NU 155 Exam 4 / NU 155 Medical Surgical
Nursing I Exam 4 Newest Practice Test Bank
with 230 Questions and Correct Answers/
NU155 Exam 4 prep (Latest 2026-2027)
The nurse practitioner is performing an abdominal assessment on a newly admitted
client. In which order should the nurse proceed with assessment technique?
Auscultation, percussion, palpation, inspection
Inspection, auscultation, percussion, palpation
Palpation, percussion, inspection, auscultation
Percussion, auscultation, palpation, inspection - ANSWER-The abdomen is
assessed by using the four techniques of examination, but in a sequence different
from that used for other body systems: inspection, auscultation, percussion, and
then palpation. This sequence is preferred so that palpation and percussion do not
increase intestinal activity and bowel sounds. Nurse generalists may perform
inspection, auscultation, and light palpation; percussion and deep palpation may be
done by advanced practice nurses.
A client with gastroesophageal reflux disease (GERD) is prescribed to start
pantoprazole (Protonix) 40 mg every day. Which statement by the client requires
further teaching by the nurse?
A. "When I feel better, I can stop taking this drug."
B. "I'll take this drug at 8 AM every morning."
C. "This drug can cause headache and dizziness."
D. "I should not crush the drug because it has a delayed release." - ANSWER-
Answer: A
1
,Rationale: Treatment for GERD should be continued even if a client begins to feel
better. Discontinuation of therapy can result in return of original GERD symptoms,
which can further damage esophageal tissues. Side effects of pantoprazole
(Protonix) can include headache and dizziness, which should immediately be
reported to the client's health care provider. This medication should be taken on a
regular, predictable schedule because proton pump inhibitors provide effective,
long-acting inhibition of gastric acid secretion by affecting the proton pump of the
gastric parietal cells. This medication should not be crushed because of its delayed
release properties.
Over the past 3 months, a client with a history of gastroesophageal reflux disease
and obesity has implemented lifestyle changes. What lifestyle changes does the
nurse recognize as important for the client to decrease chances of development of
cancer of the esophagus? Select all that apply.
A. Lost 10 pounds
B. Sleeps with two pillows
C. Has quit eating processed foods
D. Drinks a glass of wine every night
E. Uses a nicotine patch instead of smoking - ANSWER-Answer: A, B, C, E
Rationale: Losing weight can result in a decrease in intra-abdominal pressure,
which can reduce the symptoms of reflux that are associated with an increased risk
for development of esophageal cancer. Nocturnal reflux can be reduced by
sleeping with the head of the bed elevated or with the use of two pillows.
Chemicals used in processed foods, as well as smoking, can contribute to an
increased risk for esophageal (and other types of) cancer. Excessive alcohol intake
is associated with esophageal cancer.
The nurse is monitoring a client with gastric cancer for signs and symptoms of
upper gastrointestinal bleeding. Which change in vital signs is most indicative of
bleeding related to cancer?
2
,Respiratory rate from 24 to 20 breaths/min
Apical pulse from 80 to 72 beats/min
Temperature from 98.9° F to 97.9° F
Blood pressure from 140/90 to 110/70 mm Hg - ANSWER-A decrease in blood
pressure is the most indicative sign of bleeding. A slight decrease in respiratory
rate, apical pulse, and temperature is not the primary indication of bleeding.
Which nursing action is best for the charge nurse to delegate to an experienced
LPN/LVN?
Retape the nasogastric tube for a client who has had a subtotal gastrectomy and
vagotomy.
Reinforce the teaching about avoiding alcohol and caffeine for a client with
chronic gastritis.
Document instructions for a client with chronic gastritis about how to use "triple
therapy."
Assess the gag reflex for a client who has arrived from the postanesthesia care unit
after a laparoscopic gastrectomy. - ANSWER-Reinforcement of teaching done by
the RN is within the scope of practice for an LPN/LVN. Retaping the nasogastric
tube for a client who has had a subtotal gastrectomy and vagotomy is a complex
task that should be done by the RN. Assessment and documenting instructions
about how to use triple therapy are nursing functions that should be done by the
RN.
