GALEN COLLEGE OF NURSING · PRACTICAL NURSING PROGRAM
NUR 242 Exam 3
Comprehensive Practice
Question Bank
GI Disorders · Respiratory Disorders · Medical-Surgical Nursing
NCLEX-Style Review for Medical-Surgical Nursing Concepts
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. GERD & Hiatal Hernia 2
3. Peptic Ulcer Disease (PUD) 3
4. Irritable Bowel Syndrome (IBS) 4
5. Intestinal Obstruction 5
,6. Appendicitis & Peritonitis 6
7. Gastroenteritis & Inflammatory Bowel Disease 7
8. Diverticulitis, Hepatitis, & Gallbladder Disease 8
9. Bariatric Surgery & Postoperative Care 9
10. Respiratory Assessment & Breath Sounds 10
11. Sleep Apnea, Tracheostomy, & Oxygen Therapy 11
12. Asthma & COPD 12
13. Pneumonia, TB, & Respiratory Infections 13
14. Chest Drainage, Thoracentesis, & Emphysema 14
NUR 242 · Galen College of Nursing Page 1
,NUR 242 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & QUESTIONS
How to Use This Guide
Read each question stem carefully, select your answer, then review the rationale to understand the clinical
reasoning behind the correct choice. Each question includes the tested concept and the source concept
from your course material. Questions marked with SATA require selecting all that apply.
Section 1: GERD & Hiatal Hernia
1 The nurse is teaching a client about risk factors for GERD. Which lifestyle factors should the
nurse include? Select all that apply.
A Consumption of caffeine and alcohol
B Consumption of spicy or fried foods
C Eating chocolate and tomatoes
D Regular exercise
E Smoking
CORRECT ANSWER: A, B, C, E
Rationale: GERD risk factors include consumption of foods such as caffeine, alcohol, spicy or fried foods,
chocolate, and tomatoes. Lifestyle factors play a big part, especially alcohol and smoking. Regular exercise
is not a risk factor for GERD.
Tested Concept: GERD risk factors
Source Concept: GERD Risk factors include Consumption of foods such as caffeine, alcohol, spicy or fried foods,
chocolate, and tomatoes. Lifestyle factors play a big part especially alcohol and smoking.
, 2 A client reports substernal burning that moves up and down the chest, occurring 30-60
minutes after meals. The nurse recognizes this as which symptom of GERD?
A Dyspepsia (indigestion)
B Heartburn (pyrosis)
C Regurgitation
D Dysphagia
CORRECT ANSWER: B
Rationale: Heartburn (pyrosis) is described as substernal burning moving up and down the chest. GERD
pain usually develops within 30-60 minutes after meals. Severe heartburn pain can radiate to the neck,
jaw, or back.
Tested Concept: GERD — heartburn characteristics
Source Concept: GERD most common symptoms: Heartburn (pyrosis), Dyspepsia (Indigestion). May be described as
substernal burning moving up and down the chest. GERD pain usually develops within 30-60 minutes after meals.
3 The nurse is teaching a client with GERD about positions that exacerbate symptoms. Which
position should the client avoid to prevent reflux?
A Sitting upright
B Lying down flat
C Standing
D Walking
CORRECT ANSWER: B
Rationale: GERD symptoms are exacerbated when lying down flat or bending over. Patients should be
advised to remain upright after meals and elevate the head of the bed to prevent reflux.
Tested Concept: GERD — positions that exacerbate symptoms
Source Concept: GERD symptoms are exacerbated when lying down flat or bending over.
NUR 242 Exam 3
Comprehensive Practice
Question Bank
GI Disorders · Respiratory Disorders · Medical-Surgical Nursing
NCLEX-Style Review for Medical-Surgical Nursing Concepts
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. GERD & Hiatal Hernia 2
3. Peptic Ulcer Disease (PUD) 3
4. Irritable Bowel Syndrome (IBS) 4
5. Intestinal Obstruction 5
,6. Appendicitis & Peritonitis 6
7. Gastroenteritis & Inflammatory Bowel Disease 7
8. Diverticulitis, Hepatitis, & Gallbladder Disease 8
9. Bariatric Surgery & Postoperative Care 9
10. Respiratory Assessment & Breath Sounds 10
11. Sleep Apnea, Tracheostomy, & Oxygen Therapy 11
12. Asthma & COPD 12
13. Pneumonia, TB, & Respiratory Infections 13
14. Chest Drainage, Thoracentesis, & Emphysema 14
NUR 242 · Galen College of Nursing Page 1
,NUR 242 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & QUESTIONS
How to Use This Guide
Read each question stem carefully, select your answer, then review the rationale to understand the clinical
reasoning behind the correct choice. Each question includes the tested concept and the source concept
from your course material. Questions marked with SATA require selecting all that apply.
Section 1: GERD & Hiatal Hernia
1 The nurse is teaching a client about risk factors for GERD. Which lifestyle factors should the
nurse include? Select all that apply.
A Consumption of caffeine and alcohol
B Consumption of spicy or fried foods
C Eating chocolate and tomatoes
D Regular exercise
E Smoking
CORRECT ANSWER: A, B, C, E
Rationale: GERD risk factors include consumption of foods such as caffeine, alcohol, spicy or fried foods,
chocolate, and tomatoes. Lifestyle factors play a big part, especially alcohol and smoking. Regular exercise
is not a risk factor for GERD.
Tested Concept: GERD risk factors
Source Concept: GERD Risk factors include Consumption of foods such as caffeine, alcohol, spicy or fried foods,
chocolate, and tomatoes. Lifestyle factors play a big part especially alcohol and smoking.
, 2 A client reports substernal burning that moves up and down the chest, occurring 30-60
minutes after meals. The nurse recognizes this as which symptom of GERD?
A Dyspepsia (indigestion)
B Heartburn (pyrosis)
C Regurgitation
D Dysphagia
CORRECT ANSWER: B
Rationale: Heartburn (pyrosis) is described as substernal burning moving up and down the chest. GERD
pain usually develops within 30-60 minutes after meals. Severe heartburn pain can radiate to the neck,
jaw, or back.
Tested Concept: GERD — heartburn characteristics
Source Concept: GERD most common symptoms: Heartburn (pyrosis), Dyspepsia (Indigestion). May be described as
substernal burning moving up and down the chest. GERD pain usually develops within 30-60 minutes after meals.
3 The nurse is teaching a client with GERD about positions that exacerbate symptoms. Which
position should the client avoid to prevent reflux?
A Sitting upright
B Lying down flat
C Standing
D Walking
CORRECT ANSWER: B
Rationale: GERD symptoms are exacerbated when lying down flat or bending over. Patients should be
advised to remain upright after meals and elevate the head of the bed to prevent reflux.
Tested Concept: GERD — positions that exacerbate symptoms
Source Concept: GERD symptoms are exacerbated when lying down flat or bending over.
