NUR 170 Med Surg Exam 4 – 2026/2027
Edition – Actual Questions with 100% Verified
Correct Answers
Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
OVERVIEW:
NUR 170 Med Surg Exam 4 – 2026/2027 covers GI disorders including
bowel obstruction, IBD, GERD, hiatal hernia, bariatric surgery, PUD,
cholecystitis, appendicitis, diverticulitis, hepatitis, TPN, and ostomy care,
plus renal/urinary conditions like UTI, BPH, TURP, CBI, kidney stones,
ESWL, PKD, pyelonephritis, AGN, and integumentary topics infection
precautions, skin cancer, psoriasis, pressure ulcers, scabies, cellulitis,
pruritus, pediculosis, urticaria and bedbugs.
Answers are in bold Green, with rationales after.
1. Small Bowel Obstruction: Upper abdominal distension, N/V (may contain fecal
material), Blood possible in stool - Large Bowel Obstruction Lower abdominal
distension, Lower cramping, NGT - place in high fowler's, x-ray for placement, hear
peristalsis above but not below obstruction, decreased or absent bowel sounds.
A. Upper distention, fecal N/V, decreased/absent below, hyperactive above - SBO
B. Lower distention, cramping - LBO
C. Normal bowel sounds only
D. No NGT needed
,Rationale: SBO = upper distention, N/V may contain fecal material, blood possible,
hear peristalsis above not below, decreased/absent. LBO = lower distention cramping.
NGT high Fowler's x-ray placement per notes page 2.
2. Appropriate diet for Inflammatory bowel disease (Crohn's and ulcerative colitis)
A. High fiber regular dairy caffeine
B. High calorie high protein high vitamin low fiber NO caffeine/alcohol/lactose
offer Ensure
C. Low calorie low protein
D. NPO forever
Rationale: IBD: High calorie high protein high vitamin low fiber, NO
caffeine/alcohol/lactose (dairy), offer Ensure. Page 2.
3. Know what may be included in a nursing plan for patients with gastroenteritis.
Inflammation of stomach or small bowel from virus or bacteria (Norovirus)
A. Encourage fluids Gatorade Powerade Pedialyte, wash fruits/veg, do NOT take
Imodium, lasts 3 days elderly needs sooner hydration, do not eat/drink after
infected person
B. Encourage Imodium immediately
C. Restrict all fluids
D. Share utensils with infected
Rationale: Gastroenteritis Norovirus: encourage electrolyte fluids
Gatorade/Powerade/Pedialyte, abdominal cramping diarrhea do NOT take Imodium,
lasts 3 days elderly sooner, wash fruits/veg, do not eat/drink after infected.
4. High risk for developing GERD: (Gastroesophageal reflux disease or acid reflux)
A. Obesity, NGT, autoimmune, diet chocolate acidic caffeine, pregnancy - S/S
burning indigestion belching dysphagia bloody stools - Tx eat 3hrs before bed
elevate HOB no spicy/fatty/peppermint small frequent meals H2 Pepcid Zantac PPI
Prilosec Nexium
B. Only thin patients
C. No Tx needed
, D. Only surgery
Rationale: GERD high risk obesity NGT autoimmune diet chocolate acidic caffeine
pregnancy. S/S burning indigestion belching dysphagia bloody stools. Tx 3hrs before
bed HOB elevated no spicy/fatty/peppermint small frequent meals H2 blockers Pepcid
Zantac PPI Prilosec Nexium. Dx barium swallow/enema increase fluids flush barium.
5. Definition: involve the protrusion of the stomach through the esophageal hiatus of
the diaphragm into the chest. Weak diaphragm, S/S- most pts are asymptomatic
similar to GERD, Fullness, dyspepsia, discomfort, Diagnosed by barium swallow
A. Protrusion stomach through esophageal hiatus diaphragm into chest weak
diaphragm most asymptomatic similar GERD fullness dyspepsia diagnosed barium
swallow PPI diet like GERD H2 small frequent meals HOB elevated sit up after
eating surgery Nissen wrapped around distal esophagus post-op watch aspiration
NGT gas cannot belch/vomit
B. Appendicitis
C. Umbilical hernia only
D. No treatment
Rationale: Hiatal hernia definition protrusion stomach through esophageal hiatus
diaphragm into chest weak diaphragm most asymptomatic similar GERD diagnosed
barium swallow most specific PPI diet like GERD H2 small frequent HOB elevated sit
up after eating Nissen procedure dysphagia wrapped around distal esophagus anchor
reinforce post-op watch aspiration NGT cannot belch/vomit gas.
