GALEN NUR 242 MED-SURG EXAM 3 -
COMPREHENSIVE NURSING
QUESTIONS AND ANSWERS
1. A patient with Crohn’s disease is admitted with a potential bowel obstruction. Which
clinical finding would the nurse expect that differentiates Crohn’s from Ulcerative Colitis?
A. Continuous involvement of the rectal mucosa
B. Frequent bloody stools exceeding 10 per day
C. Presence of toxic megacolon
D. Transmural inflammation and skip lesions
Answer: D
Conceptual Explanation: Crohn’s disease is characterized by transmural inflammation (all
layers) and skip lesions (patchy areas of inflammation), whereas Ulcerative Colitis typically
involves continuous inflammation starting from the rectum and limited to the mucosa.
2. A patient is 24 hours post-gastrectomy. The nurse notes the patient is experiencing
tachycardia, dizziness, and diaphoresis 20 minutes after eating. What is the priority
intervention?
A. Administer an antiemetic immediately
,B. Increase the infusion rate of intravenous fluids
C. Instruct the patient to lie down for 30 minutes
D. Offer a high-carbohydrate snack
Answer: C
Conceptual Explanation: These are signs of dumping syndrome. Lying down after meals
slows the transit of food into the small intestine, alleviating symptoms. Meals should be low
in carbohydrates and fluids should be avoided during meals.
3. A patient with Peptic Ulcer Disease (PUD) suddenly develops severe upper abdominal pain
that radiates to the shoulder and a board-like abdomen. Which complication does the nurse
suspect?
A. Perforation
B. Pyloric obstruction
C. Gastrointestinal hemorrhage
D. Dumping syndrome
Answer: A
Conceptual Explanation: A rigid, board-like abdomen and sudden severe pain radiating to
the shoulder are hallmark signs of perforation leading to peritonitis.
, 4. Which electrolyte imbalance is a patient with a small bowel obstruction and frequent
projectile vomiting most at risk for developing?
A. Metabolic Acidosis and Hyperkalemia
B. Respiratory Acidosis and Hypernatremia
C. Metabolic Alkalosis and Hypokalemia
D. Respiratory Alkalosis and Hyponatremia
Answer: C
Conceptual Explanation: Vomiting causes the loss of hydrochloric acid and potassium,
leading to metabolic alkalosis and hypokalemia.
5. A patient is admitted with acute diverticulitis. Which order from the healthcare provider
should the nurse question?
A. Low-fiber diet
B. Intravenous antibiotics
C. Barium enema
D. NPO status
Answer: C
Conceptual Explanation: A barium enema or colonoscopy is contraindicated in acute
diverticulitis because the increased pressure can cause perforation of the inflamed
diverticula.
COMPREHENSIVE NURSING
QUESTIONS AND ANSWERS
1. A patient with Crohn’s disease is admitted with a potential bowel obstruction. Which
clinical finding would the nurse expect that differentiates Crohn’s from Ulcerative Colitis?
A. Continuous involvement of the rectal mucosa
B. Frequent bloody stools exceeding 10 per day
C. Presence of toxic megacolon
D. Transmural inflammation and skip lesions
Answer: D
Conceptual Explanation: Crohn’s disease is characterized by transmural inflammation (all
layers) and skip lesions (patchy areas of inflammation), whereas Ulcerative Colitis typically
involves continuous inflammation starting from the rectum and limited to the mucosa.
2. A patient is 24 hours post-gastrectomy. The nurse notes the patient is experiencing
tachycardia, dizziness, and diaphoresis 20 minutes after eating. What is the priority
intervention?
A. Administer an antiemetic immediately
,B. Increase the infusion rate of intravenous fluids
C. Instruct the patient to lie down for 30 minutes
D. Offer a high-carbohydrate snack
Answer: C
Conceptual Explanation: These are signs of dumping syndrome. Lying down after meals
slows the transit of food into the small intestine, alleviating symptoms. Meals should be low
in carbohydrates and fluids should be avoided during meals.
3. A patient with Peptic Ulcer Disease (PUD) suddenly develops severe upper abdominal pain
that radiates to the shoulder and a board-like abdomen. Which complication does the nurse
suspect?
A. Perforation
B. Pyloric obstruction
C. Gastrointestinal hemorrhage
D. Dumping syndrome
Answer: A
Conceptual Explanation: A rigid, board-like abdomen and sudden severe pain radiating to
the shoulder are hallmark signs of perforation leading to peritonitis.
, 4. Which electrolyte imbalance is a patient with a small bowel obstruction and frequent
projectile vomiting most at risk for developing?
A. Metabolic Acidosis and Hyperkalemia
B. Respiratory Acidosis and Hypernatremia
C. Metabolic Alkalosis and Hypokalemia
D. Respiratory Alkalosis and Hyponatremia
Answer: C
Conceptual Explanation: Vomiting causes the loss of hydrochloric acid and potassium,
leading to metabolic alkalosis and hypokalemia.
5. A patient is admitted with acute diverticulitis. Which order from the healthcare provider
should the nurse question?
A. Low-fiber diet
B. Intravenous antibiotics
C. Barium enema
D. NPO status
Answer: C
Conceptual Explanation: A barium enema or colonoscopy is contraindicated in acute
diverticulitis because the increased pressure can cause perforation of the inflamed
diverticula.
