• Med Surg Exam 09/19/2026
Capstone Med Surg EXAM Assessment 2
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
A client arrives at the hospital emergency department complaining of acute right lower quadrant abdominal
pain. Appendicitis is suspected, and appropriate laboratory tests are performed. The emergency department
nurse reviews the test results and notes that the client's white blood cell (WBC) count is elevated. The nurse also
reviews the prescriptions from the health care provider (HCP). The nurse should contact the HCP to question
which prescription if noted in the client's record?
A. Maintain a semi Fowler's position.
P 1
, • Med Surg Exam 09/19/2026
B. Maintain on NPO (nothing by mouth) status.
C.Apply a heating pad to the lower abdomen for comfort.
D. Initiate an intravenous (IV) line with the administration of IV fluids. - Correct Answer :C.Apply a heating pad to
the lower abdomen for comfort.
Rationale:
Appendicitis should be suspected in a client with an elevated WBC count who is complaining of acute right lower
quadrant abdominal pain. A semi Fowler's position is maintained for comfort. The client would be on NPO status
and given IV fluids in preparation for possible surgery. Heat should never be applied to the abdomen because
this may increase circulation to the appendix, potentially leading to increased inflammation and perforation.
The nurse is caring for a client prescribed enteral feeding via a newly inserted nasogastric (NG) tube. Before
initiating the enteral feeding, the nurse should perform which action first?
A. Warm the feeding to 103°F (39.4°C).
B. Confirm NG placement by x-ray study.
C. Make sure the continuous enteral feeding tubing is primed.
D. Position the head of the client's bed to 30 degrees or greater. - Correct Answer :B. Confirm NG placement by
x-ray study.
Rationale:
Before initiating enteral feedings via a newly inserted NG tube, the placement of the tube is confirmed by x-ray. If
the tube is not in the stomach, the client is at risk for aspiration. Formulas are administered at room
temperature, not at 103°F. To prevent aspiration while administering a tube feeding, the nurse should place the
client in an upright sitting position or elevate the head of the bed at least 30 degrees. Although an important
action, it is not the priority. Priming the enteral feeding tube is important prior to initiating the feedings;
however, it is not the priority action.
The nurse is caring for a client who had a subtotal gastrectomy. The nurse should assess the client for which
signs and symptoms of dumping syndrome?
A. Diarrhea, chills, and hiccups
B. Weakness, diaphoresis, and diarrhea
P 2
, • Med Surg Exam 09/19/2026
C. Fever, constipation, and rectal bleeding
D. Abdominal pain, elevated temperature, and weakness - Correct Answer :B. Weakness, diaphoresis, and
diarrhea
Rationale:
Dumping syndrome occurs after gastric surgery because food is not held long enough in the stomach and is
"dumped" into the small intestine as a hypertonic mass. This causes fluid to shift into the intestines, causing
cardiovascular and gastrointestinal symptoms. Signs and symptoms typically include weakness, dizziness,
diaphoresis, flushing, hypotension, abdominal pain and distention, hyperactive bowel sounds, and diarrhea.
The nurse is caring for a client who has just returned from the operating room after the creation of a colostomy.
The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and
notes serosanguineous drainage. Which nursing action is appropriate based on this assessment?
A. Apply ice to the stoma site.
B. Apply pressure to the stoma site.
C. Notify the health care provider (HCP).
D. Document the amount and characteristics of the drainage. - Correct Answer :D. Document the amount and
characteristics of the drainage.
Rationale:
During the first 24 to 72 hours following surgery, mucus and serosanguineous drainage are expected from the
stoma. Applying ice or pressure to the stoma site are inappropriate actions. Notifying the HCP is unnecessary
because this is an expected finding.
A client has a large, deep duodenal ulcer diagnosed by endoscopy. Which sign or symptom indicative of a
complication should the nurse look for during the client's postprocedure assessment?
A. Bradycardia
B. Nausea and vomiting
C. Numbness in the legs
D. A rigid, boardlike abdomen - Correct Answer :D. A rigid, boardlike abdomen
P 3
, • Med Surg Exam 09/19/2026
Rationale:
The client with a large, deep duodenal ulcer is at risk for perforation of the ulcer. If this occurs, the client will
experience sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the
abdomen, which then becomes rigid and boardlike. Tachycardia, not bradycardia, may occur as hypovolemic
shock develops. Nausea and vomiting may not occur if the pyloric sphincter is intact. Numbness in the legs is not
an associated finding.
The nurse is assisting a client with Crohn's disease to ambulate to the bathroom. After the client has a bowel
movement, the nurse should assess the stool for which characteristic that is expected with this disease?
A. Blood in the stool
B. Chalky gray stool
C. Loose, watery stool
D. Dry, hard, constipated stool - Correct Answer :C. Loose, watery stool
Rationale:
Crohn's disease is characterized by nonbloody diarrhea of usually not more than 4 or 5 stools daily. Over time,
the episodes of diarrhea increase in frequency, duration, and severity. Options 1, 2, and 4 are not characteristics
of the stool in Crohn's disease.
