NCLEX MED SURG ACTUAL FINAL EXAM TEST BANK
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM REAL QUESTIONS WITH
WELL ELABORATED ANSWERS WITH DETAILED
RATIONALES (RELIABLE SOLUTIONS) CURRENTLY
UPDATED VERSION 2026 EDITION |GUARANTEED
SUCCESS A+
"All of the following factors predispose to cecal volvulus EXCEPT:
A. pregnancy
B. age 25-35
C. prior abdominal surgery
D. marathon running
E. severe chronic constipation"
"E. severe chronic constipation
The answer is E. Cecal volvulus occurs as a result of abnormal
fixation of the right colon and increased mobility of the cecum.
Depending on the degree of rotation around the mesenteric axis,
cecal volvulus can lead to twisting of the mesentery and its blood
vessels. Cecal volvulus occurs most commonly in people 25-35
years old and should be suspected in cases of bowel obstruction
without known risk factors. Prior abdominal surgery and pregnancy
predispose to obstruction or cecal volvulus; however, chronic
constipation is not known to predispose to cecal volvulus.
Interestingly, marathon runners have been found to have a higher
incidence of cecal volvulus, perhaps from having a thin, flexible
mesentery that more easily permits rotation of the cecum around
the mesenteric pedicle."
,"A 57 year old ill-appearing man presents with fever, chills,
abdominal pain, nausea and vomiting. His abdominal CT is shown in
the Figure. Which of the following is LEAST correct regarding this
patient's condition?
[image]
A. Etiologic agents of this condition include bacteroides, E. coli,
Klebsiella, Pseudomonas, Enterococcus, anaerobic Streptococci,
and E. histolytica.
B. Elevations of WBC, bilirubin, alkapine phosphatase and serum
aminotransferases will be seen on laboratory studies.
C. Emergent percutaneous drainage in the emergency department
is indicated.
D. Treatment with triple coverage antibiotics such as gentamicin,
metronidazole and ampicillin should be instituted immediately.
E. CXR may demonstrate a right-sided effusion and elevation of the
right hemidiaphragm."
"C. Emergent percutaneous drainage in the emergency department
is indicated.
The answer is C. The patient has a hepatic abscess, typically caused
by gram negatives, anaerobic Streptococci or Entameoba
histolytica. Laboratory findings include elevations of WBC, bilirubin,
alkaline phosphatase and serum aminotransferases. CXR may
demonstrate a right-sided effusion and elevation of the right
hemidiaphragm. Treatment with triple coverage antibiotics such as
gentamicin, metronidazole and ampicillin should be instituted
immediately, however consultation with a general surgeon,
interventional radiologist, or gastroenterologist is necessary for
definitive treatment, which is drainage of the abscess."
,"Which of the following pairings of referred pain and causal disease
is least likely to be encountered?
A. sacral pain—ovarian torsion
B. inguinal pain—ureteral colic
C. epigastric pain—myocardial infarction
D. shoulder pain—ruptured spleen
E. thoracic back pain—pancreatitis"
"A. sacral pain—ovarian torsion
he answer is A. Ovarian torsion may cause lower abdominal pain,
pelvic pain, adnexal tenderness, and cervical motion tenderness,
but it is not known to cause sacral pain."
, "A 72 year old man with a history of diverticulosis presents with
vague abdominal pain for the past day. His physical exam is notable
for normal vital signs, left lower quadrant abdominal tenderness
without rebound or guarding, and guaiac positive brown stool.
Work-up including KUB and abdominal/pelvic CT scan reveals
diverticulitis without perforation. Of the following choices, which is
the most appropriate management of this patient?
A. type and cross two units of packed red blood cells
B. immediate surgical intervention
C. discharge on oral pain medications
D. barium enema to evaluate for carcinoma of the colon
E. admission for intravenous antibiotics and fluids"
"E. admission for intravenous antibiotics and fluids
The answer is E. For mild episodes of diverticulitis in which there is
no evidence of perforation or peritonitis, there is no indication for
immediate surgical intervention. Conservative management with
intravenous fluids and antibiotics as well as bowel rest is typically
first attempted. Although colon carcinoma may be a precipitating
factor in the development of diverticulitis, barium enema should be
avoided in the acute period due to high risk of bowel perforation.
Although some patients with mild cases of diverticulitis may be
discharged home with conservative treatment, the elderly are at
higher risk of perforation and should be admitted. Guaiac positive
stool in seen in up to 50% of patients with diverticulitis. There is no
reason to suspect acute blood loss requiring transfusion in
diverticulitis."