The nurse prepares a teaching session regarding lifestyle changes needed to
decrease the discomfort associated with a client's hiatal hernia. Which change does
the nurse recommend to this client?
Eat only two or three meals daily.
Sleep flat in a left side-lying position.
Drink tea instead of coffee.
3
, Avoid working while bent over the computer. - ANSWER-The client should
avoid working while bent over because this position presses on the diaphragm,
causing discomfort. The client with a hiatal hernia should eat four to six meals a
day. The head of the client's bed should be elevated approximately 6 inches. Both
tea and coffee should be eliminated from this client's diet because of the caffeine
content.
The nurse is reinforcing the instructions on swallowing provided by the speech-
language pathologist to a client diagnosed with esophageal cancer. Which
instruction to the client is the highest priority?
Place food at the back of the mouth as you eat.
Do not be overly concerned with tongue or lip movements.
Before swallowing, tilt the head back to straighten the esophagus.
Do not attempt to reach food particles that are on the lips or around the mouth. -
ANSWER-Placing food at the back of the mouth when eating will help the client
avoid aspirating. Both tongue movements and sealing of the lips should be
monitored in this client. The client's head should be tilted forward in the chin-tuck
position. The client should be able to reach food particles on her or his lips and
around the mouth with the tongue.
A client has undergone conventional esophageal surgery. The client's diet has been
advanced to semi-solid, and feedings are well tolerated. The client reports
experiencing diarrhea about 1 hour after each meal. What is the priority nursing
intervention to help prevent further diarrhea?
Ensure that the client takes adequate amounts of fluids with meals.
Advance the diet to solid food and encourage eating as much as possible at meals.
Give the client a dose of magnesium hydroxide (Milk of Magnesia) after each
meal.
Encourage the client to take fluids between meals rather than with meals. -
ANSWER-Diarrhea is believed to be the result of vagotomy syndrome and can be
managed by taking fluids between meals rather than with meals. For this client,
4
Nursing I Exam 4 Newest Practice Test Bank
with 230 Questions and Correct Answers/
NU155 Exam 4 prep (Latest 2026-2027)
The nurse practitioner is performing an abdominal assessment on a newly admitted
client. In which order should the nurse proceed with assessment technique?
Auscultation, percussion, palpation, inspection
Inspection, auscultation, percussion, palpation
Palpation, percussion, inspection, auscultation
Percussion, auscultation, palpation, inspection - ANSWER-The abdomen is
assessed by using the four techniques of examination, but in a sequence different
from that used for other body systems: inspection, auscultation, percussion, and
then palpation. This sequence is preferred so that palpation and percussion do not
increase intestinal activity and bowel sounds. Nurse generalists may perform
inspection, auscultation, and light palpation; percussion and deep palpation may be
done by advanced practice nurses.
A client with gastroesophageal reflux disease (GERD) is prescribed to start
pantoprazole (Protonix) 40 mg every day. Which statement by the client requires
further teaching by the nurse?
A. "When I feel better, I can stop taking this drug."
B. "I'll take this drug at 8 AM every morning."
C. "This drug can cause headache and dizziness."
D. "I should not crush the drug because it has a delayed release." - ANSWER-
Answer: A
1
,Rationale: Treatment for GERD should be continued even if a client begins to feel
better. Discontinuation of therapy can result in return of original GERD symptoms,
which can further damage esophageal tissues. Side effects of pantoprazole
(Protonix) can include headache and dizziness, which should immediately be
reported to the client's health care provider. This medication should be taken on a
regular, predictable schedule because proton pump inhibitors provide effective,
long-acting inhibition of gastric acid secretion by affecting the proton pump of the
gastric parietal cells. This medication should not be crushed because of its delayed
release properties.
Over the past 3 months, a client with a history of gastroesophageal reflux disease
and obesity has implemented lifestyle changes. What lifestyle changes does the
nurse recognize as important for the client to decrease chances of development of
cancer of the esophagus? Select all that apply.
