GALEN NUR 242 EXAM 3 STREB MED SURG EXAM 3 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027]
Section One: Questions 1–100
A patient with cirrhosis presents with ascites. Which dietary modification is most appropriate to
manage this condition?
A. High protein diet
B. Sodium restriction
C. Increased fluid intake
D. Potassium supplementation
🟢 B. Sodium restriction
🔴 RATIONALE: Sodium restriction is essential in managing ascites to prevent further fluid
retention caused by the osmotic pressure exerted by sodium.
A patient is diagnosed with cholecystitis. Which assessment finding is most likely to be reported?
A. Right lower quadrant pain
B. Pain radiating to the left shoulder
C. Right upper quadrant pain after a high-fat meal
D. Constant, dull epigastric pain relieved by eating
🟢 C. Right upper quadrant pain after a high-fat meal
🔴 RATIONALE: Cholecystitis involves gallbladder inflammation, often triggered by the ingestion of
fatty foods which stimulate bile contraction.
When caring for a patient with a T-tube after a cholecystectomy, what should the nurse expect to
observe?
A. Bright red drainage
B. Dark green-brown bile drainage
,C. Absence of drainage
D. Clear, watery drainage
🟢 B. Dark green-brown bile drainage
🔴 RATIONALE: A T-tube is placed to drain bile; it is normal for this to appear dark green or brown
as bile is produced by the liver.
A patient with acute pancreatitis is NPO. What is the priority nursing intervention?
A. Administering prophylactic antibiotics
B. Maintaining IV fluid hydration
C. Providing oral hygiene
D. Encouraging deep breathing exercises
🟢 B. Maintaining IV fluid hydration
🔴 RATIONALE: Patients with pancreatitis are at high risk for hypovolemia due to third-spacing of
fluids, making fluid resuscitation the priority.
Which laboratory finding is most specific to a diagnosis of acute pancreatitis?
A. Elevated ALT
B. Elevated serum lipase
C. Decreased white blood cell count
D. Elevated alkaline phosphatase
🟢 B. Elevated serum lipase
🔴 RATIONALE: Serum lipase is highly specific to pancreatic injury and remains elevated longer
than amylase.
A patient is diagnosed with Hepatitis A. Which transmission route should the nurse educate the
patient about?
A. Blood-to-blood contact
,B. Sexual contact
C. Fecal-oral route
D. Contaminated needles
🟢 C. Fecal-oral route
🔴 RATIONALE: Hepatitis A is primarily transmitted through the fecal-oral route, often via
contaminated water or food.
Which medication is contraindicated in a patient with advanced cirrhosis and hepatic
encephalopathy?
A. Lactulose
B. Neomycin
C. Sedatives
D. Thiamine
🟢 C. Sedatives
🔴 RATIONALE: The liver cannot properly metabolize sedatives in cirrhosis, leading to increased
risk of toxicity and worsening encephalopathy.
A patient has a Sengstaken-Blakemore tube. What is the most important equipment to keep at the
bedside?
A. Suction setup
B. Scissors
C. Sterile water
D. Extra lubricant
🟢 B. Scissors
🔴 RATIONALE: Scissors must be kept at the bedside to emergency-cut the tube if airway
obstruction occurs due to balloon displacement.
, What is a cardinal sign of peritonitis?
A. Soft, non-tender abdomen
B. Increased bowel sounds
C. Board-like rigidity of the abdomen
D. Bradycardia
🟢 C. Board-like rigidity of the abdomen
🔴 RATIONALE: Peritonitis causes intense inflammation leading to muscle guarding and the
classic board-like rigid abdomen.
A patient with portal hypertension is at risk for which life-threatening complication?
A. Esophageal varices
B. Peripheral neuropathy
C. Vitamin K deficiency
D. Splenomegaly
🟢 A. Esophageal varices
🔴 RATIONALE: Portal hypertension increases venous pressure in the esophagus, leading to the
development of fragile varices susceptible to rupture.
Which nursing action is appropriate for a patient undergoing a paracentesis?
A. Place the patient in a prone position
B. Ensure the patient voids before the procedure
C. Administer a high-sodium snack afterward
D. Monitor for hypertension during the procedure
🟢 B. Ensure the patient voids before the procedure
🔴 RATIONALE: Emptying the bladder reduces the risk of accidental bladder puncture during the
needle insertion for paracentesis.
