Medical-Surgical Nursing Concepts (NUR 242)/ NUR242 Exam 3 Review Questions and Answers- Updated Fall 2026- Galen.

Medical-Surgical Nursing Concepts (NUR 242)/ NUR242 Exam 3 Review Questions and Answers- Updated Fall 2026- Galen. 1. Which symptom is most commonly associated with gastroesophageal reflux disease (GERD)? A. Right lower quadrant abdominal pain B. Substernal burning or heartburn C. Severe diarrhea D. Hematuria 2. When are GERD symptoms most likely to become worse? A. When the patient remains upright after eating B. When lying flat or bending over C. During moderate exercise D. When drinking water 3. Which foods are identified as risk factors for GERD? A. Caffeine, alcohol, spicy foods, fried foods, chocolate, and tomatoes B. Whole grains and lean meats C. Water and vegetables only D. High-protein foods only 4. Why is a patient with GERD at risk for aspiration? A. GERD causes excessive intestinal motility. B. Regurgitated gastric contents may enter the airway. C. GERD causes airway obstruction directly. D. GERD decreases the gag reflex permanently. 5. Which instruction should the nurse provide to a patient with a hiatal hernia? A. Lie flat immediately after meals. B. Eat two very large meals each day. C. Elevate the head of the bed and remain upright after meals. D. Perform vigorous exercise immediately after eating. 6. Which meal pattern is recommended for a patient with a hiatal hernia? A. One large meal daily B. Small, frequent meals C. High-fat meals D. Meals followed by vigorous activity 7. What is the purpose of an esophagogastroduodenoscopy (EGD)? A. To examine only the colon B. To visualize the esophagus, stomach, and duodenum C. To examine the lungs D. To measure pulmonary function 8. How long should patients generally remain NPO before an EGD according to the provided review? A. 1 hour B. 2 hours C. At least 8 hours D. 24 hours 9. Why should the nurse monitor the gag reflex after an EGD? A. Sedation can suppress the gag reflex and increase aspiration risk. B. The gag reflex causes hypertension. C. The gag reflex determines bowel function. D. Sedation increases gastric emptying. 10. When should oral intake generally resume after an EGD according to the document? A. Immediately after the procedure B. After the gag reflex returns C. After 24 hours D. Only after a bowel movement 11. Which medications may need to be discontinued before an EGD to reduce bleeding risk? A. Aspirin, anticoagulants, and NSAIDs B. Antacids only C. Vitamins only D. Antibiotics only 12. Which nursing assessment is a priority for a patient with gastritis? A. Hydration status B. Visual acuity C. Hearing ability D. Peripheral pulses only 13. Which medications may be used to reduce gastric acid in gastritis? A. Antacids, H2 antagonists, and proton pump inhibitors B. Anticoagulants C. Bronchodilators D. Diuretics 14. Which infection is associated with duodenal peptic ulcer disease in the provided document? A. Influenza B. H. pylori C. Hepatitis C D. Tuberculosis 15. Which statement about gastric ulcers is correct? A. Eating always relieves the pain. B. Pain may occur shortly after eating and may worsen with food. C. Pain occurs only in the right lower quadrant. D. Gastric ulcers do not cause nausea. 16. Which lifestyle factor contributes to peptic ulcer disease? A. Smoking B. Walking C. Adequate hydration D. Regular exercise 17. Following gastrectomy, which long-term therapy may be necessary to prevent pernicious anemia? A. Vitamin C B. Vitamin B12 injections C. Calcium only D. Iron-free therapy 18. Which intervention is appropriate for a patient with irritable bowel syndrome (IBS)? A. Encourage stress reduction and regular exercise. B. Encourage smoking. C. Eliminate all physical activity. D. Encourage high-fat meals. 19. Which factors can contribute to IBS? A. Stress, smoking, caffeine, alcohol, and gas-producing foods B. Adequate hydration only C. Regular exercise only D. Low-fat foods only Hernias and Intestinal Disorders 20. Which factor increases intra-abdominal pressure and contributes to hernia formation? A. Obesity B. Low fluid intake C. Rest D. Normal nutrition 21. What is an indirect inguinal hernia? A. A hernia through a weak point in the abdominal wall B. A peritoneal sac containing bowel or omentum that enters the inguinal canal C. A hernia occurring only at the umbilicus D. A hernia caused by lung disease 22. What is an incisional hernia commonly associated with? A. Previous surgical incision B. Asthma C. GERD D. Hepatitis 23. Which factors can contribute to an incisional hernia? A. Poor nutrition, obesity, and postoperative wound infection B. Exercise and adequate nutrition C. Low blood pressure D. Increased oxygenation 24. What occurs with an intestinal obstruction? A. Intestinal contents move more rapidly through the bowel. B. Intestinal contents cannot pass normally through the bowel. C. Gastric emptying becomes normal. D. Fluid never accumulates. 