Med-Surg Exam 3 Study Guide & Practice Q&A |
Galen College of Nursing NUR 242 (Latest 2025
Update)
**Q:** A client with GERD reports frequent heartburn,
especially at night. Which nursing teaching is most
appropriate?
a) Lie flat after meals to aid digestion
b) Sleep with head of bed elevated on blocks
c) Increase intake of spicy foods to desensitize reflux
d) Drink large amounts of fluid with meals
,,,correct answers,,,,b) Sleep with head of bed elevated on
blocks**
**Rationale:** Elevating the head prevents reflux by using
gravity. Lying flat worsens symptoms. Spicy foods worsen
GERD, and excess fluids during meals can distend the
stomach and increase reflux.
---
**Q:** Which statement by a client with a hiatal hernia
indicates the need for further teaching?
a) “I will eat small frequent meals.”
b) “I should avoid spicy and greasy foods.”
c) “I’ll lie down for 30 minutes after eating to help with
digestion.”
d) “I will avoid drinking citrus juices.”
,,,,correct answers,,,,c) “I’ll lie down for 30 minutes after
eating to help with digestion.”**
**Rationale:** Lying down after meals increases reflux.
Clients should remain upright after meals.
---
**Q:** A client with acute gastritis is admitted. Which
intervention is priority?
a) Monitor intake and output
b) Encourage a high-fiber diet
c) Ambulate patient every 2 hours
d) Provide coffee with meals
,,,correct answers,,,,a) Monitor intake and output**
**Rationale:** Acute gastritis can cause fluid imbalance due
to vomiting or bleeding. Hydration and monitoring I\&O is
priority. Fiber and caffeine are not appropriate
interventions.
---
**Q:** A client with PUD reports sudden severe abdominal
pain with a rigid, board-like abdomen. What is the nurse’s
first action?
a) Give prescribed antacids
b) Place client in Trendelenburg position
c) Notify the provider immediately
d) Encourage the client to eat a snack
,,,,correct answers,,,,c) Notify the provider immediately**
**Rationale:** These are signs of perforation, a medical
emergency. Immediate provider notification and prep for
surgery are required.
---
**Q:** A patient with GERD is prescribed omeprazole. What
should the nurse include in teaching?
a) Take the medication at bedtime
b) Stop the medication once symptoms resolve
c) Take the medication before meals
d) Take the medication with an antacid
,,,correct answers,,,,c) Take the medication before meals**
**Rationale:** PPIs like omeprazole should be taken before
meals to reduce gastric acid secretion during digestion. They
are usually continued as prescribed, not stopped abruptly.
Perfect 👍 — let’s expand your **Med-Surg Exam 3 practice
bank** with more **questions + answers + rationales**
(covering **GERD, Hiatal Hernia, Gastritis, Peptic Ulcer
Disease, GI bleeding**).
---
**Q:** A patient with a suspected upper GI bleed vomits
“coffee-ground” emesis. What does this finding indicate?
a) Active, massive hemorrhage
b) Old blood partially digested by stomach acid
, c) Bleeding from hemorrhoids
d) Bile reflux into the stomach
,,,correct answers,,,,b) Old blood partially digested by
stomach acid**
**Rationale:** Coffee-ground emesis suggests slower or
older bleeding that has been exposed to gastric acid. Bright
red emesis would indicate active, fresh bleeding.
---
### 7. Hiatal Hernia Surgery (Nissen Fundoplication)
**Q:** After a Nissen fundoplication, which nursing
intervention is priority?
a) Encourage early ambulation
b) Monitor for dysphagia with first oral feeding
c) Provide ice chips as tolerated immediately post-op
d) Encourage the patient to cough forcefully every hour
,,,correct answers,,,,b) Monitor for dysphagia with first oral
feeding**
**Rationale:** Dysphagia may indicate obstruction from a
tight fundoplication wrap and must be reported
immediately.
