Grand Canyon University NSG-320 Exam 3 (2026/2027 Academic Year) – Adult
Health Nursing I Comprehensive Exam Review Guide | Complete Study
Materials Covering Medical-Surgical Nursing Concepts, Clinical Judgment,
Disease Processes, Nursing Interventions, Pharmacology, Patient Care Priorities,
Practice Questions, Verified Answers, Detailed Rationales & NCLEX-Style Exam
Preparation
Gastrointestinal Disorders
1. A patient reports burning epigastric pain that worsens 2 hours after meals
and is relieved by eating. Which condition is most consistent?
A) Gastric ulcer
B) Duodenal ulcer
C) GERD
D) Pancreatitis
Correct Answer: B
Rationale: Duodenal ulcers cause pain 2-3 hours after meals due to acid secretion
in an empty stomach; pain is relieved by food. Gastric ulcers cause pain 30-60
minutes after eating and are worsened by food .
2. A nurse is caring for a patient with a suspected peptic ulcer. Which diagnostic
study is most useful in confirming Peptic Ulcer Disease (PUD)?
A) Abdominal X-ray
B) Upper GI endoscopy with biopsy
C) CT scan with contrast
D) MRI of the abdomen
Correct Answer: B
Rationale: Upper GI endoscopy with biopsy is the gold standard for confirming
PUD and allows visualization of the ulcer and biopsy for H. pylori testing .
3. What is the most lethal complication associated with Peptic Ulcer Disease
(PUD)?
,A) Hemorrhage
B) Perforation
C) Obstruction
D) Gastric outlet obstruction
Correct Answer: B
Rationale: Perforation is the most lethal complication because it leads to
peritonitis and sepsis, requiring immediate surgical intervention .
4. Which of the following is a classic sign of peritonitis?
A) Hypotension and bradycardia
B) Rigid, board-like abdomen
C) Hyperactive bowel sounds
D) Pain that decreases with movement
Correct Answer: B
Rationale: Peritonitis presents with fever >100.3°F, rebound tenderness, rigid or
board-like abdomen, increased pain and tenderness, and restlessness .
5. A patient with GERD asks when to take their prescribed proton pump
inhibitor (PPI). What should the nurse instruct?
A) Take with meals
B) Take 30 minutes before meals
C) Take at bedtime
D) Take immediately after meals
Correct Answer: B
Rationale: PPIs and H2 blockers should be taken 30 minutes before meals for
maximum effectiveness in reducing gastric acid secretion .
6. Which diagnostic assessment is performed to determine function of the lower
esophageal sphincter (LES)?
,A) Esophageal manometry
B) Upper GI endoscopy
C) Barium swallow
D) CT scan
Correct Answer: B
Rationale: Upper GI endoscopy evaluates LES function and can visualize
esophageal changes such as Barrett's esophagus .
7. A patient with diverticulitis is experiencing severe LLQ pain. What nursing
intervention is most appropriate?
A) Encourage high-fiber diet
B) Administer oral laxatives
C) Keep patient NPO and provide IV fluids
D) Apply heat to the abdomen
Correct Answer: C
Rationale: During acute diverticulitis, the bowel needs rest. NPO status with IV
fluids is standard to allow inflammation to subside .
8. What is the primary cause of diverticula formation in the colon?
A) High-fiber diet
B) Low-fiber diet leading to constipation and increased intraluminal pressure
C) Bacterial infection
D) Genetic predisposition
Correct Answer: B
Rationale: A diet with decreased fiber causes constipation, which increases
pressure in the bowels and leads to diverticula formation in weakened areas of
the colon wall .
, 9. A patient with ulcerative colitis would most likely present with which of the
following?
A) 15-20 bloody liquid stools per day
B) Hard, dry stools with mucus
C) Alternating constipation and diarrhea
D) Painless rectal bleeding
Correct Answer: A
Rationale: Ulcerative colitis is characterized by chronic inflammation of the colon
with presence of ulcers that bleed, resulting in frequent bloody liquid stools .
10. Which medication class is considered first-line therapy for mild to moderate
Crohn's disease, especially when the colon is involved?
A) Corticosteroids
B) Aminosalicylates
C) Biologic agents
D) Immunosuppressants
Correct Answer: B
Rationale: Aminosalicylates such as sulfasalazine and mesalamine are first-line
therapies for mild to moderate Crohn's disease, especially when the colon is
involved. They are more effective for ulcerative colitis .
11. A patient receiving sulfasalazine should be taught to monitor for which side
effects?
