NR324/NR 324 Exam 3 V1 | Adult Health I
Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient with acute pancreatitis. Which of the following laboratory
findings is most specific for this diagnosis?
A. Elevated serum bilirubin
B. Elevated serum amylase
C. Decreased serum calcium
D. Elevated serum lipase
Correct Answer: D
Rationale: Serum lipase is more specific than amylase for diagnosing acute pancreatitis
because it stays elevated longer. While amylase rises early, it returns to normal within a
few days, whereas lipase remains elevated for up to two weeks. Monitoring these enzymes
is crucial for assessing the severity of pancreatic inflammation.
2. A patient with cirrhosis of the liver has developed ascites. Which medication should the
nurse expect the provider to prescribe to manage this condition?
A. Spironolactone
B. Lactulose
C. Propranolol
,D. Neomycin
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic often used as the first-line
treatment for ascites in cirrhosis. It helps counteract the effects of secondary
hyperaldosteronism, which leads to sodium and water retention. Proper management of
fluid balance is essential to prevent respiratory compromise and skin breakdown.
3. The nurse is educating a patient with GERD about lifestyle modifications. Which statement
by the patient indicates a need for further teaching?
A. I will drink a glass of milk before bed to soothe my stomach.
B. I will wait at least three hours after eating before lying down.
C. I will sleep with the head of my bed elevated.
D. I will eat small, frequent meals throughout the day.
Correct Answer: A
Rationale: Drinking milk before bed can actually worsen GERD symptoms because it
increases gastric acid secretion. Patients should avoid eating within three hours of bedtime
to prevent reflux while sleeping. Lifestyle changes are the cornerstone of managing
symptoms and preventing esophageal damage.
4. A patient is diagnosed with an acute Upper GI bleed. Which of the following is the nurse’s
priority action?
A. Administering a prescribed proton pump inhibitor
, B. Preparing the patient for an urgent EGD
C. Checking the patient’s stool for occult blood
D. Inserting a large-bore IV catheter for fluid resuscitation
Correct Answer: D
Rationale: The priority in an acute GI bleed is maintaining hemodynamic stability through
fluid resuscitation. Large-bore IV access allows for rapid administration of isotonic fluids or
blood products if needed. Once the patient is stable, the source of the bleed can be
identified via diagnostic procedures.
5. A patient presents with rebound tenderness at McBurney’s point and a low-grade fever.
Which condition does the nurse suspect?
A. Diverticulitis
B. Cholecystitis
C. Pancreatitis
D. Appendicitis
Correct Answer: D
Rationale: Rebound tenderness at McBurney’s point, located in the right lower quadrant,
is a classic sign of appendicitis. The nurse should keep the patient NPO in anticipation of
potential emergency surgery. Early recognition is vital to prevent complications such as
rupture or peritonitis.
Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient with acute pancreatitis. Which of the following laboratory
findings is most specific for this diagnosis?
A. Elevated serum bilirubin
B. Elevated serum amylase
C. Decreased serum calcium
D. Elevated serum lipase
Correct Answer: D
Rationale: Serum lipase is more specific than amylase for diagnosing acute pancreatitis
because it stays elevated longer. While amylase rises early, it returns to normal within a
few days, whereas lipase remains elevated for up to two weeks. Monitoring these enzymes
is crucial for assessing the severity of pancreatic inflammation.
2. A patient with cirrhosis of the liver has developed ascites. Which medication should the
nurse expect the provider to prescribe to manage this condition?
A. Spironolactone
B. Lactulose
C. Propranolol
,D. Neomycin
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic often used as the first-line
treatment for ascites in cirrhosis. It helps counteract the effects of secondary
hyperaldosteronism, which leads to sodium and water retention. Proper management of
fluid balance is essential to prevent respiratory compromise and skin breakdown.
3. The nurse is educating a patient with GERD about lifestyle modifications. Which statement
by the patient indicates a need for further teaching?
A. I will drink a glass of milk before bed to soothe my stomach.
B. I will wait at least three hours after eating before lying down.
C. I will sleep with the head of my bed elevated.
D. I will eat small, frequent meals throughout the day.
Correct Answer: A
Rationale: Drinking milk before bed can actually worsen GERD symptoms because it
increases gastric acid secretion. Patients should avoid eating within three hours of bedtime
to prevent reflux while sleeping. Lifestyle changes are the cornerstone of managing
symptoms and preventing esophageal damage.
4. A patient is diagnosed with an acute Upper GI bleed. Which of the following is the nurse’s
priority action?
A. Administering a prescribed proton pump inhibitor
, B. Preparing the patient for an urgent EGD
C. Checking the patient’s stool for occult blood
D. Inserting a large-bore IV catheter for fluid resuscitation
Correct Answer: D
Rationale: The priority in an acute GI bleed is maintaining hemodynamic stability through
fluid resuscitation. Large-bore IV access allows for rapid administration of isotonic fluids or
blood products if needed. Once the patient is stable, the source of the bleed can be
identified via diagnostic procedures.
5. A patient presents with rebound tenderness at McBurney’s point and a low-grade fever.
Which condition does the nurse suspect?
A. Diverticulitis
B. Cholecystitis
C. Pancreatitis
D. Appendicitis
Correct Answer: D
Rationale: Rebound tenderness at McBurney’s point, located in the right lower quadrant,
is a classic sign of appendicitis. The nurse should keep the patient NPO in anticipation of
potential emergency surgery. Early recognition is vital to prevent complications such as
rupture or peritonitis.