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027]
Section One: Questions 1–100
A patient with cirrhosis presents with ascites. Which dietary modification is most appropriate to
manage this condition?
A. High protein diet
B. Sodium restriction
C. Increased fluid intake
D. Potassium supplementation
🟢 B. Sodium restriction
🔴 RATIONALE: Sodium restriction is essential in managing ascites to prevent further fluid
retention caused by the osmotic pressure exerted by sodium.
A patient is diagnosed with cholecystitis. Which assessment finding is most likely to be reported?
A. Right lower quadrant pain
B. Pain radiating to the left shoulder
C. Right upper quadrant pain after a high-fat meal
D. Constant, dull epigastric pain relieved by eating
🟢 C. Right upper quadrant pain after a high-fat meal
🔴 RATIONALE: Cholecystitis involves gallbladder inflammation, often triggered by the ingestion of
fatty foods which stimulate bile contraction.
When caring for a patient with a T-tube after a cholecystectomy, what should the nurse expect to
observe?
A. Bright red drainage
B. Dark green-brown bile drainage
,C. Absence of drainage
D. Clear, watery drainage
🟢 B. Dark green-brown bile drainage
🔴 RATIONALE: A T-tube is placed to drain bile; it is normal for this to appear dark green or brown
as bile is produced by the liver.
A patient with acute pancreatitis is NPO. What is the priority nursing intervention?
A. Administering prophylactic antibiotics
B. Maintaining IV fluid hydration
C. Providing oral hygiene
D. Encouraging deep breathing exercises
🟢 B. Maintaining IV fluid hydration
🔴 RATIONALE: Patients with pancreatitis are at high risk for hypovolemia due to third-spacing of
fluids, making fluid resuscitation the priority.
Which laboratory finding is most specific to a diagnosis of acute pancreatitis?
A. Elevated ALT
B. Elevated serum lipase
C. Decreased white blood cell count
D. Elevated alkaline phosphatase
🟢 B. Elevated serum lipase
🔴 RATIONALE: Serum lipase is highly specific to pancreatic injury and remains elevated longer
than amylase.
A patient is diagnosed with Hepatitis A. Which transmission route should the nurse educate the
patient about?
A. Blood-to-blood contact
,B. Sexual contact
C. Fecal-oral route
D. Contaminated needles
🟢 C. Fecal-oral route
🔴 RATIONALE: Hepatitis A is primarily transmitted through the fecal-oral route, often via
contaminated water or food.
Which medication is contraindicated in a patient with advanced cirrhosis and hepatic
encephalopathy?
A. Lactulose
B. Neomycin
C. Sedatives
D. Thiamine
🟢 C. Sedatives
🔴 RATIONALE: The liver cannot properly metabolize sedatives in cirrhosis, leading to increased
risk of toxicity and worsening encephalopathy.
A patient has a Sengstaken-Blakemore tube. What is the most important equipment to keep at the
bedside?
A. Suction setup
B. Scissors
C. Sterile water
D. Extra lubricant
🟢 B. Scissors
🔴 RATIONALE: Scissors must be kept at the bedside to emergency-cut the tube if airway
obstruction occurs due to balloon displacement.
, What is a cardinal sign of peritonitis?
A. Soft, non-tender abdomen
B. Increased bowel sounds
C. Board-like rigidity of the abdomen
D. Bradycardia
🟢 C. Board-like rigidity of the abdomen
🔴 RATIONALE: Peritonitis causes intense inflammation leading to muscle guarding and the
classic board-like rigid abdomen.
A patient with portal hypertension is at risk for which life-threatening complication?
A. Esophageal varices
B. Peripheral neuropathy
C. Vitamin K deficiency
D. Splenomegaly
🟢 A. Esophageal varices
🔴 RATIONALE: Portal hypertension increases venous pressure in the esophagus, leading to the
development of fragile varices susceptible to rupture.
Which nursing action is appropriate for a patient undergoing a paracentesis?
A. Place the patient in a prone position
B. Ensure the patient voids before the procedure
C. Administer a high-sodium snack afterward
D. Monitor for hypertension during the procedure
🟢 B. Ensure the patient voids before the procedure
🔴 RATIONALE: Emptying the bladder reduces the risk of accidental bladder puncture during the
needle insertion for paracentesis.
