Prothrombin time (PT) and INR
Rationale: The liver produces clotting factors. In cirrhosis, impaired liver function leads to prolonged
PT and INR, increasing bleeding risk. Albumin, bilirubin, and ammonia are also affected but do not
directly indicate bleeding risk. Monitoring PT/INR is essential for clients with liver disease to prevent
hemorrhagic complications.
7. A client with hepatitis A asks the nurse how the virus is transmitted. Which response is most
accurate?
A) "Hepatitis A is transmitted through blood and body fluids"
B) "Hepatitis A is transmitted through the fecal-oral route"
Medical-Surgical Nursing | Galen College |
26 /27Updated (PDF)
1. The pancreas is located in which abdominal quadrant?
A) Right upper quadrant
B) Left upper quadrant
C) Right lower quadrant
D) Left lower quadrant
Correct Answer: Left upper quadrant
Rationale: The pancreas is a retroperitoneal organ located in the left upper quadrant (LUQ) of the
abdomen, extending horizontally across the posterior abdominal wall. The right upper quadrant
contains the liver and gallbladder. The lower quadrants contain intestinal structures. This anatomical
knowledge is foundational for understanding pancreatic function in digestion and metabolism.
2. A client with acute pancreatitis reports severe epigastric pain that radiates to the back. Which
laboratory finding most strongly supports this diagnosis?
A) Elevated serum amylase and lipase
B) Elevated serum bilirubin
C) Decreased serum calcium
D) Elevated serum glucose
Correct Answer: Elevated serum amylase and lipase
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase, with lipase being
more specific to the pancreas. Elevated bilirubin suggests biliary obstruction. Decreased calcium can
occur but is not diagnostic. Elevated glucose may occur but is not specific. Early recognition of
pancreatitis is essential to prevent complications.
,3. A client with ulcerative colitis is experiencing an acute exacerbation with 15–20 bloody stools per
day. Which provider order should the nurse prioritize first?
A) Administer 0.9% Normal Saline at 125 mL/hr
B) Obtain a stool culture for Clostridium difficile
C) Administer the prescribed dose of sulfasalazine
D) Initiate a referral for a dietary consult
Correct Answer: Administer 0.9% Normal Saline at 125 mL/hr
Rationale: In an acute exacerbation of ulcerative colitis with frequent bloody stools, the client is at
high risk for fluid volume deficit and electrolyte imbalances. Intravenous fluid resuscitation is the
priority to maintain hemodynamic stability and prevent hypovolemic shock. While diagnostics and
medications are important, stabilizing the client's circulatory status takes precedence according to the
ABC (Airway, Breathing, Circulation) framework.
4. A client with Crohn's disease is at risk for which complication due to chronic inflammation?
A) Stricture formation and bowel obstruction
B) Toxic megacolon
C) Perforation of the colon
D) Liver cirrhosis
Correct Answer: Stricture formation and bowel obstruction
Rationale: Crohn's disease is a transmural inflammatory process that can lead to fibrosis, stricture
formation, and bowel obstruction. Toxic megacolon and perforation are more commonly associated
with ulcerative colitis. Liver cirrhosis is not a direct complication of Crohn's disease. Recognizing the
differences between Crohn's disease and ulcerative colitis is essential for nursing care.
5. A client is diagnosed with irritable bowel syndrome (IBS). Which statement accurately describes this
disorder?
, A) It is characterized by chronic or recurrent diarrhea, constipation, or both, with abdominal pain and
bloating
B) It is an autoimmune disorder causing inflammation of the intestinal lining
C) It is caused by a bacterial infection of the gastrointestinal tract
D) It is a structural abnormality of the colon
Correct Answer: It is characterized by chronic or recurrent diarrhea, constipation, or both, with
abdominal pain and bloating
Rationale: IBS is a functional GI disorder that causes chronic or recurrent diarrhea, constipation, or
both, along with abdominal pain and bloating. It is not autoimmune, infectious, or structural. It is the
most common digestive disorder and is often associated with psychological factors such as depression
and anxiety.
6. A client with cirrhosis is at risk for bleeding. Which laboratory value should the nurse monitor
closely?
A) Serum albumin
B) Prothrombin time (PT) and INR
C) Serum bilirubin
D) Serum ammonia
Correct Answer: Prothrombin time (PT) and INR
Rationale: The liver produces clotting factors. In cirrhosis, impaired liver function leads to prolonged
PT and INR, increasing bleeding risk. Albumin, bilirubin, and ammonia are also affected but do not
directly indicate bleeding risk. Monitoring PT/INR is essential for clients with liver disease to prevent
hemorrhagic complications.
7. A client with hepatitis A asks the nurse how the virus is transmitted. Which response is most
accurate?
A) "Hepatitis A is transmitted through blood and body fluids"
B) "Hepatitis A is transmitted through the fecal-oral route"
