NUR 170 Med-Surg Exam 4
Practice Exam
2025-2026 Update | 80 Questions
Instructions: Choose the best answer for each question and write the corresponding word on your
answer sheet.
Module: Gastrointestinal Disorders (GERD, PUD, Obstructions)
1. A nurse is providing dietary teaching for a client with newly diagnosed gastroesophageal reflux
disease (GERD). Which of the following foods should the nurse instruct the client to avoid?
A. Applesauce
B. Baked chicken
C. CHOCOLATE
D. Oatmeal
2. A client with a history of peptic ulcer disease (PUD) reports a sudden onset of severe epigastric pain
that radiates to the right shoulder, followed by a rigid, board-like abdomen. Which complication should
the nurse suspect?
A. Gastric hemorrhage
B. Pyloric obstruction
C. PERFORATION
D. Intestinal obstruction
3. A nurse is reviewing the medication list for a client with GERD. Which medication, if taken by the
client, could exacerbate their symptoms by decreasing lower esophageal sphincter (LES) pressure?
A. Acetaminophen (Tylenol)
B. Ibuprofen (Motrin)
C. CALCIUM CHANNEL BLOCKERS
D. Amoxicillin
4. The nurse is caring for a client with a small bowel obstruction. Which assessment finding is most
consistent with this condition?
, A. Lower abdominal cramping and obstipation
B. PROFUSE VOMITING AND UPPER ABDOMINAL DISTENTION
C. Ribbon-like stools
D. Metabolic acidosis
5. A client with a large bowel obstruction is likely to present with which of the following acid-base
imbalances?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. METABOLIC ACIDOSIS
6. A nurse is caring for a client who has a nasogastric (NG) tube in place for an intestinal obstruction.
Which of the following actions is most important for the nurse to perform?
A. Irrigate the tube with sterile water every shift.
B. VERIFY TUBE PLACEMENT PRIOR TO EACH USE
C. Keep the suction on continuously at the highest setting.
D. Re-position the client every 4 hours.
7. The nurse is teaching a client with GERD about lifestyle modifications. Which statement indicates the
client understands the teaching?
A. "I should lie down for 30 minutes after eating to aid digestion."
B. "I will elevate the head of my bed by 6 to 12 inches."
C. "Drinking a cup of hot tea before bed will help me relax."
D. "It is okay to have a small snack right before bedtime."
8. A client is scheduled for an esophagogastroduodenoscopy (EGD). What is the priority nursing action
after the procedure?
A. Offer the client a glass of water immediately.
B. Encourage the client to ambulate in the hall.
C. CHECK FOR THE RETURN OF THE GAG REFLEX
D. Monitor the client's blood glucose level.
9. A client with a history of NSAID use presents with dyspepsia and a burning sensation in the stomach.
The nurse suspects peptic ulcer disease. Which diagnostic test is most commonly used to confirm this
diagnosis?
, A. Barium swallow
B. Abdominal ultrasound
C. ESOPHAGOGASTRODUODENOSCOPY (EGD)
D. Stool culture
10. A client is diagnosed with an H. pylori infection. Which of the following medications would the nurse
most likely expect to be included in the treatment regimen?
A. Sucralfate (Carafate) only
B. ANTIBIOTICS AND A PROTON PUMP INHIBITOR
C. Antacids as needed
D. Promethazine (Phenergan)
11. A post-operative day one client reports severe abdominal pain and is not passing flatus. The nurse
assesses absent bowel sounds. Which condition should the nurse suspect?
A. PARALYTIC ILEUS
B. Small bowel obstruction
C. Peritonitis
D. Wound dehiscence
12. For a client experiencing a paralytic ileus, which of the following interventions should the nurse
anticipate?
A. INSERTION OF A NASOGASTRIC (NG) TUBE
B. Administration of a bulk-forming laxative
C. Encouraging a high-fiber diet
D. Applying a truss to the abdomen
13. A client is diagnosed with a hiatal hernia. The nurse understands that this condition increases the
risk for GERD primarily because it:
A. Decreases the production of gastric acid.
B. INCREASES INTRA-ABDOMINAL PRESSURE ON THE LES
C. Causes rapid gastric emptying.
D. Leads to esophageal strictures.
14. The nurse is providing discharge instructions to a client following a Nissen fundoplication. What is an
important point for the nurse to include?