---
### 8. Peptic Ulcer Disease Risk Factors
Galen College of Nursing NUR 242 (Latest 2025
Update)
**Q:** A client with GERD reports frequent heartburn,
especially at night. Which nursing teaching is most
appropriate?
a) Lie flat after meals to aid digestion
b) Sleep with head of bed elevated on blocks
c) Increase intake of spicy foods to desensitize reflux
d) Drink large amounts of fluid with meals
,,,correct answers,,,,b) Sleep with head of bed elevated on
blocks**
**Rationale:** Elevating the head prevents reflux by using
gravity. Lying flat worsens symptoms. Spicy foods worsen
GERD, and excess fluids during meals can distend the
stomach and increase reflux.
---
**Q:** Which statement by a client with a hiatal hernia
indicates the need for further teaching?
a) “I will eat small frequent meals.”
b) “I should avoid spicy and greasy foods.”
c) “I’ll lie down for 30 minutes after eating to help with
digestion.”
d) “I will avoid drinking citrus juices.”
,,,,correct answers,,,,c) “I’ll lie down for 30 minutes after
eating to help with digestion.”**
**Rationale:** Lying down after meals increases reflux.
Clients should remain upright after meals.
---
**Q:** A client with acute gastritis is admitted. Which
intervention is priority?
a) Monitor intake and output
b) Encourage a high-fiber diet
c) Ambulate patient every 2 hours
d) Provide coffee with meals
,,,correct answers,,,,a) Monitor intake and output**
**Rationale:** Acute gastritis can cause fluid imbalance due
to vomiting or bleeding. Hydration and monitoring I\&O is
priority. Fiber and caffeine are not appropriate
interventions.
---
**Q:** A client with PUD reports sudden severe abdominal
pain with a rigid, board-like abdomen. What is the nurse’s
first action?
a) Give prescribed antacids
b) Place client in Trendelenburg position
c) Notify the provider immediately
d) Encourage the client to eat a snack
,,,,correct answers,,,,c) Notify the provider immediately**
**Rationale:** These are signs of perforation, a medical
emergency. Immediate provider notification and prep for
surgery are required.
---
**Q:** A patient with GERD is prescribed omeprazole. What
should the nurse include in teaching?
a) Take the medication at bedtime
b) Stop the medication once symptoms resolve
c) Take the medication before meals
d) Take the medication with an antacid
,,,correct answers,,,,c) Take the medication before meals**
**Rationale:** PPIs like omeprazole should be taken before
meals to reduce gastric acid secretion during digestion. They
are usually continued as prescribed, not stopped abruptly.
Perfect 👍 — let’s expand your **Med-Surg Exam 3 practice
bank** with more **questions + answers + rationales**
(covering **GERD, Hiatal Hernia, Gastritis, Peptic Ulcer
Disease, GI bleeding**).
---
**Q:** A patient with a suspected upper GI bleed vomits
“coffee-ground” emesis. What does this finding indicate?
a) Active, massive hemorrhage
b) Old blood partially digested by stomach acid
, c) Bleeding from hemorrhoids
d) Bile reflux into the stomach
,,,correct answers,,,,b) Old blood partially digested by
stomach acid**
**Rationale:** Coffee-ground emesis suggests slower or
older bleeding that has been exposed to gastric acid. Bright
red emesis would indicate active, fresh bleeding.
---
### 7. Hiatal Hernia Surgery (Nissen Fundoplication)
**Q:** After a Nissen fundoplication, which nursing
intervention is priority?
a) Encourage early ambulation
b) Monitor for dysphagia with first oral feeding
c) Provide ice chips as tolerated immediately post-op
d) Encourage the patient to cough forcefully every hour
,,,correct answers,,,,b) Monitor for dysphagia with first oral
feeding**
**Rationale:** Dysphagia may indicate obstruction from a
tight fundoplication wrap and must be reported
immediately.
---
### 8. Peptic Ulcer Disease Risk Factors
