NRSG 110 Exam 3 V2 | NRSG 110 Medical
Surgical Nursing II | Actual Q&A with
Rationale (NRSG110 Exam 3) | Ivy Tech
1. The nurse is providing discharge instructions to a client newly diagnosed with
Gastroesophageal Reflux Disease (GERD). Which dietary modification should the nurse
prioritize to prevent symptom exacerbation?
A. Increase intake of spicy citrus juices.
B. Avoid peppermint and caffeinated beverages.
C. Eat three large meals per day instead of snacks.
D. Consume a high-fat snack right before bedtime.
Correct Answer: B
Peppermint and caffeine are known to decrease the pressure of the lower esophageal
sphincter, allowing gastric contents to reflux. Patients are encouraged to eat smaller, more
frequent meals to prevent gastric distension. Avoiding food at least 2 to 3 hours before
sleep is also a critical component of managing GERD symptoms.
2. A nurse is reviewing the medication administration record for a client with Type 1 Diabetes
Mellitus who is prescribed Insulin Glargine. Which characteristic of this medication is
essential for the nurse to understand?
A. The medication has no peak and provides a steady level of insulin for 24 hours.
,B. It is a short-acting insulin that must be given 30 minutes before meals.
C. The medication can be safely mixed with Regular insulin in the same syringe.
D. The insulin has a peak action time of 4 to 6 hours.
E. It should only be administered intravenously during episodes of ketoacidosis.
Correct Answer: A
Insulin Glargine is a long-acting basal insulin designed to maintain blood glucose levels
over a 24-hour period. Because it has no peak, it significantly reduces the risk of
hypoglycemia compared to NPH insulin. It must never be mixed with any other insulin in
the same syringe because the low pH of the solution can cause precipitation.
3. A client is admitted to the medical-surgical unit with a diagnosis of Acute
Glomerulonephritis. Which finding in the client’s history is most likely related to the
development of this condition?
A. A diagnosis of kidney stones three months ago.
B. History of chronic urinary tract infections treated with sulfonamides.
C. A recent sore throat caused by Group A beta-hemolytic streptococcus.
D. Exposure to hepatitis B through a needlestick injury.
Correct Answer: C
Acute glomerulonephritis often occurs as a post-infectious complication of a streptococcal
infection of the throat or skin. The immune complexes formed during the infection deposit
,in the glomerular basement membrane, leading to inflammation. Nursing care focuses on
monitoring blood pressure and managing fluid volume excess during the acute phase.
4. The nurse is assessing a client who is 24 hours post-operative following a colostomy
placement. The nurse notes the stoma is beefy red and moist with a small amount of edema.
Which action by the nurse is most appropriate?
A. Notify the surgeon immediately of a potential bowel obstruction.
B. Irrigate the stoma with normal saline to check for patency.
C. Apply a cold pack to the stoma to reduce the swelling.
D. Document the findings as a normal expected post-operative appearance.
Correct Answer: D
A healthy, newly created stoma should appear beefy red and moist, indicating adequate
blood flow. Mild edema is common in the immediate post-operative period as the tissue
recovers from surgical trauma. The nurse should continue to monitor the stoma, as a dusky,
pale, or cyanotic appearance would indicate impaired circulation and require urgent
intervention.
5. A client with Peptic Ulcer Disease (PUD) tests positive for Helicobacter pylori. The nurse
should expect the healthcare provider to prescribe which combination of medications?
A. A Proton Pump Inhibitor (PPI) and two different antibiotics.
B. Antacids and an H2-receptor antagonist only.
C. NSAIDs and a mucosal protectant like sucralfate.
, D. Corticosteroids and a bulk-forming laxative.
Correct Answer: A
Triple therapy is the standard of care for eradicating H. pylori and usually includes a PPI
and two antibiotics such as clarithromycin and amoxicillin. This combination effectively
kills the bacteria while reducing gastric acid to allow the ulcer to heal. Patient education
must emphasize completing the entire course of antibiotics to prevent drug resistance.
6. The nurse is caring for a client with Hypothyroidism who is starting Levothyroxine. Which
instruction is vital for the nurse to include in the teaching plan?
A. Take the medication with a full meal to increase absorption.
B. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
C. Stop the medication immediately if you feel heart palpitations.
D. Expect the full effects of the medication within 24 to 48 hours.
Correct Answer: B
Levothyroxine absorption is best when taken on an empty stomach without other
medications or food. Patients should be taught that it may take several weeks to see a full
clinical response in their energy levels and metabolism. It is a lifelong therapy, and patients
should report signs of hyperthyroidism, such as tachycardia, to their provider.
