NU 155 Exam 3 Medical-Surgical Nursing I
(2026) PDF | Galen College of Nursing
Question 1. A nurse is caring for a client who has an acute small-bowel obstruction.
Which of the following assessment findings is a priority to report?
A. Nausea and vomiting
B. Abdominal rigidity
C. Hyperactive bowel sounds
D. Abdominal distention
Correct Answer: B
Rationale: Abdominal rigidity is a sign of peritoneal irritation and may indicate bowel
perforation or ischemia, which are life-threatening complications of a small-bowel
obstruction. This finding requires immediate notification of the healthcare provider.
Nausea, hyperactive bowel sounds, and distention are expected findings in a bowel
obstruction and are not the priority for immediate reporting .
Question 2. A client with peptic ulcer disease (PUD) has a new prescription for
magnesium hydroxide. The nurse understands that this medication is used to:
A. Decrease gastric acid production
B. Coat the stomach lining
C. Neutralize gastric acid
D. Kill Helicobacter pylori bacteria
Correct Answer: C
Rationale: Magnesium hydroxide is an antacid that works by neutralizing gastric acid,
providing symptomatic relief in peptic ulcer disease. It does not decrease acid
production (A) like H2 blockers or PPIs, does not coat the stomach (B) like sucralfate,
and does not have antimicrobial effects against H. pylori (D) .
,Question 3. The nurse is caring for a client who has diabetes mellitus and reports sharp,
burning pain in bilateral lower extremities. The nurse understands that the client may be
experiencing:
A. Somatic pain
B. Visceral pain
C. Neuropathic pain
D. Referred pain
Correct Answer: C
Rationale: Neuropathic pain results from nerve damage and is commonly described as
sharp, burning, or shooting. Diabetic neuropathy is a classic cause of neuropathic pain in
the lower extremities. Somatic pain (A) is from skin, muscle, or bone; visceral pain (B) is
from internal organs; referred pain (D) is felt at a site distant from the source .
Question 4. The nurse is monitoring a client's surgical incision and notes an increase in
drainage, separation of the incision line, and appearance of underlying tissue. What is
the appropriate action?
A. Apply a dry sterile dressing
B. Apply a sterile, normal-saline-soaked dressing to the wound
C. Apply an antibiotic ointment
D. Leave the wound open to air
Correct Answer: B
Rationale: Wound dehiscence (separation of incision layers) with exposed underlying
tissue requires immediate coverage with a sterile, normal-saline-soaked dressing to
keep the tissue moist and protect it from infection until the provider can evaluate. Dry
dressings (A) would adhere to the tissue. Leaving it open (D) increases infection risk .
,Question 5. The nurse is providing preoperative instructions to a client scheduled for
surgery to correct spinal curvature. Which statement by the client best demonstrates
correct understanding?
A. "I will ask my family to help me move around after surgery."
B. "I will show you the method of turning I will use after surgery."
C. "I will try to stay in bed as much as possible after surgery."
D. "I will avoid any movement after surgery to protect my spine."
Correct Answer: B
Rationale: Having the client demonstrate the method of turning, especially after spinal
surgery, is the best way to evaluate understanding. Return demonstration confirms
correct learning and technique. Relying solely on family help (A) or avoiding movement
(C, D) could lead to complications .
Question 6. A nurse is assessing a postoperative client with advanced cognitive
impairment. What is the most effective method for assessing pain?
A. Ask the client to rate pain on a 0-10 scale
B. Monitor the client's body language, facial expressions, emotional status, and
consolability
C. Ask the family to describe the client's pain
D. Wait for the client to verbalize pain
Correct Answer: B
Rationale: For clients with cognitive impairment, behavioral pain assessment using
body language, facial expressions, emotional status, and consolability is most effective.
Numeric rating scales (A) require cognitive ability, family reports (C) are less reliable than
direct observation, and waiting for verbalization (D) may miss pain in non-verbal clients .
Question 7. The nurse is preparing a client for surgery the following day. Which finding
requires notification of the primary healthcare provider?
, A. Client reports a family history of hypertension
B. Client reports a family history of high fever during a surgical procedure
C. Client reports a history of seasonal allergies
D. Client reports a family history of diabetes
Correct Answer: B
Rationale: A family history of high fever during surgery may indicate a risk for
malignant hyperthermia, a life-threatening inherited disorder triggered by certain
anesthetic agents. This is a critical finding requiring immediate notification.
Hypertension (A), allergies (C), and diabetes (D) are important but do not require
immediate notification for the same urgent reason .
Question 8. A postoperative client is at risk for deep vein thrombosis (DVT). Which
action should the nurse take to minimize this risk?
A. Apply sequential compression devices only at night
B. Maintain strict bed rest
C. Assist the client to ambulate frequently as early as tolerated
D. Restrict oral fluid intake
Correct Answer: C
Rationale: Early and frequent ambulation promotes venous return and reduces venous
stasis, which is the primary mechanism for DVT prevention. Sequential compression
devices (A) should be used continuously, not just at night. Bed rest (B) increases stasis.
Restricting fluids (D) would worsen stasis by causing dehydration and increasing blood
viscosity .
Question 9. A client who had a cardiac catheterization via the right femoral artery 1
hour ago reports numbness in the right leg. What is the nurse's priority action?
