NUR 170
Medical-Surgical Exam 3 Study Guide
Exam 3 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 170
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 170 Medical-Surgical Exam 3 Study Guide 2026/2027 UPDATED – Galen
1. A patient with a history of peptic ulcer disease presents to the emergency department with
sudden, severe upper abdominal pain that radiates to the shoulder. On assessment, the nurse
notes a rigid, board-like abdomen. Which complication should the nurse suspect?
A. Upper gastrointestinal hemorrhage
B. Gastric outlet obstruction
C. Perforation of the ulcer
D. Pyloric stenosis
Answer: C
Rationale: A rigid, board-like abdomen is a classic sign of peritonitis resulting from a
perforated ulcer, which is a surgical emergency. Radiation to the shoulder suggests
diaphragmatic irritation.
2. When caring for a patient with acute pancreatitis, which laboratory value is the most
specific indicator of pancreatic cell injury?
A. Elevated serum amylase
B. Elevated serum lipase
C. Increased white blood cell count
D. Decreased serum calcium
, Answer: B
Rationale: While both amylase and lipase rise in pancreatitis, lipase stays elevated longer
and is more specific to the pancreas than amylase.
3. A patient is diagnosed with hepatic encephalopathy. The nurse administers lactulose as
prescribed. Which finding indicates the medication is having the desired therapeutic effect?
A. The patient has three soft bowel movements per day.
B. The patient’s serum potassium level is 4.0 mEq/L.
C. The patient’s blood pressure is stable.
D. The patient’s bilirubin level has normalized.
E. The patient’s flapping tremors (asterixis) have decreased.
Answer: E
Rationale: Lactulose reduces ammonia levels in the blood by excreting it through the stool.
A reduction in asterixis and improved mental status indicate decreased ammonia levels.
4. Which assessment finding should the nurse prioritize in a patient who just returned from a
subtotal thyroidectomy?
A. Temperature of 99.4°F (37.4°C)
B. Pain at the incision site
C. Hoarseness of the voice
D. Laryngeal stridor
Medical-Surgical Exam 3 Study Guide
Exam 3 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 170
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 170 Medical-Surgical Exam 3 Study Guide 2026/2027 UPDATED – Galen
1. A patient with a history of peptic ulcer disease presents to the emergency department with
sudden, severe upper abdominal pain that radiates to the shoulder. On assessment, the nurse
notes a rigid, board-like abdomen. Which complication should the nurse suspect?
A. Upper gastrointestinal hemorrhage
B. Gastric outlet obstruction
C. Perforation of the ulcer
D. Pyloric stenosis
Answer: C
Rationale: A rigid, board-like abdomen is a classic sign of peritonitis resulting from a
perforated ulcer, which is a surgical emergency. Radiation to the shoulder suggests
diaphragmatic irritation.
2. When caring for a patient with acute pancreatitis, which laboratory value is the most
specific indicator of pancreatic cell injury?
A. Elevated serum amylase
B. Elevated serum lipase
C. Increased white blood cell count
D. Decreased serum calcium
, Answer: B
Rationale: While both amylase and lipase rise in pancreatitis, lipase stays elevated longer
and is more specific to the pancreas than amylase.
3. A patient is diagnosed with hepatic encephalopathy. The nurse administers lactulose as
prescribed. Which finding indicates the medication is having the desired therapeutic effect?
A. The patient has three soft bowel movements per day.
B. The patient’s serum potassium level is 4.0 mEq/L.
C. The patient’s blood pressure is stable.
D. The patient’s bilirubin level has normalized.
E. The patient’s flapping tremors (asterixis) have decreased.
Answer: E
Rationale: Lactulose reduces ammonia levels in the blood by excreting it through the stool.
A reduction in asterixis and improved mental status indicate decreased ammonia levels.
4. Which assessment finding should the nurse prioritize in a patient who just returned from a
subtotal thyroidectomy?
A. Temperature of 99.4°F (37.4°C)
B. Pain at the incision site
C. Hoarseness of the voice
D. Laryngeal stridor
