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NUR 170 MED SURG EXAM 4 – V1 & V2 Questions with Answers &
Rationales | Galen College of Nursing
VERSION 1 (Questions 1–50)
Question 1
Which of the following is the most common cause of acute
pancreatitis?
A. Gallstones and alcohol
B. Trauma only
C. Medications only
D. Viral infection only
Answer: A
Rationale: Gallstones and alcohol account for the majority of
acute pancreatitis cases.
Question 2
A client with cirrhosis and portal hypertension develops ascites.
What is the primary mechanism?
A. Increased hydrostatic pressure and decreased oncotic
pressure
B. Increased albumin
C. Decreased portal pressure
D. Increased renal sodium excretion
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Answer: A
Rationale: Portal hypertension increases hydrostatic pressure,
and hypoalbuminemia decreases oncotic pressure, leading to
ascites.
Question 3
Which of the following is a hallmark of ulcerative colitis?
A. Skip lesions and transmural inflammation
B. Continuous mucosal inflammation starting in the rectum
C. Fistulas and abscesses
D. Perianal disease
Answer: B
Rationale: Ulcerative colitis is continuous mucosal inflammation
from the rectum upward; Crohn's has skip lesions and
transmural involvement.
Question 4
A client with Crohn's disease is at risk for which complication?
A. Fistulas and strictures
B. Toxic megacolon only
C. Continuous rectal involvement
D. Only mucosal inflammation
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Answer: A
Rationale: Crohn's is transmural and can cause fistulas,
strictures, and abscesses.
Question 5
Which of the following is the most common cause of
hypothyroidism?
A. Graves' disease
B. Hashimoto thyroiditis
C. Subacute thyroiditis
D. Iodine excess
Answer: B
Rationale: Hashimoto thyroiditis (autoimmune) is the most
common cause of hypothyroidism in iodine-sufficient areas.
Question 6
A client with diabetic ketoacidosis (DKA) will have which acid-
base imbalance?
A. High anion gap metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
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Answer: A
Rationale: DKA produces ketoacids, causing high anion gap
metabolic acidosis with Kussmaul respirations.
Question 7
Which of the following is the first-line medication for type 2
diabetes unless contraindicated?
A. Glipizide
B. Metformin
C. Pioglitazone
D. Insulin only
Answer: B
Rationale: Metformin is first-line for type 2 diabetes due to
efficacy, safety, and weight neutrality.
Question 8
A client with Addison's disease will have which finding?
A. Hyperpigmentation, hypotension, and hyperkalemia
B. Truncal obesity and striae
C. Hypertension and hypokalemia
D. Tachycardia and weight loss only
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NUR 170 MED SURG EXAM 4 – V1 & V2 Questions with Answers &
Rationales | Galen College of Nursing
VERSION 1 (Questions 1–50)
Question 1
Which of the following is the most common cause of acute
pancreatitis?
A. Gallstones and alcohol
B. Trauma only
C. Medications only
D. Viral infection only
Answer: A
Rationale: Gallstones and alcohol account for the majority of
acute pancreatitis cases.
Question 2
A client with cirrhosis and portal hypertension develops ascites.
What is the primary mechanism?
A. Increased hydrostatic pressure and decreased oncotic
pressure
B. Increased albumin
C. Decreased portal pressure
D. Increased renal sodium excretion
1|Page
, Page |2
Answer: A
Rationale: Portal hypertension increases hydrostatic pressure,
and hypoalbuminemia decreases oncotic pressure, leading to
ascites.
Question 3
Which of the following is a hallmark of ulcerative colitis?
A. Skip lesions and transmural inflammation
B. Continuous mucosal inflammation starting in the rectum
C. Fistulas and abscesses
D. Perianal disease
Answer: B
Rationale: Ulcerative colitis is continuous mucosal inflammation
from the rectum upward; Crohn's has skip lesions and
transmural involvement.
Question 4
A client with Crohn's disease is at risk for which complication?
A. Fistulas and strictures
B. Toxic megacolon only
C. Continuous rectal involvement
D. Only mucosal inflammation
2|Page
, Page |3
Answer: A
Rationale: Crohn's is transmural and can cause fistulas,
strictures, and abscesses.
Question 5
Which of the following is the most common cause of
hypothyroidism?
A. Graves' disease
B. Hashimoto thyroiditis
C. Subacute thyroiditis
D. Iodine excess
Answer: B
Rationale: Hashimoto thyroiditis (autoimmune) is the most
common cause of hypothyroidism in iodine-sufficient areas.
Question 6
A client with diabetic ketoacidosis (DKA) will have which acid-
base imbalance?
A. High anion gap metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
3|Page
, Page |4
Answer: A
Rationale: DKA produces ketoacids, causing high anion gap
metabolic acidosis with Kussmaul respirations.
Question 7
Which of the following is the first-line medication for type 2
diabetes unless contraindicated?
A. Glipizide
B. Metformin
C. Pioglitazone
D. Insulin only
Answer: B
Rationale: Metformin is first-line for type 2 diabetes due to
efficacy, safety, and weight neutrality.
Question 8
A client with Addison's disease will have which finding?
A. Hyperpigmentation, hypotension, and hyperkalemia
B. Truncal obesity and striae
C. Hypertension and hypokalemia
D. Tachycardia and weight loss only
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