25. Which finding is associated with small bowel obstruction? A. Abdominal distention and altered bowel sounds B. Increased urine output C. Bradycardia only D. Clear lung sounds only 26. In a complete small bowel obstruction, what may the patient eventually vomit? A. Only saliva B. Fecal contents from the ileum C. Only blood D. Only water 27. What is the primary goal of treatment for intestinal obstruction? A. Increase food intake immediately B. Relieve symptoms and correct fluid/electrolyte imbalance C. Encourage large meals D. Prevent all bowel movements Dumping Syndrome and Ostomies 28. What causes dumping syndrome? A. Slow movement of gastric contents B. Rapid emptying of gastric contents into the small intestine C. Complete intestinal obstruction D. Decreased insulin production only 29. When does early dumping syndrome typically occur? A. Within 30 minutes after eating B. 12 hours after eating C. 24 hours after eating D. Before eating 30. Which finding is associated with early dumping syndrome? A. Tachycardia, sweating, pallor, and vertigo B. Bradycardia and hypothermia C. Severe hypertension only D. Increased appetite 31. When does late dumping syndrome usually occur? A. Immediately before eating B. 90 minutes to 3 hours after eating C. Only during sleep D. Several days after eating 32. What causes late dumping syndrome? A. Excessive insulin release following a rapid rise in blood glucose B. Lack of gastric acid C. Increased bile production D. Low protein intake 33. Which dietary teaching is appropriate for dumping syndrome? A. Eat large meals with liquids. B. Eat small frequent meals and avoid liquids with meals. C. Increase simple carbohydrates. D. Drink large amounts of fluid during meals. 34. What should a healthy colostomy stoma look like? A. Pale, dry, and dusky B. Pink to red, warm, and moist C. Black and dry D. Yellow and cold 35. What should the nurse recognize as an abnormal stoma finding? A. Pink and moist B. Beefy red C. Pale, dusky, gray, or dry appearance D. Small amount of mucus 36. Approximately how long may it take for a newly created stoma to shrink to its final size? A. 1–2 days B. 1 week C. 6–8 weeks D. 1 year 37. What should a patient with an ileostomy understand about drainage? A. There should never be drainage. B. Drainage from the small intestine is expected. C. Drainage should always be solid. D. Drainage indicates infection. 38. Which action should be avoided when there is no drainage from an ileostomy? A. Contacting the healthcare provider B. Monitoring the patient C. Giving a laxative or enema D. Assessing the stoma 39. How full should an ostomy pouch generally be allowed to become before emptying it? A. Completely full B. About one-third to one-half full at most C. Three-quarters full D. Only when it leaks 40. Which foods should an ostomy patient consider avoiding because they can increase gas? A. Cabbage, broccoli, and beans B. Rice and water C. Lean meats only D. Plain toast only Appendicitis and Inflammatory Bowel Disorders 41. Which finding is classic for appendicitis? A. Pain that begins around the abdomen and localizes to the right lower quadrant B. Left shoulder pain only C. Chest pain D. Bilateral flank pain 42. What is rebound tenderness associated with appendicitis? A. Pain when pressure is quickly released from the abdomen B. Pain relieved by eating C. Pain only when standing D. Pain occurring only during sleep 43. Why is untreated appendicitis dangerous? A. It can perforate and cause peritonitis. B. It always causes diabetes. C. It causes asthma. D. It causes GERD. 44. What is peritonitis? A. Inflammation caused by contamination of the normally sterile peritoneal cavity B. Inflammation of the lungs C. Inflammation of the gallbladder only D. Inflammation of the skin 45. Which finding is characteristic of peritonitis? A. Abrupt onset of diffuse, severe abdominal pain B. Mild painless diarrhea only C. Increased appetite D. Painless abdominal distention only 46. Which electrolyte imbalance may occur with gastroenteritis? A. Hypercalcemia B. Hypokalemia C. Hypernatremia only D. Hypermagnesemia 47. What is an important treatment focus for severe gastroenteritis? A. IV fluids and monitoring for cardiac dysrhythmias B. Restrict all fluids C. Encourage high-fat meals D. Avoid monitoring electrolytes 48. Which finding is characteristic of Crohn's disease according to the document? A. Right lower quadrant abdominal pain B. Left shoulder pain C. Chest pain D. Epigastric pain only 49. Which complication may require parenteral nutrition in an acutely ill patient with Crohn's disease? A. Need for total bowel rest B. Increased appetite C. Mild constipation D. Normal bowel function 50. Which medication is identified as an immune response modifier used for Crohn's disease? A. Adalimumab B. Acetaminophen C. Albuterol D. Metformin 51. What should a patient taking immune response modifiers for Crohn's disease report? A. Cold-like symptoms or sore throat B. Increased appetite C. Improved sleep D. Normal bowel movements 52. What dietary teaching is appropriate for a patient with an ostomy related to inflammatory bowel disease? A. Maintain adequate fluid intake and recognize dehydration. B. Avoid all fluids. C. Eat only high-fat foods. D. Drink no water. 