NUR 242 | Exam 3
OBJECTIVE ASSESSMENT - EXAM
NUR 242 Exam 3 (2026/2027) |
Med-Surg Nursing | Galen
College (A+ Guarantee) | PDF
2026/2027
Medical-Surgical Nursing Concepts | Galen College of Nursing
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
GI Assessment and Upper GI Disorders (GERD,
Fluid,
PUD,
Electrolyte,
Gastritis)and Acid-Base Imbalances
Inflammatory Bowel Disease and DiverticulitisRenal Failure and Genitourinary Conditions
Hepatitis, Cirrhosis, and Gallbladder Disorders
Nutritional Support and Metabolic Disorders
COVER PAGE - 1
, SECTION 1 | Gastrointestinal Disorders | Q1-Q20 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen C
Q1 Question 1 of 75
A 58-year-old male with a history of daily NSAID use presents with epigastric pain
described as burning, occurring 2 to 3 hours after meals and at night. He reports dark,
tarry stools for the past day. Which nursing action is the priority?
A. Administer an antacid and reassess pain in 30 minutes.
B. Initiate IV access and prepare for possible endoscopy.
C. Encourage the patient to eat a bland diet to coat the stomach.
D. Place the patient in a supine position to reduce abdominal tension.
Correct Answer: B
Rationale:
The presentation is consistent with a bleeding peptic ulcer disease (PUD) complication. Melena indicates
upper GI bleeding. Priority nursing action is to establish IV access for fluid resuscitation and prepare for
endoscopic evaluation. Antacids and diet changes are secondary, and supine positioning does not address
the bleeding.
Q2 Question 2 of 75
A 45-year-old woman with GERD reports increased retrosternal burning after eating
chocolate and drinking coffee. She asks the nurse why these foods worsen her
symptoms. Which explanation is most accurate?
A. These foods increase gastric acid secretion and decrease lower esophageal sphincter
(LES) tone.
B. Chocolate and coffee stimulate gallbladder contraction, causing referred esophageal pain.
C. Caffeine increases intestinal motility, pushing acid into the esophagus.
D. These foods irritate the gastric mucosa directly, causing chemical esophagitis.
Correct Answer: A
Rationale:
Chocolate and coffee contain methylxanthines and caffeine that reduce LES pressure and increase gastric
acid secretion, promoting reflux. They do not primarily affect gallbladder contraction or cause chemical
esophagitis directly.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 1 of 30
, SECTION 1 | Gastrointestinal Disorders | Q1-Q20 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen C
Q3 Question 3 of 75
A 62-year-old patient is admitted with a small bowel obstruction. The nurse notes
absent bowel sounds, abdominal distension, and vomiting of feculent material. Which
finding requires the most immediate intervention?
A. The patient has not had a bowel movement in 3 days.
B. The patient develops tachycardia and hypotension.
C. The patient's abdomen is mildly tender to palpation.
D. The patient reports nausea rated 6 out of 10.
Correct Answer: B
Rationale:
Tachycardia and hypotension in a bowel obstruction suggest hypovolemic shock from third-spacing and
vomiting. This is life-threatening and requires immediate fluid resuscitation. Constipation, mild tenderness,
and nausea are expected findings but not emergent.
Q4 Question 4 of 75
A 34-year-old patient with Crohn's disease has 8 to 10 loose stools daily, abdominal
cramping, and a 5-pound weight loss over 2 weeks. Which assessment finding best
indicates the patient is at risk for a stricture complication?
A. The patient reports increased flatus and bloating after meals.
B. The patient develops high-pitched, tinkling bowel sounds with cramping.
C. The patient has perianal skin tags and fissures.
D. The patient's C-reactive protein level is mildly elevated.
Correct Answer: B
Rationale:
High-pitched, tinkling bowel sounds with cramping suggest partial bowel obstruction from intestinal stricture,
a known complication of Crohn's disease. Flatus and bloating are nonspecific; perianal findings reflect
fistulizing disease, not stricture.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 2 of 30
, SECTION 1 | Gastrointestinal Disorders | Q1-Q20 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen C
Q5 Question 5 of 75
A 70-year-old patient with diverticulitis presents with left lower quadrant pain, fever of
101.2 F, and leukocytosis. The provider orders NPO status, IV antibiotics, and pain
management. Which nursing intervention is essential to monitor for perforation?
A. Assess for sudden relief of pain followed by rigid abdomen and tachycardia.
B. Monitor daily weights to detect fluid shifts from peritonitis.
C. Check stool for occult blood every 8 hours.
D. Auscultate bowel sounds every 2 hours and document frequency.
Correct Answer: A
Rationale:
Sudden relief of pain followed by a rigid, board-like abdomen and tachycardia indicates peritonitis from
colonic perforation, a surgical emergency. Daily weights and occult blood monitoring are important but not
the best indicators of perforation.
Q6 Question 6 of 75
A 28-year-old patient with a history of bulimia is admitted with severe upper GI
bleeding. During the physical exam, the nurse notes scarring on the dorsal surface of
the hand. Which complication is most likely associated with this finding?