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM REAL QUESTIONS WITH
WELL ELABORATED ANSWERS WITH DETAILED
RATIONALES (RELIABLE SOLUTIONS) CURRENTLY
UPDATED VERSION 2026 EDITION |GUARANTEED
SUCCESS A+
"All of the following factors predispose to cecal volvulus EXCEPT:
A. pregnancy
B. age 25-35
C. prior abdominal surgery
D. marathon running
E. severe chronic constipation"
"E. severe chronic constipation
The answer is E. Cecal volvulus occurs as a result of abnormal
fixation of the right colon and increased mobility of the cecum.
Depending on the degree of rotation around the mesenteric axis,
cecal volvulus can lead to twisting of the mesentery and its blood
vessels. Cecal volvulus occurs most commonly in people 25-35
years old and should be suspected in cases of bowel obstruction
without known risk factors. Prior abdominal surgery and pregnancy
predispose to obstruction or cecal volvulus; however, chronic
constipation is not known to predispose to cecal volvulus.
Interestingly, marathon runners have been found to have a higher
incidence of cecal volvulus, perhaps from having a thin, flexible
mesentery that more easily permits rotation of the cecum around
the mesenteric pedicle."
,"A 57 year old ill-appearing man presents with fever, chills,
abdominal pain, nausea and vomiting. His abdominal CT is shown in
the Figure. Which of the following is LEAST correct regarding this
patient's condition?
[image]
A. Etiologic agents of this condition include bacteroides, E. coli,
Klebsiella, Pseudomonas, Enterococcus, anaerobic Streptococci,
and E. histolytica.
B. Elevations of WBC, bilirubin, alkapine phosphatase and serum
aminotransferases will be seen on laboratory studies.
C. Emergent percutaneous drainage in the emergency department
is indicated.
D. Treatment with triple coverage antibiotics such as gentamicin,
metronidazole and ampicillin should be instituted immediately.
E. CXR may demonstrate a right-sided effusion and elevation of the
right hemidiaphragm."
"C. Emergent percutaneous drainage in the emergency department
is indicated.
The answer is C. The patient has a hepatic abscess, typically caused
by gram negatives, anaerobic Streptococci or Entameoba
histolytica. Laboratory findings include elevations of WBC, bilirubin,
alkaline phosphatase and serum aminotransferases. CXR may
demonstrate a right-sided effusion and elevation of the right
hemidiaphragm. Treatment with triple coverage antibiotics such as
gentamicin, metronidazole and ampicillin should be instituted
immediately, however consultation with a general surgeon,
interventional radiologist, or gastroenterologist is necessary for
definitive treatment, which is drainage of the abscess."
,"Which of the following pairings of referred pain and causal disease
is least likely to be encountered?
A. sacral pain—ovarian torsion
B. inguinal pain—ureteral colic
C. epigastric pain—myocardial infarction
D. shoulder pain—ruptured spleen
E. thoracic back pain—pancreatitis"
"A. sacral pain—ovarian torsion
he answer is A. Ovarian torsion may cause lower abdominal pain,
pelvic pain, adnexal tenderness, and cervical motion tenderness,
but it is not known to cause sacral pain."
, "A 72 year old man with a history of diverticulosis presents with
vague abdominal pain for the past day. His physical exam is notable
for normal vital signs, left lower quadrant abdominal tenderness
without rebound or guarding, and guaiac positive brown stool.
Work-up including KUB and abdominal/pelvic CT scan reveals
diverticulitis without perforation. Of the following choices, which is
the most appropriate management of this patient?
A. type and cross two units of packed red blood cells
B. immediate surgical intervention
C. discharge on oral pain medications
D. barium enema to evaluate for carcinoma of the colon
E. admission for intravenous antibiotics and fluids"
"E. admission for intravenous antibiotics and fluids
The answer is E. For mild episodes of diverticulitis in which there is
no evidence of perforation or peritonitis, there is no indication for
immediate surgical intervention. Conservative management with
intravenous fluids and antibiotics as well as bowel rest is typically
first attempted. Although colon carcinoma may be a precipitating
factor in the development of diverticulitis, barium enema should be
avoided in the acute period due to high risk of bowel perforation.
Although some patients with mild cases of diverticulitis may be
discharged home with conservative treatment, the elderly are at
higher risk of perforation and should be admitted. Guaiac positive
stool in seen in up to 50% of patients with diverticulitis. There is no
reason to suspect acute blood loss requiring transfusion in
diverticulitis."