Surgical Nursing II | Actual Q&A with
Rationale (NRSG110 Exam 3) | Ivy Tech
1. The nurse is providing discharge instructions to a client newly diagnosed with
Gastroesophageal Reflux Disease (GERD). Which dietary modification should the nurse
prioritize to prevent symptom exacerbation?
A. Increase intake of spicy citrus juices.
B. Avoid peppermint and caffeinated beverages.
C. Eat three large meals per day instead of snacks.
D. Consume a high-fat snack right before bedtime.
Correct Answer: B
Peppermint and caffeine are known to decrease the pressure of the lower esophageal
sphincter, allowing gastric contents to reflux. Patients are encouraged to eat smaller, more
frequent meals to prevent gastric distension. Avoiding food at least 2 to 3 hours before
sleep is also a critical component of managing GERD symptoms.
2. A nurse is reviewing the medication administration record for a client with Type 1 Diabetes
Mellitus who is prescribed Insulin Glargine. Which characteristic of this medication is
essential for the nurse to understand?
A. The medication has no peak and provides a steady level of insulin for 24 hours.
,B. It is a short-acting insulin that must be given 30 minutes before meals.
C. The medication can be safely mixed with Regular insulin in the same syringe.
D. The insulin has a peak action time of 4 to 6 hours.
E. It should only be administered intravenously during episodes of ketoacidosis.
Correct Answer: A
Insulin Glargine is a long-acting basal insulin designed to maintain blood glucose levels
over a 24-hour period. Because it has no peak, it significantly reduces the risk of
hypoglycemia compared to NPH insulin. It must never be mixed with any other insulin in
the same syringe because the low pH of the solution can cause precipitation.
3. A client is admitted to the medical-surgical unit with a diagnosis of Acute
Glomerulonephritis. Which finding in the client’s history is most likely related to the
development of this condition?
A. A diagnosis of kidney stones three months ago.
B. History of chronic urinary tract infections treated with sulfonamides.
C. A recent sore throat caused by Group A beta-hemolytic streptococcus.
D. Exposure to hepatitis B through a needlestick injury.
Correct Answer: C
Acute glomerulonephritis often occurs as a post-infectious complication of a streptococcal
infection of the throat or skin. The immune complexes formed during the infection deposit
,in the glomerular basement membrane, leading to inflammation. Nursing care focuses on
monitoring blood pressure and managing fluid volume excess during the acute phase.
4. The nurse is assessing a client who is 24 hours post-operative following a colostomy
placement. The nurse notes the stoma is beefy red and moist with a small amount of edema.
Which action by the nurse is most appropriate?
A. Notify the surgeon immediately of a potential bowel obstruction.
B. Irrigate the stoma with normal saline to check for patency.
C. Apply a cold pack to the stoma to reduce the swelling.
D. Document the findings as a normal expected post-operative appearance.
Correct Answer: D
A healthy, newly created stoma should appear beefy red and moist, indicating adequate
blood flow. Mild edema is common in the immediate post-operative period as the tissue
recovers from surgical trauma. The nurse should continue to monitor the stoma, as a dusky,
pale, or cyanotic appearance would indicate impaired circulation and require urgent
intervention.
5. A client with Peptic Ulcer Disease (PUD) tests positive for Helicobacter pylori. The nurse
should expect the healthcare provider to prescribe which combination of medications?
A. A Proton Pump Inhibitor (PPI) and two different antibiotics.
B. Antacids and an H2-receptor antagonist only.
C. NSAIDs and a mucosal protectant like sucralfate.
, D. Corticosteroids and a bulk-forming laxative.
Correct Answer: A
Triple therapy is the standard of care for eradicating H. pylori and usually includes a PPI
and two antibiotics such as clarithromycin and amoxicillin. This combination effectively
kills the bacteria while reducing gastric acid to allow the ulcer to heal. Patient education
must emphasize completing the entire course of antibiotics to prevent drug resistance.
6. The nurse is caring for a client with Hypothyroidism who is starting Levothyroxine. Which
instruction is vital for the nurse to include in the teaching plan?
A. Take the medication with a full meal to increase absorption.
B. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
C. Stop the medication immediately if you feel heart palpitations.
D. Expect the full effects of the medication within 24 to 48 hours.
Correct Answer: B
Levothyroxine absorption is best when taken on an empty stomach without other
medications or food. Patients should be taught that it may take several weeks to see a full
clinical response in their energy levels and metabolism. It is a lifelong therapy, and patients
should report signs of hyperthyroidism, such as tachycardia, to their provider.
