Galen College NU 185 Exam 3 (pdf) | 2026/2027 | Med-Surg II Q&A |
Medical-Surgical Nursing
1. A nurse is teaching a client newly diagnosed with chronic gastritis. Which
statement by the client indicates a need for further teaching?
A) "I will avoid drinking alcohol."
B) "I should take NSAIDs regularly for my joint pain."
C) "I will quit smoking."
D) "I will follow up with my provider about my H. pylori test."
Correct Answer: "I should take NSAIDs regularly for my joint pain."
Rationale: NSAIDs (like ibuprofen) are a major irritant to the gastric lining and
a common cause of both acute and chronic gastritis. Clients with chronic
gastritis should avoid regular NSAID use. The other choices reflect
appropriate understanding and management.
2. Which statement made by a client with GERD indicates correct
understanding of discharge teaching?
A) "I'll lie down right after eating to help with digestion."
B) "I will eat small meals throughout the day."
C) "I should avoid elevating the head of my bed."
D) "Spicy foods help reduce acid production."
Correct Answer: "I will eat small meals throughout the day."
Rationale: Small, frequent meals reduce gastric pressure and acid reflux.
Lying down after meals and spicy foods worsen GERD. The head of the bed
should be elevated 6-8 inches to reduce nighttime reflux.
,3. A client with acute gastritis reports vomiting for 12 hours and shows signs
of dry mucous membranes and poor skin turgor. Which intervention takes
priority?
A) Begin a clear liquid diet
B) Administer antiemetic medication
C) Initiate IV fluid replacement
D) Administer oral rehydration therapy
Correct Answer: Initiate IV fluid replacement
Rationale: The client is showing signs of dehydration (dry mucous
membranes, poor skin turgor) after 12 hours of vomiting. IV fluid
replacement is the priority to restore fluid volume and prevent further
complications. Clear liquids and oral rehydration may be initiated once
vomiting is controlled.
4. A client with a history of peptic ulcer disease presents with a rigid
abdomen and severe pain. Which action should the nurse take first?
A) Administer prescribed pain medication
B) Notify the healthcare provider
C) Prepare the client for surgery
D) Place the client in a supine position
Correct Answer: Notify the healthcare provider
Rationale: A rigid abdomen and severe pain in a client with peptic ulcer
disease may indicate perforation, a life-threatening emergency. The nurse
should notify the healthcare provider immediately. Pain medication should
not be given until a full assessment is completed, as it may mask symptoms.
,5. Which of the following best describes the most common cause of acute
tubular necrosis?
A) Prolonged renal ischemia
B) Allergic interstitial nephritis
C) Acute glomerulonephritis
D) Polycystic kidney disease
Correct Answer: Prolonged renal ischemia
Rationale: Acute tubular necrosis is primarily caused by ischemia (prerenal)
or nephrotoxic agents that directly damage tubular cells. Ischemia from
hypotension or hypovolemia is the most frequent cause. Glomerulonephritis
and interstitial nephritis affect other renal structures.
6. The nurse is reviewing laboratory data for a client with chronic kidney
disease. Which value best reflects renal function?
A) Serum glucose
B) Serum creatinine and glomerular filtration rate
C) Alanine aminotransferase
D) White blood cell count
Correct Answer: Serum creatinine and glomerular filtration rate
Rationale: Creatinine is a waste product filtered by the kidneys; elevated
levels indicate impaired function. GFR estimates the rate of filtration.
Glucose, liver enzymes, and WBC do not directly measure renal function.
7. A nurse is teaching a client with diabetes insipidus about desmopressin
therapy. Which statement indicates a need for further instruction?
, A) "I will monitor my fluid intake and output."
B) "I can stop taking this medication if I feel better."
C) "I should report any headaches or confusion."
D) "I will weigh myself daily."
Correct Answer: "I can stop taking this medication if I feel better."
Rationale: Desmopressin is a lifelong medication for diabetes insipidus and
should not be stopped without a provider's guidance. Stopping abruptly can
lead to return of polyuria, dehydration, and hypernatremia. The other
statements reflect appropriate understanding.
8. A client develops tetany and muscle cramps after a thyroidectomy. The
nurse suspects which complication?
A) Hyperkalemia
B) Hypocalcemia
C) Hyperglycemia
D) Hyponatremia
Correct Answer: Hypocalcemia
Rationale: Parathyroid hormone deficiency leads to decreased calcium
mobilization and renal reabsorption, causing hypocalcemia. Neuromuscular
excitability increases, resulting in tetany, cramps, and positive
Chvostek/Trousseau signs.
9. During teaching about propylthiouracil for hyperthyroidism, the client
should be instructed to report which symptom immediately?