53. Which treatment may be used for diverticulitis? A. Liquid or low-fiber diet and antibiotics B. High-fiber diet during an acute attack only C. Large meals D. Routine laxatives Hepatitis and GI Procedures 54. How is hepatitis A primarily transmitted? A. Fecal-oral route B. Airborne transmission C. Mosquito bites D. Droplet transmission 55. Which transmission route is associated with hepatitis B? A. Unprotected sexual intercourse and blood exposure B. Contaminated drinking water only C. Airborne droplets D. Mosquito bites 56. How is hepatitis C commonly transmitted? A. Blood-to-blood exposure B. Casual conversation C. Food contamination only D. Airborne droplets 57. What is the purpose of an ERCP? A. To examine and treat obstruction of the biliary and pancreatic ducts B. To measure lung capacity C. To examine the brain D. To diagnose asthma 58. What is an important preparation before ERCP? A. NPO for at least 8 hours B. Eat a high-fat meal C. Drink several liters of milk D. Exercise immediately before the procedure 59. Which complication should the nurse closely monitor for after ERCP? A. Bleeding and perforation B. Improved appetite C. Weight gain D. Hypothermia only 60. What is an important preparation for colonoscopy? A. Bowel cleansing and a clear-liquid diet B. High-fat meals C. No bowel preparation D. Solid foods immediately before the procedure 61. Which instruction is appropriate before a colonoscopy according to the document? A. Avoid red, orange, and purple beverages or gelatin. B. Drink only red beverages. C. Eat solid foods throughout the preparation. D. Avoid all fluids. 62. What should occur before oral intake resumes after colonoscopy? A. The patient should pass flatus indicating return of peristalsis. B. The patient should develop abdominal pain. C. The patient should remain flat for 24 hours. D. The patient should eat a high-fat meal. Gallbladder Disorders 63. Which symptom is most characteristic of acute cholecystitis? A. Right upper quadrant abdominal pain B. Left lower quadrant pain only C. Chest pain only D. Headache 64. What commonly triggers a gallbladder attack according to the document? A. Eating a large high-fat meal B. Drinking water C. Skipping exercise D. Eating a low-fat meal 65. Which laboratory findings may be elevated with gallbladder disease? A. Bilirubin and alkaline phosphatase B. Hemoglobin only C. Calcium only D. Sodium only 66. Which diagnostic test can evaluate bile production and flow? A. HIDA scan B. EEG C. Spirometry D. Colonoscopy 67. Which dietary instruction is appropriate for a patient with gallbladder disease? A. Eat a low-fat diet and avoid skipping meals. B. Eat large high-fat meals. C. Avoid all carbohydrates. D. Eat only one meal per day. Malnutrition and Obesity 68. Which finding may indicate malnutrition in an adult? A. Muscle wasting and poor wound healing B. Increased muscle mass C. Excessive energy D. Improved skin integrity 69. Which factor should the nurse assess when evaluating nutritional status? A. Access to food and socioeconomic factors B. Hair color C. Eye color D. Hand dominance only 70. Which intervention can help improve nutritional intake in an undernourished patient? A. Provide mouth care before meals and encourage social interaction during meals. B. Keep the patient in bed during meals. C. Offer only one large meal daily. D. Restrict calories. 71. When oral intake is inadequate, which nutritional therapies may be required? A. Enteral or parenteral nutrition B. Fluid restriction only C. No nutritional support D. Exercise therapy only 72. According to the document, bariatric surgery may be considered for a patient with which BMI? A. Greater than 20 B. Greater than 25 C. Greater than 30 D. Greater than 40 73. Which finding may indicate a serious leak after bariatric surgery? A. Back, shoulder, or abdominal pain with tachycardia and oliguria B. Increased appetite only C. Normal vital signs D. Improved activity tolerance NG Tube and Respiratory Assessment 74. How should the nurse measure the appropriate length of an NG tube before insertion? A. Nose to earlobe to xiphoid process B. Mouth to shoulder C. Nose to forehead D. Ear to umbilicus 75. Which method is identified in the document as the definitive way to verify NG tube placement? A. Asking the patient to speak B. Inspecting the mouth C. X-ray confirmation D. Listening over the stomach only