,NUR 170 Exam 4 | Concepts of Medical-Surgical
Nursing (2026) Q&A | Galen College
1. A client with GERD asks about lifestyle changes. Which instruction should the
nurse include?
A) Eat large meals to reduce acid production
B) Remain upright for 1 to 2 hours after eating
C) Lie flat after meals to aid digestion
D) Drink peppermint tea to soothe the esophagus
Correct Answer: Remain upright for 1 to 2 hours after eating
Rationale: Remaining upright prevents gastric reflux by using gravity. Large
meals, lying flat, and peppermint (which relaxes the lower esophageal
sphincter) worsen GERD. The client should eat small, frequent meals and avoid
trigger foods.
2. The nurse assesses a client with a history of prolonged GERD. Which
complication is most concerning?
A) Halitosis
B) Barrett's esophagus
C) Dental caries
D) Belching
Correct Answer: Barrett's esophagus
,Rationale: Barrett's esophagus is a precancerous change in the esophageal lining
due to chronic acid exposure. It requires surveillance endoscopy. Halitosis and
belching are bothersome but not life-threatening. Dental caries result from acid
but are less urgent.
3. A client is scheduled for an esophagogastroduodenoscopy. What is the
priority pre-procedure instruction?
A) "Take your daily aspirin with a sip of water."
B) "You will remain NPO for 6 to 8 hours before the test."
C) "You may have a light breakfast the morning of the procedure."
D) "No special preparation is needed."
Correct Answer: "You will remain NPO for 6 to 8 hours before the test."
Rationale: An empty stomach is essential to prevent aspiration during sedation
and to allow clear visualization. Aspirin and NSAIDs are typically held to reduce
bleeding risk. The client must not eat or drink as directed.
4. A client returns from an EGD. The nurse's priority assessment before offering
oral fluids is to check for:
A) Bowel sounds
B) Ability to urinate
C) Return of the gag reflex
D) Pain at the IV site
Correct Answer: Return of the gag reflex
, Rationale: Topical anesthesia suppresses the gag reflex. Offering fluids before it
returns can cause aspiration. The nurse must assess the gag reflex and keep the
client NPO until it is intact, usually within 30 to 60 minutes.
5. A client who had an ERCP develops severe abdominal pain and fever. The
nurse suspects which complication?
A) Pancreatitis
B) Gastroesophageal reflux
C) Constipation
D) Hiatal hernia
Correct Answer: Pancreatitis
Rationale: Pancreatitis is a serious post-ERCP complication. Severe pain and
fever require immediate notification of the provider. Other complications
include cholangitis, bleeding, perforation, and sepsis.
6. During an abdominal assessment, the nurse observes a bulging, pulsating
mass. What is the priority action?
A) Palpate gently to assess size
B) Percuss for dullness
C) Notify the health care provider immediately and do not palpate
D) Apply a warm compress
Correct Answer: Notify the health care provider immediately and do not palpate
Nursing (2026) Q&A | Galen College
1. A client with GERD asks about lifestyle changes. Which instruction should the
nurse include?
A) Eat large meals to reduce acid production
B) Remain upright for 1 to 2 hours after eating
C) Lie flat after meals to aid digestion
D) Drink peppermint tea to soothe the esophagus
Correct Answer: Remain upright for 1 to 2 hours after eating
Rationale: Remaining upright prevents gastric reflux by using gravity. Large
meals, lying flat, and peppermint (which relaxes the lower esophageal
sphincter) worsen GERD. The client should eat small, frequent meals and avoid
trigger foods.
2. The nurse assesses a client with a history of prolonged GERD. Which
complication is most concerning?
A) Halitosis
B) Barrett's esophagus
C) Dental caries
D) Belching
Correct Answer: Barrett's esophagus
,Rationale: Barrett's esophagus is a precancerous change in the esophageal lining
due to chronic acid exposure. It requires surveillance endoscopy. Halitosis and
belching are bothersome but not life-threatening. Dental caries result from acid
but are less urgent.
3. A client is scheduled for an esophagogastroduodenoscopy. What is the
priority pre-procedure instruction?
A) "Take your daily aspirin with a sip of water."
B) "You will remain NPO for 6 to 8 hours before the test."
C) "You may have a light breakfast the morning of the procedure."
D) "No special preparation is needed."
Correct Answer: "You will remain NPO for 6 to 8 hours before the test."
Rationale: An empty stomach is essential to prevent aspiration during sedation
and to allow clear visualization. Aspirin and NSAIDs are typically held to reduce
bleeding risk. The client must not eat or drink as directed.
4. A client returns from an EGD. The nurse's priority assessment before offering
oral fluids is to check for:
A) Bowel sounds
B) Ability to urinate
C) Return of the gag reflex
D) Pain at the IV site
Correct Answer: Return of the gag reflex
, Rationale: Topical anesthesia suppresses the gag reflex. Offering fluids before it
returns can cause aspiration. The nurse must assess the gag reflex and keep the
client NPO until it is intact, usually within 30 to 60 minutes.
5. A client who had an ERCP develops severe abdominal pain and fever. The
nurse suspects which complication?
A) Pancreatitis
B) Gastroesophageal reflux
C) Constipation
D) Hiatal hernia
Correct Answer: Pancreatitis
Rationale: Pancreatitis is a serious post-ERCP complication. Severe pain and
fever require immediate notification of the provider. Other complications
include cholangitis, bleeding, perforation, and sepsis.
6. During an abdominal assessment, the nurse observes a bulging, pulsating
mass. What is the priority action?
A) Palpate gently to assess size
B) Percuss for dullness
C) Notify the health care provider immediately and do not palpate
D) Apply a warm compress
Correct Answer: Notify the health care provider immediately and do not palpate
