Galen NSG 3800 – Adult Health II Exam 4 Exam
ACTUAL QUESTIONS AND ANSWERS LATEST
UPDATE THIS YEAR.pdf
Galen NSG 3800 – Adult Health II Exam 4 content areas that show up in
study guides and reviews: hepatobiliary disorders (hepatitis, cholecystitis,
cirrhosis, pancreatitis), endocrine (diabetes, thyroid, adrenal, pituitary),
and often oncology/chemo safety basics.
Hepatobiliary & GI (Q1–40)
1. A client is diagnosed with hepatitis A. Which instruction is most important for the
nurse to give to household members and sexual contacts?
A. “You should receive the hepatitis B vaccine series immediately.”
B. “You may need post-exposure prophylaxis with immune globulin; contact your
provider promptly.”
C. “You do not need any precautions because hepatitis A is not contagious.”
D. “You should start antiviral medication now to prevent infection.”
Hep A spreads fecal-orally; close contacts may need IG prophylaxis
2. A client with acute cholecystitis is being cared for. Which diet is most appropriate
during the acute phase?
,A. High-fat, high-protein diet to promote healing
B. Low-fat or no-fat diet to reduce gallbladder stimulation
C. Clear liquids only for the entire hospital stay
D. High-fiber diet with raw vegetables and whole grains
Fat triggers gallbladder contraction; low-fat reduces pain.
3. After a laparoscopic cholecystectomy, which discharge instruction is most
appropriate regarding diet?
A. “Resume a regular high-fat diet as soon as you feel hungry.”
B. “Start with small, low-fat meals and gradually advance as tolerated.”
C. “Avoid all dairy products for 6 weeks to prevent diarrhea.”
D. “Maintain a strict liquid diet for 2 weeks post-surgery.”
Low-fat, small frequent meals help prevent post-cholecystectomy symptoms.
4. A client with cirrhosis has elevated ammonia levels and increasing confusion.
Which medication is the nurse likely to anticipate?
A. Lactulose
B. Lactulose to reduce ammonia absorption in the gut
C. Insulin to lower blood glucose
D. Furosemide to decrease ascites
Lactulose acidifies the colon, trapping ammonia for excretion.
,5. A client with suspected hepatitis B is being assessed. Which finding is most
consistent with the icteric phase of hepatitis?
A. Pale stools and dark urine with jaundice
B. Jaundice, dark urine, and clay-colored stools
C. Bright red blood in stool and pale urine
D. Normal urine color with yellow sclera only
Bilirubin excretion issues cause dark urine and pale stools with jaundice.
6. A client with chronic pancreatitis is being taught about pancreatic enzyme
replacement therapy. Which instruction is correct?
A. “Take the enzymes on an empty stomach to maximize absorption.”
B. “Take the enzymes with every meal and snack to aid digestion.”
C. “Crush the enteric-coated tablets before taking for better effect.”
D. “Skip the dose if you are not eating fatty foods.”
Enzymes must be taken with food to assist digestion.
7. A client with cirrhosis has large esophageal varices. Which nursing intervention is
highest priority to reduce risk of bleeding?
A. Encourage a high-fiber diet to prevent constipation
B. Avoid straining, coughing, vomiting, and heavy lifting that increase portal pressure
C. Administer routine IM injections for medications
D. Encourage vigorous exercise to improve circulation
Increased intra-abdominal/portal pressure can precipitate variceal rupture.
, 8. A client with acute pancreatitis is admitted with severe epigastric pain radiating to
the back. Which initial intervention is most appropriate?
A. Encourage oral high-protein, high-fat meals
B. Maintain NPO status and provide IV fluids for pancreatic rest
C. Apply a heating pad to the abdomen to reduce pain
D. Administer oral pancreatic enzymes immediately
NPO and IV fluids reduce pancreatic stimulation and support perfusion.
9. A client with hepatitis C asks about transmission. Which statement by the nurse is
most accurate?
A. “Hepatitis C is spread primarily through contaminated food and water.”
B. “Hepatitis C is spread mainly through blood and body fluids, such as sharing
needles.”
C. “Hepatitis C cannot be transmitted through sexual contact.”
D. “Hepatitis C is only transmitted from mother to infant during breastfeeding.”
Hep C is blood-borne; sharing needles is a major route.
10. A client with cirrhosis has ascites and is on spironolactone. Which lab value
requires close monitoring?
