NURS 372 MED SURG 3 EXAM NEWEST 2026 ACTUAL
EXAM TEST BANK| COMPLETE REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+
Comprehensive Review for Medical-Surgical Nursing III
This comprehensive test bank contains 450 exam-style questions and
detailed rationales designed to prepare nursing students for the NURS 372
Medical-Surgical Nursing III examination. Questions cover key content
areas including gastrointestinal disorders, hepatic and biliary diseases,
neurological conditions, endocrine disorders, renal and urinary system
diseases, hematological disorders, immunology, oncology, transplant
nursing, and critical care concepts. Each question includes the Correct
Answer with a detailed rationale explaining the underlying
pathophysiology, nursing interventions, and clinical reasoning to promote
deep understanding and NCLEX success. All questions are organized
sequentially by content area for systematic study.
SECTION 1: GASTROINTESTINAL DISORDERS (Questions 1-90)
Question 1:
A client with a history of peptic ulcer disease reports experiencing sharp,
sudden epigastric pain that radiates to the shoulder, accompanied by
nausea and abdominal rigidity. Which complication should the nurse
suspect?
A) Gastric outlet obstruction
B) Perforation of the ulcer
C) Hemorrhage
D) Penetration into the pancreas
,Correct Answer: B
Detailed Rationale: Perforation of a peptic ulcer is a life-threatening
emergency characterized by sudden, sharp epigastric pain that often
radiates to the shoulder (referred pain from diaphragmatic irritation). The
client typically presents with a rigid, board-like abdomen, nausea, and
signs of peritoneal irritation. Gastric outlet obstruction (A) would present
with early satiety and vomiting. Hemorrhage (C) typically presents with
hematemesis or melena. Penetration into the pancreas (D) would cause
pain radiating to the back rather than the shoulder and would be more
gradual in onset .
Question 2:
The nurse is caring for a client who underwent a Billroth II procedure
(gastrojejunostomy) for gastric cancer. Which postoperative complication
should the nurse monitor for that is specific to this surgical approach?
A) Gastric retention
B) Duodenal stump leakage
C) Esophageal reflux
D) Hiatal hernia formation
Correct Answer: B
Detailed Rationale: Billroth II involves removal of the distal stomach and
anastomosis of the remaining stomach to the jejunum, with the duodenal
stump being closed. Duodenal stump leakage (B) is a serious complication
specific to this procedure that can lead to peritonitis, sepsis, and abscess
formation. Signs include sudden abdominal pain, fever, tachycardia, and
peritoneal signs. Gastric retention (A) is more common with vagotomy
procedures. Esophageal reflux (C) and hiatal hernia formation (D) are not
specific to this surgical approach .
,Question 3:
A client diagnosed with dumping syndrome following gastric surgery
reports experiencing diaphoresis, palpitations, and diarrhea approximately
30 minutes after meals. Which dietary modification should the nurse
recommend to manage these symptoms?
A) High-carbohydrate meals with fluids between meals
B) Low-carbohydrate, high-protein meals with fluids between meals
C) High-fat meals with fluids during meals
D) Liquid meals only for the first 6 months post-surgery
Correct Answer: B
Detailed Rationale: Dumping syndrome occurs when hyperosmolar gastric
contents rapidly empty into the small intestine, causing fluid shifts and
rapid glucose absorption. Management includes eating low-carbohydrate,
high-protein, high-fat meals and consuming fluids between meals rather
than with meals (B). This slows gastric emptying and reduces osmotic
shifts. High-carbohydrate meals (A) worsen dumping syndrome. High-fat
meals with fluids during meals (C) would exacerbate symptoms. Liquid
meals (D) would likely worsen dumping due to rapid emptying .
Question 4:
The healthcare provider orders a high-protein, high-fat, low-carbohydrate
diet with limited fluids during meals for a client recovering from gastric
surgery. The client asks the nurse about the purpose of this diet. Which
rationale should the nurse provide?
A) It is quickly digested and absorbed
B) It does not cause diarrhea
C) It does not dilate the stomach
D) It is slow to leave the stomach
, Correct Answer: D
Detailed Rationale: This dietary pattern is prescribed to prevent dumping
syndrome. Foods high in protein and fat are digested more slowly and
remain in the stomach longer (D). Limiting fluids during meals further
slows gastric emptying and reduces the osmotic shift that causes dumping
symptoms. This diet is not quickly digested (A), preventing diarrhea is not
the primary rationale (B), and while it doesn't dilate the stomach (C), this is
not the main purpose .
Question 5:
The nurse is assessing a client with suspected esophageal cancer. Which
clinical manifestation is most concerning and requires immediate
intervention?
A) Progressive dysphagia with weight loss
B) Sensation of a mass in the throat
C) Hoarseness and chronic cough
D) Acute airway compromise
Correct Answer: D
Detailed Rationale: While progressive dysphagia (A), sensation of a mass
(B), and hoarseness (C) are common findings in esophageal cancer, acute
airway compromise (D) is a medical emergency that requires immediate
intervention. Esophageal tumors can compress the trachea or cause
aspiration, leading to airway obstruction and respiratory distress. The
nurse must prioritize airway assessment and management over other
symptoms .
Question 6:
A client with cirrhosis is scheduled for a paracentesis to manage ascites.