A. Lost 10 pounds
B. Sleeps with two pillows
C. Has quit eating processed foods
D. Drinks a glass of wine every night
E. Uses a nicotine patch instead of smoking - ANSWER-Answer: A, B, C, E
Rationale: Losing weight can result in a decrease in intra-abdominal pressure,
which can reduce the symptoms of reflux that are associated with an increased risk
for development of esophageal cancer. Nocturnal reflux can be reduced by
sleeping with the head of the bed elevated or with the use of two pillows.
Chemicals used in processed foods, as well as smoking, can contribute to an
increased risk for esophageal (and other types of) cancer. Excessive alcohol intake
is associated with esophageal cancer.
The nurse is monitoring a client with gastric cancer for signs and symptoms of
upper gastrointestinal bleeding. Which change in vital signs is most indicative of
bleeding related to cancer?
2
,Respiratory rate from 24 to 20 breaths/min
Apical pulse from 80 to 72 beats/min
Temperature from 98.9° F to 97.9° F
Blood pressure from 140/90 to 110/70 mm Hg - ANSWER-A decrease in blood
pressure is the most indicative sign of bleeding. A slight decrease in respiratory
rate, apical pulse, and temperature is not the primary indication of bleeding.
Which nursing action is best for the charge nurse to delegate to an experienced
LPN/LVN?
Retape the nasogastric tube for a client who has had a subtotal gastrectomy and
vagotomy.
Reinforce the teaching about avoiding alcohol and caffeine for a client with
chronic gastritis.
Document instructions for a client with chronic gastritis about how to use "triple
therapy."
Assess the gag reflex for a client who has arrived from the postanesthesia care unit
after a laparoscopic gastrectomy. - ANSWER-Reinforcement of teaching done by
the RN is within the scope of practice for an LPN/LVN. Retaping the nasogastric
tube for a client who has had a subtotal gastrectomy and vagotomy is a complex
task that should be done by the RN. Assessment and documenting instructions
about how to use triple therapy are nursing functions that should be done by the
RN.
The nurse prepares a teaching session regarding lifestyle changes needed to
decrease the discomfort associated with a client's hiatal hernia. Which change does
the nurse recommend to this client?
Eat only two or three meals daily.
Sleep flat in a left side-lying position.
Drink tea instead of coffee.
3
, Avoid working while bent over the computer. - ANSWER-The client should
avoid working while bent over because this position presses on the diaphragm,
causing discomfort. The client with a hiatal hernia should eat four to six meals a
day. The head of the client's bed should be elevated approximately 6 inches. Both
tea and coffee should be eliminated from this client's diet because of the caffeine
content.
The nurse is reinforcing the instructions on swallowing provided by the speech-
language pathologist to a client diagnosed with esophageal cancer. Which
instruction to the client is the highest priority?
Place food at the back of the mouth as you eat.
Do not be overly concerned with tongue or lip movements.
Before swallowing, tilt the head back to straighten the esophagus.
Do not attempt to reach food particles that are on the lips or around the mouth. -
ANSWER-Placing food at the back of the mouth when eating will help the client
avoid aspirating. Both tongue movements and sealing of the lips should be
monitored in this client. The client's head should be tilted forward in the chin-tuck
position. The client should be able to reach food particles on her or his lips and
around the mouth with the tongue.
A client has undergone conventional esophageal surgery. The client's diet has been
advanced to semi-solid, and feedings are well tolerated. The client reports
experiencing diarrhea about 1 hour after each meal. What is the priority nursing
intervention to help prevent further diarrhea?
Ensure that the client takes adequate amounts of fluids with meals.
Advance the diet to solid food and encourage eating as much as possible at meals.
Give the client a dose of magnesium hydroxide (Milk of Magnesia) after each
meal.
Encourage the client to take fluids between meals rather than with meals. -
ANSWER-Diarrhea is believed to be the result of vagotomy syndrome and can be
managed by taking fluids between meals rather than with meals. For this client,
4