A. Sodium
B. Potassium, due to risk of hyperkalemia with potassium-sparing diuretics
ACTUAL QUESTIONS AND ANSWERS LATEST
UPDATE THIS YEAR.pdf
Galen NSG 3800 – Adult Health II Exam 4 content areas that show up in
study guides and reviews: hepatobiliary disorders (hepatitis, cholecystitis,
cirrhosis, pancreatitis), endocrine (diabetes, thyroid, adrenal, pituitary),
and often oncology/chemo safety basics.
Hepatobiliary & GI (Q1–40)
1. A client is diagnosed with hepatitis A. Which instruction is most important for the
nurse to give to household members and sexual contacts?
A. “You should receive the hepatitis B vaccine series immediately.”
B. “You may need post-exposure prophylaxis with immune globulin; contact your
provider promptly.”
C. “You do not need any precautions because hepatitis A is not contagious.”
D. “You should start antiviral medication now to prevent infection.”
Hep A spreads fecal-orally; close contacts may need IG prophylaxis
2. A client with acute cholecystitis is being cared for. Which diet is most appropriate
during the acute phase?
,A. High-fat, high-protein diet to promote healing
B. Low-fat or no-fat diet to reduce gallbladder stimulation
C. Clear liquids only for the entire hospital stay
D. High-fiber diet with raw vegetables and whole grains
Fat triggers gallbladder contraction; low-fat reduces pain.
3. After a laparoscopic cholecystectomy, which discharge instruction is most
appropriate regarding diet?
A. “Resume a regular high-fat diet as soon as you feel hungry.”
B. “Start with small, low-fat meals and gradually advance as tolerated.”
C. “Avoid all dairy products for 6 weeks to prevent diarrhea.”
D. “Maintain a strict liquid diet for 2 weeks post-surgery.”
Low-fat, small frequent meals help prevent post-cholecystectomy symptoms.
4. A client with cirrhosis has elevated ammonia levels and increasing confusion.
Which medication is the nurse likely to anticipate?
A. Lactulose
B. Lactulose to reduce ammonia absorption in the gut
C. Insulin to lower blood glucose
D. Furosemide to decrease ascites
Lactulose acidifies the colon, trapping ammonia for excretion.
,5. A client with suspected hepatitis B is being assessed. Which finding is most
consistent with the icteric phase of hepatitis?
A. Pale stools and dark urine with jaundice
B. Jaundice, dark urine, and clay-colored stools
C. Bright red blood in stool and pale urine
D. Normal urine color with yellow sclera only
Bilirubin excretion issues cause dark urine and pale stools with jaundice.
6. A client with chronic pancreatitis is being taught about pancreatic enzyme
replacement therapy. Which instruction is correct?
A. “Take the enzymes on an empty stomach to maximize absorption.”
B. “Take the enzymes with every meal and snack to aid digestion.”
C. “Crush the enteric-coated tablets before taking for better effect.”
D. “Skip the dose if you are not eating fatty foods.”
Enzymes must be taken with food to assist digestion.
7. A client with cirrhosis has large esophageal varices. Which nursing intervention is
highest priority to reduce risk of bleeding?
A. Encourage a high-fiber diet to prevent constipation
B. Avoid straining, coughing, vomiting, and heavy lifting that increase portal pressure
C. Administer routine IM injections for medications
D. Encourage vigorous exercise to improve circulation
Increased intra-abdominal/portal pressure can precipitate variceal rupture.
, 8. A client with acute pancreatitis is admitted with severe epigastric pain radiating to
the back. Which initial intervention is most appropriate?
A. Encourage oral high-protein, high-fat meals
B. Maintain NPO status and provide IV fluids for pancreatic rest
C. Apply a heating pad to the abdomen to reduce pain
D. Administer oral pancreatic enzymes immediately
NPO and IV fluids reduce pancreatic stimulation and support perfusion.
9. A client with hepatitis C asks about transmission. Which statement by the nurse is
most accurate?
A. “Hepatitis C is spread primarily through contaminated food and water.”
B. “Hepatitis C is spread mainly through blood and body fluids, such as sharing
needles.”
C. “Hepatitis C cannot be transmitted through sexual contact.”
D. “Hepatitis C is only transmitted from mother to infant during breastfeeding.”
Hep C is blood-borne; sharing needles is a major route.
10. A client with cirrhosis has ascites and is on spironolactone. Which lab value
requires close monitoring?
A. Sodium
B. Potassium, due to risk of hyperkalemia with potassium-sparing diuretics