A) Headache, nausea, and fatigue
B) Hypertension and tachycardia
C) Urinary retention and constipation
D) Hair loss and dry skin
Correct Answer: A
Health Nursing I Comprehensive Exam Review Guide | Complete Study
Materials Covering Medical-Surgical Nursing Concepts, Clinical Judgment,
Disease Processes, Nursing Interventions, Pharmacology, Patient Care Priorities,
Practice Questions, Verified Answers, Detailed Rationales & NCLEX-Style Exam
Preparation
Gastrointestinal Disorders
1. A patient reports burning epigastric pain that worsens 2 hours after meals
and is relieved by eating. Which condition is most consistent?
A) Gastric ulcer
B) Duodenal ulcer
C) GERD
D) Pancreatitis
Correct Answer: B
Rationale: Duodenal ulcers cause pain 2-3 hours after meals due to acid secretion
in an empty stomach; pain is relieved by food. Gastric ulcers cause pain 30-60
minutes after eating and are worsened by food .
2. A nurse is caring for a patient with a suspected peptic ulcer. Which diagnostic
study is most useful in confirming Peptic Ulcer Disease (PUD)?
A) Abdominal X-ray
B) Upper GI endoscopy with biopsy
C) CT scan with contrast
D) MRI of the abdomen
Correct Answer: B
Rationale: Upper GI endoscopy with biopsy is the gold standard for confirming
PUD and allows visualization of the ulcer and biopsy for H. pylori testing .
3. What is the most lethal complication associated with Peptic Ulcer Disease
(PUD)?
,A) Hemorrhage
B) Perforation
C) Obstruction
D) Gastric outlet obstruction
Correct Answer: B
Rationale: Perforation is the most lethal complication because it leads to
peritonitis and sepsis, requiring immediate surgical intervention .
4. Which of the following is a classic sign of peritonitis?
A) Hypotension and bradycardia
B) Rigid, board-like abdomen
C) Hyperactive bowel sounds
D) Pain that decreases with movement
Correct Answer: B
Rationale: Peritonitis presents with fever >100.3°F, rebound tenderness, rigid or
board-like abdomen, increased pain and tenderness, and restlessness .
5. A patient with GERD asks when to take their prescribed proton pump
inhibitor (PPI). What should the nurse instruct?
A) Take with meals
B) Take 30 minutes before meals
C) Take at bedtime
D) Take immediately after meals
Correct Answer: B
Rationale: PPIs and H2 blockers should be taken 30 minutes before meals for
maximum effectiveness in reducing gastric acid secretion .
6. Which diagnostic assessment is performed to determine function of the lower
esophageal sphincter (LES)?
,A) Esophageal manometry
B) Upper GI endoscopy
C) Barium swallow
D) CT scan
Correct Answer: B
Rationale: Upper GI endoscopy evaluates LES function and can visualize
esophageal changes such as Barrett's esophagus .
7. A patient with diverticulitis is experiencing severe LLQ pain. What nursing
intervention is most appropriate?
A) Encourage high-fiber diet
B) Administer oral laxatives
C) Keep patient NPO and provide IV fluids
D) Apply heat to the abdomen
Correct Answer: C
Rationale: During acute diverticulitis, the bowel needs rest. NPO status with IV
fluids is standard to allow inflammation to subside .
8. What is the primary cause of diverticula formation in the colon?
A) High-fiber diet
B) Low-fiber diet leading to constipation and increased intraluminal pressure
C) Bacterial infection
D) Genetic predisposition
Correct Answer: B
Rationale: A diet with decreased fiber causes constipation, which increases
pressure in the bowels and leads to diverticula formation in weakened areas of
the colon wall .
, 9. A patient with ulcerative colitis would most likely present with which of the
following?
A) 15-20 bloody liquid stools per day
B) Hard, dry stools with mucus
C) Alternating constipation and diarrhea
D) Painless rectal bleeding
Correct Answer: A
Rationale: Ulcerative colitis is characterized by chronic inflammation of the colon
with presence of ulcers that bleed, resulting in frequent bloody liquid stools .
10. Which medication class is considered first-line therapy for mild to moderate
Crohn's disease, especially when the colon is involved?
A) Corticosteroids
B) Aminosalicylates
C) Biologic agents
D) Immunosuppressants
Correct Answer: B
Rationale: Aminosalicylates such as sulfasalazine and mesalamine are first-line
therapies for mild to moderate Crohn's disease, especially when the colon is
involved. They are more effective for ulcerative colitis .
11. A patient receiving sulfasalazine should be taught to monitor for which side
effects?
A) Headache, nausea, and fatigue
B) Hypertension and tachycardia
C) Urinary retention and constipation
D) Hair loss and dry skin
Correct Answer: A