Practice Exam
2025-2026 Update | 80 Questions
Instructions: Choose the best answer for each question and write the corresponding word on your
answer sheet.
Module: Gastrointestinal Disorders (GERD, PUD, Obstructions)
1. A nurse is providing dietary teaching for a client with newly diagnosed gastroesophageal reflux
disease (GERD). Which of the following foods should the nurse instruct the client to avoid?
A. Applesauce
B. Baked chicken
C. CHOCOLATE
D. Oatmeal
2. A client with a history of peptic ulcer disease (PUD) reports a sudden onset of severe epigastric pain
that radiates to the right shoulder, followed by a rigid, board-like abdomen. Which complication should
the nurse suspect?
A. Gastric hemorrhage
B. Pyloric obstruction
C. PERFORATION
D. Intestinal obstruction
3. A nurse is reviewing the medication list for a client with GERD. Which medication, if taken by the
client, could exacerbate their symptoms by decreasing lower esophageal sphincter (LES) pressure?
A. Acetaminophen (Tylenol)
B. Ibuprofen (Motrin)
C. CALCIUM CHANNEL BLOCKERS
D. Amoxicillin
4. The nurse is caring for a client with a small bowel obstruction. Which assessment finding is most
consistent with this condition?
, A. Lower abdominal cramping and obstipation
B. PROFUSE VOMITING AND UPPER ABDOMINAL DISTENTION
C. Ribbon-like stools
D. Metabolic acidosis
5. A client with a large bowel obstruction is likely to present with which of the following acid-base
imbalances?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. METABOLIC ACIDOSIS
6. A nurse is caring for a client who has a nasogastric (NG) tube in place for an intestinal obstruction.
Which of the following actions is most important for the nurse to perform?
A. Irrigate the tube with sterile water every shift.
B. VERIFY TUBE PLACEMENT PRIOR TO EACH USE
C. Keep the suction on continuously at the highest setting.
D. Re-position the client every 4 hours.
7. The nurse is teaching a client with GERD about lifestyle modifications. Which statement indicates the
client understands the teaching?
A. "I should lie down for 30 minutes after eating to aid digestion."
B. "I will elevate the head of my bed by 6 to 12 inches."
C. "Drinking a cup of hot tea before bed will help me relax."
D. "It is okay to have a small snack right before bedtime."
8. A client is scheduled for an esophagogastroduodenoscopy (EGD). What is the priority nursing action
after the procedure?
A. Offer the client a glass of water immediately.
B. Encourage the client to ambulate in the hall.
C. CHECK FOR THE RETURN OF THE GAG REFLEX
D. Monitor the client's blood glucose level.
9. A client with a history of NSAID use presents with dyspepsia and a burning sensation in the stomach.
The nurse suspects peptic ulcer disease. Which diagnostic test is most commonly used to confirm this
diagnosis?
, A. Barium swallow
B. Abdominal ultrasound
C. ESOPHAGOGASTRODUODENOSCOPY (EGD)
D. Stool culture
10. A client is diagnosed with an H. pylori infection. Which of the following medications would the nurse
most likely expect to be included in the treatment regimen?
A. Sucralfate (Carafate) only
B. ANTIBIOTICS AND A PROTON PUMP INHIBITOR
C. Antacids as needed
D. Promethazine (Phenergan)
11. A post-operative day one client reports severe abdominal pain and is not passing flatus. The nurse
assesses absent bowel sounds. Which condition should the nurse suspect?
A. PARALYTIC ILEUS
B. Small bowel obstruction
C. Peritonitis
D. Wound dehiscence
12. For a client experiencing a paralytic ileus, which of the following interventions should the nurse
anticipate?
A. INSERTION OF A NASOGASTRIC (NG) TUBE
B. Administration of a bulk-forming laxative
C. Encouraging a high-fiber diet
D. Applying a truss to the abdomen
13. A client is diagnosed with a hiatal hernia. The nurse understands that this condition increases the
risk for GERD primarily because it:
A. Decreases the production of gastric acid.
B. INCREASES INTRA-ABDOMINAL PRESSURE ON THE LES
C. Causes rapid gastric emptying.
D. Leads to esophageal strictures.
14. The nurse is providing discharge instructions to a client following a Nissen fundoplication. What is an
important point for the nurse to include?
