,Galen NSG 4100 Exam 1 | Nursing Practice – Adult
Health III (2026) Actual Q&A PDF
1. In acute pancreatitis, the priority nursing action is to:
A) Place the client on NPO status and insert an NGT to low intermittent wall
suction
B) Administer oral pain medication
C) Encourage the client to eat a low‑fat diet
D) Prepare the client for immediate surgery
Correct Answer: Place the client on NPO status and insert an NGT to low
intermittent wall suction
Rationale: Pancreatic rest is essential to reduce autodigestion. NPO status and
NGT decompression decrease pancreatic stimulation by removing gastric
contents. Oral intake and pain medication without rest can worsen the
condition, and surgery is reserved for complications.
2. The most specific laboratory test for confirming acute pancreatitis is:
A) Serum amylase
B) Serum lipase
C) Complete blood count
D) Liver function tests
Correct Answer: Serum lipase
,Rationale: Serum lipase is more specific to the pancreas than amylase and
remains elevated longer. Amylase can rise in other conditions. CBC and LFTs are
nonspecific for pancreatitis.
3. When discharging a client with chronic pancreatitis, the most critical
instruction is to:
A) Take pancreatic enzymes on an empty stomach
B) Eat a high‑fat diet to maintain weight
C) Avoid all alcohol
D) Limit fluids to one liter per day
Correct Answer: Avoid all alcohol
Rationale: Alcohol is a major cause of pancreatitis and can trigger recurrent
episodes and progressive damage. Enzyme replacement should be taken with
meals. A low‑fat diet is recommended, and fluid restriction is not standard
unless renal issues coexist.
4. The classic pain pattern of acute pancreatitis is:
A) Severe epigastric or left upper quadrant pain radiating to the back
B) Right lower quadrant pain with rebound tenderness
C) Periumbilical cramping relieved by defecation
D) Diffuse aching that improves with ambulation
Correct Answer: Severe epigastric or left upper quadrant pain radiating to the
back
, Rationale: Pancreatic inflammation causes intense epigastric or LUQ pain that
often penetrates to the back. Eating and lying flat worsen it. RLQ pain suggests
appendicitis. Pain relief with defecation is typical of IBS.
5. A positive Murphy’s sign is a classic finding in which condition?
A) Cholecystitis
B) Pancreatitis
C) Appendicitis
D) Hepatitis
Correct Answer: Cholecystitis
Rationale: Murphy’s sign is pain with deep palpation of the right upper
quadrant during inspiration, indicating acute cholecystitis. Pancreatitis has LUQ
pain; appendicitis has RLQ pain. Hepatitis causes general tenderness.
6. The diagnostic test of choice for detecting gallstones and gallbladder
inflammation is:
A) Abdominal CT scan
B) Right upper quadrant ultrasound
C) HIDA scan
D) ERCP
Correct Answer: Right upper quadrant ultrasound
Health III (2026) Actual Q&A PDF
1. In acute pancreatitis, the priority nursing action is to:
A) Place the client on NPO status and insert an NGT to low intermittent wall
suction
B) Administer oral pain medication
C) Encourage the client to eat a low‑fat diet
D) Prepare the client for immediate surgery
Correct Answer: Place the client on NPO status and insert an NGT to low
intermittent wall suction
Rationale: Pancreatic rest is essential to reduce autodigestion. NPO status and
NGT decompression decrease pancreatic stimulation by removing gastric
contents. Oral intake and pain medication without rest can worsen the
condition, and surgery is reserved for complications.
2. The most specific laboratory test for confirming acute pancreatitis is:
A) Serum amylase
B) Serum lipase
C) Complete blood count
D) Liver function tests
Correct Answer: Serum lipase
,Rationale: Serum lipase is more specific to the pancreas than amylase and
remains elevated longer. Amylase can rise in other conditions. CBC and LFTs are
nonspecific for pancreatitis.
3. When discharging a client with chronic pancreatitis, the most critical
instruction is to:
A) Take pancreatic enzymes on an empty stomach
B) Eat a high‑fat diet to maintain weight
C) Avoid all alcohol
D) Limit fluids to one liter per day
Correct Answer: Avoid all alcohol
Rationale: Alcohol is a major cause of pancreatitis and can trigger recurrent
episodes and progressive damage. Enzyme replacement should be taken with
meals. A low‑fat diet is recommended, and fluid restriction is not standard
unless renal issues coexist.
4. The classic pain pattern of acute pancreatitis is:
A) Severe epigastric or left upper quadrant pain radiating to the back
B) Right lower quadrant pain with rebound tenderness
C) Periumbilical cramping relieved by defecation
D) Diffuse aching that improves with ambulation
Correct Answer: Severe epigastric or left upper quadrant pain radiating to the
back
, Rationale: Pancreatic inflammation causes intense epigastric or LUQ pain that
often penetrates to the back. Eating and lying flat worsen it. RLQ pain suggests
appendicitis. Pain relief with defecation is typical of IBS.
5. A positive Murphy’s sign is a classic finding in which condition?
A) Cholecystitis
B) Pancreatitis
C) Appendicitis
D) Hepatitis
Correct Answer: Cholecystitis
Rationale: Murphy’s sign is pain with deep palpation of the right upper
quadrant during inspiration, indicating acute cholecystitis. Pancreatitis has LUQ
pain; appendicitis has RLQ pain. Hepatitis causes general tenderness.
6. The diagnostic test of choice for detecting gallstones and gallbladder
inflammation is:
A) Abdominal CT scan
B) Right upper quadrant ultrasound
C) HIDA scan
D) ERCP
Correct Answer: Right upper quadrant ultrasound