6. Post-op care for bariatric surgery
A. Give B12, do not manipulate/move NG tube, HOB 30° or higher semi-high
Fowler's, priority airway, stoma beefy red black/purple/white NO GOOD, no
enteric-coated meds, DUMPING food straight to jejunum diaphoresis vertigo
tachycardia no liquids before meals small meals
B. Manipulate NG frequently
C. Lay flat large meals
D. No B12 needed
Rationale: Bariatric: Give B12, do not manipulate/move NG tube, HOB 30°+, airway
priority, stoma beefy red if black/purple/white NO GOOD, no enteric-coated,
Edition – Actual Questions with 100% Verified
Correct Answers
Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
OVERVIEW:
NUR 170 Med Surg Exam 4 – 2026/2027 covers GI disorders including
bowel obstruction, IBD, GERD, hiatal hernia, bariatric surgery, PUD,
cholecystitis, appendicitis, diverticulitis, hepatitis, TPN, and ostomy care,
plus renal/urinary conditions like UTI, BPH, TURP, CBI, kidney stones,
ESWL, PKD, pyelonephritis, AGN, and integumentary topics infection
precautions, skin cancer, psoriasis, pressure ulcers, scabies, cellulitis,
pruritus, pediculosis, urticaria and bedbugs.
Answers are in bold Green, with rationales after.
1. Small Bowel Obstruction: Upper abdominal distension, N/V (may contain fecal
material), Blood possible in stool - Large Bowel Obstruction Lower abdominal
distension, Lower cramping, NGT - place in high fowler's, x-ray for placement, hear
peristalsis above but not below obstruction, decreased or absent bowel sounds.
A. Upper distention, fecal N/V, decreased/absent below, hyperactive above - SBO
B. Lower distention, cramping - LBO
C. Normal bowel sounds only
D. No NGT needed
,Rationale: SBO = upper distention, N/V may contain fecal material, blood possible,
hear peristalsis above not below, decreased/absent. LBO = lower distention cramping.
NGT high Fowler's x-ray placement per notes page 2.
2. Appropriate diet for Inflammatory bowel disease (Crohn's and ulcerative colitis)
A. High fiber regular dairy caffeine
B. High calorie high protein high vitamin low fiber NO caffeine/alcohol/lactose
offer Ensure
C. Low calorie low protein
D. NPO forever
Rationale: IBD: High calorie high protein high vitamin low fiber, NO
caffeine/alcohol/lactose (dairy), offer Ensure. Page 2.
3. Know what may be included in a nursing plan for patients with gastroenteritis.
Inflammation of stomach or small bowel from virus or bacteria (Norovirus)
A. Encourage fluids Gatorade Powerade Pedialyte, wash fruits/veg, do NOT take
Imodium, lasts 3 days elderly needs sooner hydration, do not eat/drink after
infected person
B. Encourage Imodium immediately
C. Restrict all fluids
D. Share utensils with infected
Rationale: Gastroenteritis Norovirus: encourage electrolyte fluids
Gatorade/Powerade/Pedialyte, abdominal cramping diarrhea do NOT take Imodium,
lasts 3 days elderly sooner, wash fruits/veg, do not eat/drink after infected.
4. High risk for developing GERD: (Gastroesophageal reflux disease or acid reflux)
A. Obesity, NGT, autoimmune, diet chocolate acidic caffeine, pregnancy - S/S
burning indigestion belching dysphagia bloody stools - Tx eat 3hrs before bed
elevate HOB no spicy/fatty/peppermint small frequent meals H2 Pepcid Zantac PPI
Prilosec Nexium
B. Only thin patients
C. No Tx needed
, D. Only surgery
Rationale: GERD high risk obesity NGT autoimmune diet chocolate acidic caffeine
pregnancy. S/S burning indigestion belching dysphagia bloody stools. Tx 3hrs before
bed HOB elevated no spicy/fatty/peppermint small frequent meals H2 blockers Pepcid
Zantac PPI Prilosec Nexium. Dx barium swallow/enema increase fluids flush barium.
5. Definition: involve the protrusion of the stomach through the esophageal hiatus of
the diaphragm into the chest. Weak diaphragm, S/S- most pts are asymptomatic
similar to GERD, Fullness, dyspepsia, discomfort, Diagnosed by barium swallow
A. Protrusion stomach through esophageal hiatus diaphragm into chest weak
diaphragm most asymptomatic similar GERD fullness dyspepsia diagnosed barium
swallow PPI diet like GERD H2 small frequent meals HOB elevated sit up after
eating surgery Nissen wrapped around distal esophagus post-op watch aspiration
NGT gas cannot belch/vomit
B. Appendicitis
C. Umbilical hernia only
D. No treatment
Rationale: Hiatal hernia definition protrusion stomach through esophageal hiatus
diaphragm into chest weak diaphragm most asymptomatic similar GERD diagnosed
barium swallow most specific PPI diet like GERD H2 small frequent HOB elevated sit
up after eating Nissen procedure dysphagia wrapped around distal esophagus anchor
reinforce post-op watch aspiration NGT cannot belch/vomit gas.
6. Post-op care for bariatric surgery
A. Give B12, do not manipulate/move NG tube, HOB 30° or higher semi-high
Fowler's, priority airway, stoma beefy red black/purple/white NO GOOD, no
enteric-coated meds, DUMPING food straight to jejunum diaphoresis vertigo
tachycardia no liquids before meals small meals
B. Manipulate NG frequently
C. Lay flat large meals
D. No B12 needed
Rationale: Bariatric: Give B12, do not manipulate/move NG tube, HOB 30°+, airway
priority, stoma beefy red if black/purple/white NO GOOD, no enteric-coated,