A. Document the finding as expected
B. Apply a warm compress to the leg
C. Notify the healthcare provider immediately
D. Reposition the client to the left side
(2026) PDF | Galen College of Nursing
Question 1. A nurse is caring for a client who has an acute small-bowel obstruction.
Which of the following assessment findings is a priority to report?
A. Nausea and vomiting
B. Abdominal rigidity
C. Hyperactive bowel sounds
D. Abdominal distention
Correct Answer: B
Rationale: Abdominal rigidity is a sign of peritoneal irritation and may indicate bowel
perforation or ischemia, which are life-threatening complications of a small-bowel
obstruction. This finding requires immediate notification of the healthcare provider.
Nausea, hyperactive bowel sounds, and distention are expected findings in a bowel
obstruction and are not the priority for immediate reporting .
Question 2. A client with peptic ulcer disease (PUD) has a new prescription for
magnesium hydroxide. The nurse understands that this medication is used to:
A. Decrease gastric acid production
B. Coat the stomach lining
C. Neutralize gastric acid
D. Kill Helicobacter pylori bacteria
Correct Answer: C
Rationale: Magnesium hydroxide is an antacid that works by neutralizing gastric acid,
providing symptomatic relief in peptic ulcer disease. It does not decrease acid
production (A) like H2 blockers or PPIs, does not coat the stomach (B) like sucralfate,
and does not have antimicrobial effects against H. pylori (D) .
,Question 3. The nurse is caring for a client who has diabetes mellitus and reports sharp,
burning pain in bilateral lower extremities. The nurse understands that the client may be
experiencing:
A. Somatic pain
B. Visceral pain
C. Neuropathic pain
D. Referred pain
Correct Answer: C
Rationale: Neuropathic pain results from nerve damage and is commonly described as
sharp, burning, or shooting. Diabetic neuropathy is a classic cause of neuropathic pain in
the lower extremities. Somatic pain (A) is from skin, muscle, or bone; visceral pain (B) is
from internal organs; referred pain (D) is felt at a site distant from the source .
Question 4. The nurse is monitoring a client's surgical incision and notes an increase in
drainage, separation of the incision line, and appearance of underlying tissue. What is
the appropriate action?
A. Apply a dry sterile dressing
B. Apply a sterile, normal-saline-soaked dressing to the wound
C. Apply an antibiotic ointment
D. Leave the wound open to air
Correct Answer: B
Rationale: Wound dehiscence (separation of incision layers) with exposed underlying
tissue requires immediate coverage with a sterile, normal-saline-soaked dressing to
keep the tissue moist and protect it from infection until the provider can evaluate. Dry
dressings (A) would adhere to the tissue. Leaving it open (D) increases infection risk .
,Question 5. The nurse is providing preoperative instructions to a client scheduled for
surgery to correct spinal curvature. Which statement by the client best demonstrates
correct understanding?
A. "I will ask my family to help me move around after surgery."
B. "I will show you the method of turning I will use after surgery."
C. "I will try to stay in bed as much as possible after surgery."
D. "I will avoid any movement after surgery to protect my spine."
Correct Answer: B
Rationale: Having the client demonstrate the method of turning, especially after spinal
surgery, is the best way to evaluate understanding. Return demonstration confirms
correct learning and technique. Relying solely on family help (A) or avoiding movement
(C, D) could lead to complications .
Question 6. A nurse is assessing a postoperative client with advanced cognitive
impairment. What is the most effective method for assessing pain?
A. Ask the client to rate pain on a 0-10 scale
B. Monitor the client's body language, facial expressions, emotional status, and
consolability
C. Ask the family to describe the client's pain
D. Wait for the client to verbalize pain
Correct Answer: B
Rationale: For clients with cognitive impairment, behavioral pain assessment using
body language, facial expressions, emotional status, and consolability is most effective.
Numeric rating scales (A) require cognitive ability, family reports (C) are less reliable than
direct observation, and waiting for verbalization (D) may miss pain in non-verbal clients .
Question 7. The nurse is preparing a client for surgery the following day. Which finding
requires notification of the primary healthcare provider?
, A. Client reports a family history of hypertension
B. Client reports a family history of high fever during a surgical procedure
C. Client reports a history of seasonal allergies
D. Client reports a family history of diabetes
Correct Answer: B
Rationale: A family history of high fever during surgery may indicate a risk for
malignant hyperthermia, a life-threatening inherited disorder triggered by certain
anesthetic agents. This is a critical finding requiring immediate notification.
Hypertension (A), allergies (C), and diabetes (D) are important but do not require
immediate notification for the same urgent reason .
Question 8. A postoperative client is at risk for deep vein thrombosis (DVT). Which
action should the nurse take to minimize this risk?
A. Apply sequential compression devices only at night
B. Maintain strict bed rest
C. Assist the client to ambulate frequently as early as tolerated
D. Restrict oral fluid intake
Correct Answer: C
Rationale: Early and frequent ambulation promotes venous return and reduces venous
stasis, which is the primary mechanism for DVT prevention. Sequential compression
devices (A) should be used continuously, not just at night. Bed rest (B) increases stasis.
Restricting fluids (D) would worsen stasis by causing dehydration and increasing blood
viscosity .
Question 9. A client who had a cardiac catheterization via the right femoral artery 1
hour ago reports numbness in the right leg. What is the nurse's priority action?
A. Document the finding as expected
B. Apply a warm compress to the leg
C. Notify the healthcare provider immediately
D. Reposition the client to the left side