A) Weight gain
Medical-Surgical Nursing
1. A nurse is teaching a client newly diagnosed with chronic gastritis. Which
statement by the client indicates a need for further teaching?
A) "I will avoid drinking alcohol."
B) "I should take NSAIDs regularly for my joint pain."
C) "I will quit smoking."
D) "I will follow up with my provider about my H. pylori test."
Correct Answer: "I should take NSAIDs regularly for my joint pain."
Rationale: NSAIDs (like ibuprofen) are a major irritant to the gastric lining and
a common cause of both acute and chronic gastritis. Clients with chronic
gastritis should avoid regular NSAID use. The other choices reflect
appropriate understanding and management.
2. Which statement made by a client with GERD indicates correct
understanding of discharge teaching?
A) "I'll lie down right after eating to help with digestion."
B) "I will eat small meals throughout the day."
C) "I should avoid elevating the head of my bed."
D) "Spicy foods help reduce acid production."
Correct Answer: "I will eat small meals throughout the day."
Rationale: Small, frequent meals reduce gastric pressure and acid reflux.
Lying down after meals and spicy foods worsen GERD. The head of the bed
should be elevated 6-8 inches to reduce nighttime reflux.
,3. A client with acute gastritis reports vomiting for 12 hours and shows signs
of dry mucous membranes and poor skin turgor. Which intervention takes
priority?
A) Begin a clear liquid diet
B) Administer antiemetic medication
C) Initiate IV fluid replacement
D) Administer oral rehydration therapy
Correct Answer: Initiate IV fluid replacement
Rationale: The client is showing signs of dehydration (dry mucous
membranes, poor skin turgor) after 12 hours of vomiting. IV fluid
replacement is the priority to restore fluid volume and prevent further
complications. Clear liquids and oral rehydration may be initiated once
vomiting is controlled.
4. A client with a history of peptic ulcer disease presents with a rigid
abdomen and severe pain. Which action should the nurse take first?
A) Administer prescribed pain medication
B) Notify the healthcare provider
C) Prepare the client for surgery
D) Place the client in a supine position
Correct Answer: Notify the healthcare provider
Rationale: A rigid abdomen and severe pain in a client with peptic ulcer
disease may indicate perforation, a life-threatening emergency. The nurse
should notify the healthcare provider immediately. Pain medication should
not be given until a full assessment is completed, as it may mask symptoms.
,5. Which of the following best describes the most common cause of acute
tubular necrosis?
A) Prolonged renal ischemia
B) Allergic interstitial nephritis
C) Acute glomerulonephritis
D) Polycystic kidney disease
Correct Answer: Prolonged renal ischemia
Rationale: Acute tubular necrosis is primarily caused by ischemia (prerenal)
or nephrotoxic agents that directly damage tubular cells. Ischemia from
hypotension or hypovolemia is the most frequent cause. Glomerulonephritis
and interstitial nephritis affect other renal structures.
6. The nurse is reviewing laboratory data for a client with chronic kidney
disease. Which value best reflects renal function?
A) Serum glucose
B) Serum creatinine and glomerular filtration rate
C) Alanine aminotransferase
D) White blood cell count
Correct Answer: Serum creatinine and glomerular filtration rate
Rationale: Creatinine is a waste product filtered by the kidneys; elevated
levels indicate impaired function. GFR estimates the rate of filtration.
Glucose, liver enzymes, and WBC do not directly measure renal function.
7. A nurse is teaching a client with diabetes insipidus about desmopressin
therapy. Which statement indicates a need for further instruction?
, A) "I will monitor my fluid intake and output."
B) "I can stop taking this medication if I feel better."
C) "I should report any headaches or confusion."
D) "I will weigh myself daily."
Correct Answer: "I can stop taking this medication if I feel better."
Rationale: Desmopressin is a lifelong medication for diabetes insipidus and
should not be stopped without a provider's guidance. Stopping abruptly can
lead to return of polyuria, dehydration, and hypernatremia. The other
statements reflect appropriate understanding.
8. A client develops tetany and muscle cramps after a thyroidectomy. The
nurse suspects which complication?
A) Hyperkalemia
B) Hypocalcemia
C) Hyperglycemia
D) Hyponatremia
Correct Answer: Hypocalcemia
Rationale: Parathyroid hormone deficiency leads to decreased calcium
mobilization and renal reabsorption, causing hypocalcemia. Neuromuscular
excitability increases, resulting in tetany, cramps, and positive
Chvostek/Trousseau signs.
9. During teaching about propylthiouracil for hyperthyroidism, the client
should be instructed to report which symptom immediately?
A) Weight gain