A. Mallory-Weiss tear from forceful vomiting.
B. Boerhaave syndrome with esophageal rupture.
C. Russell sign indicating repeated self-induced vomiting.
D. Gastric outlet obstruction from chronic pyloric spasm.
Correct Answer: C
Rationale:
Russell sign is callus or scar formation on the dorsal hand from repeated contact with teeth during
self-induced vomiting, pathognomonic for bulimia nervosa. While Mallory-Weiss tear can occur, the hand
scarring specifically indicates Russell sign.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 3 of 30
OBJECTIVE ASSESSMENT - EXAM
NUR 242 Exam 3 (2026/2027) |
Med-Surg Nursing | Galen
College (A+ Guarantee) | PDF
2026/2027
Medical-Surgical Nursing Concepts | Galen College of Nursing
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
GI Assessment and Upper GI Disorders (GERD,
Fluid,
PUD,
Electrolyte,
Gastritis)and Acid-Base Imbalances
Inflammatory Bowel Disease and DiverticulitisRenal Failure and Genitourinary Conditions
Hepatitis, Cirrhosis, and Gallbladder Disorders
Nutritional Support and Metabolic Disorders
COVER PAGE - 1
, SECTION 1 | Gastrointestinal Disorders | Q1-Q20 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen C
Q1 Question 1 of 75
A 58-year-old male with a history of daily NSAID use presents with epigastric pain
described as burning, occurring 2 to 3 hours after meals and at night. He reports dark,
tarry stools for the past day. Which nursing action is the priority?
A. Administer an antacid and reassess pain in 30 minutes.
B. Initiate IV access and prepare for possible endoscopy.
C. Encourage the patient to eat a bland diet to coat the stomach.
D. Place the patient in a supine position to reduce abdominal tension.
Correct Answer: B
Rationale:
The presentation is consistent with a bleeding peptic ulcer disease (PUD) complication. Melena indicates
upper GI bleeding. Priority nursing action is to establish IV access for fluid resuscitation and prepare for
endoscopic evaluation. Antacids and diet changes are secondary, and supine positioning does not address
the bleeding.
Q2 Question 2 of 75
A 45-year-old woman with GERD reports increased retrosternal burning after eating
chocolate and drinking coffee. She asks the nurse why these foods worsen her
symptoms. Which explanation is most accurate?
A. These foods increase gastric acid secretion and decrease lower esophageal sphincter
(LES) tone.
B. Chocolate and coffee stimulate gallbladder contraction, causing referred esophageal pain.
C. Caffeine increases intestinal motility, pushing acid into the esophagus.
D. These foods irritate the gastric mucosa directly, causing chemical esophagitis.
Correct Answer: A
Rationale:
Chocolate and coffee contain methylxanthines and caffeine that reduce LES pressure and increase gastric
acid secretion, promoting reflux. They do not primarily affect gallbladder contraction or cause chemical
esophagitis directly.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 1 of 30
, SECTION 1 | Gastrointestinal Disorders | Q1-Q20 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen C
Q3 Question 3 of 75
A 62-year-old patient is admitted with a small bowel obstruction. The nurse notes
absent bowel sounds, abdominal distension, and vomiting of feculent material. Which
finding requires the most immediate intervention?
A. The patient has not had a bowel movement in 3 days.
B. The patient develops tachycardia and hypotension.
C. The patient's abdomen is mildly tender to palpation.
D. The patient reports nausea rated 6 out of 10.
Correct Answer: B
Rationale:
Tachycardia and hypotension in a bowel obstruction suggest hypovolemic shock from third-spacing and
vomiting. This is life-threatening and requires immediate fluid resuscitation. Constipation, mild tenderness,
and nausea are expected findings but not emergent.
Q4 Question 4 of 75
A 34-year-old patient with Crohn's disease has 8 to 10 loose stools daily, abdominal
cramping, and a 5-pound weight loss over 2 weeks. Which assessment finding best
indicates the patient is at risk for a stricture complication?
A. The patient reports increased flatus and bloating after meals.
B. The patient develops high-pitched, tinkling bowel sounds with cramping.
C. The patient has perianal skin tags and fissures.
D. The patient's C-reactive protein level is mildly elevated.
Correct Answer: B
Rationale:
High-pitched, tinkling bowel sounds with cramping suggest partial bowel obstruction from intestinal stricture,
a known complication of Crohn's disease. Flatus and bloating are nonspecific; perianal findings reflect
fistulizing disease, not stricture.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 2 of 30
, SECTION 1 | Gastrointestinal Disorders | Q1-Q20 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen C
Q5 Question 5 of 75
A 70-year-old patient with diverticulitis presents with left lower quadrant pain, fever of
101.2 F, and leukocytosis. The provider orders NPO status, IV antibiotics, and pain
management. Which nursing intervention is essential to monitor for perforation?
A. Assess for sudden relief of pain followed by rigid abdomen and tachycardia.
B. Monitor daily weights to detect fluid shifts from peritonitis.
C. Check stool for occult blood every 8 hours.
D. Auscultate bowel sounds every 2 hours and document frequency.
Correct Answer: A
Rationale:
Sudden relief of pain followed by a rigid, board-like abdomen and tachycardia indicates peritonitis from
colonic perforation, a surgical emergency. Daily weights and occult blood monitoring are important but not
the best indicators of perforation.
Q6 Question 6 of 75
A 28-year-old patient with a history of bulimia is admitted with severe upper GI
bleeding. During the physical exam, the nurse notes scarring on the dorsal surface of
the hand. Which complication is most likely associated with this finding?
A. Mallory-Weiss tear from forceful vomiting.
B. Boerhaave syndrome with esophageal rupture.
C. Russell sign indicating repeated self-induced vomiting.
D. Gastric outlet obstruction from chronic pyloric spasm.
Correct Answer: C
Rationale:
Russell sign is callus or scar formation on the dorsal hand from repeated contact with teeth during
self-induced vomiting, pathognomonic for bulimia nervosa. While Mallory-Weiss tear can occur, the hand
scarring specifically indicates Russell sign.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 3 of 30