Which intervention should the nurse implement before the procedure?
EXAM TEST BANK| COMPLETE REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+
Comprehensive Review for Medical-Surgical Nursing III
This comprehensive test bank contains 450 exam-style questions and
detailed rationales designed to prepare nursing students for the NURS 372
Medical-Surgical Nursing III examination. Questions cover key content
areas including gastrointestinal disorders, hepatic and biliary diseases,
neurological conditions, endocrine disorders, renal and urinary system
diseases, hematological disorders, immunology, oncology, transplant
nursing, and critical care concepts. Each question includes the Correct
Answer with a detailed rationale explaining the underlying
pathophysiology, nursing interventions, and clinical reasoning to promote
deep understanding and NCLEX success. All questions are organized
sequentially by content area for systematic study.
SECTION 1: GASTROINTESTINAL DISORDERS (Questions 1-90)
Question 1:
A client with a history of peptic ulcer disease reports experiencing sharp,
sudden epigastric pain that radiates to the shoulder, accompanied by
nausea and abdominal rigidity. Which complication should the nurse
suspect?
A) Gastric outlet obstruction
B) Perforation of the ulcer
C) Hemorrhage
D) Penetration into the pancreas
,Correct Answer: B
Detailed Rationale: Perforation of a peptic ulcer is a life-threatening
emergency characterized by sudden, sharp epigastric pain that often
radiates to the shoulder (referred pain from diaphragmatic irritation). The
client typically presents with a rigid, board-like abdomen, nausea, and
signs of peritoneal irritation. Gastric outlet obstruction (A) would present
with early satiety and vomiting. Hemorrhage (C) typically presents with
hematemesis or melena. Penetration into the pancreas (D) would cause
pain radiating to the back rather than the shoulder and would be more
gradual in onset .
Question 2:
The nurse is caring for a client who underwent a Billroth II procedure
(gastrojejunostomy) for gastric cancer. Which postoperative complication
should the nurse monitor for that is specific to this surgical approach?
A) Gastric retention
B) Duodenal stump leakage
C) Esophageal reflux
D) Hiatal hernia formation
Correct Answer: B
Detailed Rationale: Billroth II involves removal of the distal stomach and
anastomosis of the remaining stomach to the jejunum, with the duodenal
stump being closed. Duodenal stump leakage (B) is a serious complication
specific to this procedure that can lead to peritonitis, sepsis, and abscess
formation. Signs include sudden abdominal pain, fever, tachycardia, and
peritoneal signs. Gastric retention (A) is more common with vagotomy
procedures. Esophageal reflux (C) and hiatal hernia formation (D) are not
specific to this surgical approach .
,Question 3:
A client diagnosed with dumping syndrome following gastric surgery
reports experiencing diaphoresis, palpitations, and diarrhea approximately
30 minutes after meals. Which dietary modification should the nurse
recommend to manage these symptoms?
A) High-carbohydrate meals with fluids between meals
B) Low-carbohydrate, high-protein meals with fluids between meals
C) High-fat meals with fluids during meals
D) Liquid meals only for the first 6 months post-surgery
Correct Answer: B
Detailed Rationale: Dumping syndrome occurs when hyperosmolar gastric
contents rapidly empty into the small intestine, causing fluid shifts and
rapid glucose absorption. Management includes eating low-carbohydrate,
high-protein, high-fat meals and consuming fluids between meals rather
than with meals (B). This slows gastric emptying and reduces osmotic
shifts. High-carbohydrate meals (A) worsen dumping syndrome. High-fat
meals with fluids during meals (C) would exacerbate symptoms. Liquid
meals (D) would likely worsen dumping due to rapid emptying .
Question 4:
The healthcare provider orders a high-protein, high-fat, low-carbohydrate
diet with limited fluids during meals for a client recovering from gastric
surgery. The client asks the nurse about the purpose of this diet. Which
rationale should the nurse provide?
A) It is quickly digested and absorbed
B) It does not cause diarrhea
C) It does not dilate the stomach
D) It is slow to leave the stomach
, Correct Answer: D
Detailed Rationale: This dietary pattern is prescribed to prevent dumping
syndrome. Foods high in protein and fat are digested more slowly and
remain in the stomach longer (D). Limiting fluids during meals further
slows gastric emptying and reduces the osmotic shift that causes dumping
symptoms. This diet is not quickly digested (A), preventing diarrhea is not
the primary rationale (B), and while it doesn't dilate the stomach (C), this is
not the main purpose .
Question 5:
The nurse is assessing a client with suspected esophageal cancer. Which
clinical manifestation is most concerning and requires immediate
intervention?
A) Progressive dysphagia with weight loss
B) Sensation of a mass in the throat
C) Hoarseness and chronic cough
D) Acute airway compromise
Correct Answer: D
Detailed Rationale: While progressive dysphagia (A), sensation of a mass
(B), and hoarseness (C) are common findings in esophageal cancer, acute
airway compromise (D) is a medical emergency that requires immediate
intervention. Esophageal tumors can compress the trachea or cause
aspiration, leading to airway obstruction and respiratory distress. The
nurse must prioritize airway assessment and management over other
symptoms .
Question 6:
A client with cirrhosis is scheduled for a paracentesis to manage ascites.
Which intervention should the nurse implement before the procedure?