The nurse is assessing a client with a duodenal ulcer. The nurse interprets that which sign or symptom is most
consistent with the typical presentation of duodenal ulcer?
A. Weight loss
B. Nausea and vomiting
C. Pain that is relieved by food intake
D. Pain that radiates down the right arm - Correct Answer :C. Pain that is relieved by food intake
Rationale:
The most typical finding with duodenal ulcer is pain that is relieved by food intake. The pain is often described as
a burning, heavy, sharp, or "hunger pang" pain that often localizes in the midepigastric area. It does not radiate
P 4
Capstone Med Surg EXAM Assessment 2
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
A client arrives at the hospital emergency department complaining of acute right lower quadrant abdominal
pain. Appendicitis is suspected, and appropriate laboratory tests are performed. The emergency department
nurse reviews the test results and notes that the client's white blood cell (WBC) count is elevated. The nurse also
reviews the prescriptions from the health care provider (HCP). The nurse should contact the HCP to question
which prescription if noted in the client's record?
A. Maintain a semi Fowler's position.
P 1
, • Med Surg Exam 09/19/2026
B. Maintain on NPO (nothing by mouth) status.
C.Apply a heating pad to the lower abdomen for comfort.
D. Initiate an intravenous (IV) line with the administration of IV fluids. - Correct Answer :C.Apply a heating pad to
the lower abdomen for comfort.
Rationale:
Appendicitis should be suspected in a client with an elevated WBC count who is complaining of acute right lower
quadrant abdominal pain. A semi Fowler's position is maintained for comfort. The client would be on NPO status
and given IV fluids in preparation for possible surgery. Heat should never be applied to the abdomen because
this may increase circulation to the appendix, potentially leading to increased inflammation and perforation.
The nurse is caring for a client prescribed enteral feeding via a newly inserted nasogastric (NG) tube. Before
initiating the enteral feeding, the nurse should perform which action first?
A. Warm the feeding to 103°F (39.4°C).
B. Confirm NG placement by x-ray study.
C. Make sure the continuous enteral feeding tubing is primed.
D. Position the head of the client's bed to 30 degrees or greater. - Correct Answer :B. Confirm NG placement by
x-ray study.
Rationale:
Before initiating enteral feedings via a newly inserted NG tube, the placement of the tube is confirmed by x-ray. If
the tube is not in the stomach, the client is at risk for aspiration. Formulas are administered at room
temperature, not at 103°F. To prevent aspiration while administering a tube feeding, the nurse should place the
client in an upright sitting position or elevate the head of the bed at least 30 degrees. Although an important
action, it is not the priority. Priming the enteral feeding tube is important prior to initiating the feedings;
however, it is not the priority action.
The nurse is caring for a client who had a subtotal gastrectomy. The nurse should assess the client for which
signs and symptoms of dumping syndrome?
A. Diarrhea, chills, and hiccups
B. Weakness, diaphoresis, and diarrhea
P 2
, • Med Surg Exam 09/19/2026
C. Fever, constipation, and rectal bleeding
D. Abdominal pain, elevated temperature, and weakness - Correct Answer :B. Weakness, diaphoresis, and
diarrhea
Rationale:
Dumping syndrome occurs after gastric surgery because food is not held long enough in the stomach and is
"dumped" into the small intestine as a hypertonic mass. This causes fluid to shift into the intestines, causing
cardiovascular and gastrointestinal symptoms. Signs and symptoms typically include weakness, dizziness,
diaphoresis, flushing, hypotension, abdominal pain and distention, hyperactive bowel sounds, and diarrhea.
The nurse is caring for a client who has just returned from the operating room after the creation of a colostomy.
The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and
notes serosanguineous drainage. Which nursing action is appropriate based on this assessment?
A. Apply ice to the stoma site.
B. Apply pressure to the stoma site.
C. Notify the health care provider (HCP).
D. Document the amount and characteristics of the drainage. - Correct Answer :D. Document the amount and
characteristics of the drainage.
Rationale:
During the first 24 to 72 hours following surgery, mucus and serosanguineous drainage are expected from the
stoma. Applying ice or pressure to the stoma site are inappropriate actions. Notifying the HCP is unnecessary
because this is an expected finding.
A client has a large, deep duodenal ulcer diagnosed by endoscopy. Which sign or symptom indicative of a
complication should the nurse look for during the client's postprocedure assessment?
A. Bradycardia
B. Nausea and vomiting
C. Numbness in the legs
D. A rigid, boardlike abdomen - Correct Answer :D. A rigid, boardlike abdomen
P 3
, • Med Surg Exam 09/19/2026
Rationale:
The client with a large, deep duodenal ulcer is at risk for perforation of the ulcer. If this occurs, the client will
experience sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the
abdomen, which then becomes rigid and boardlike. Tachycardia, not bradycardia, may occur as hypovolemic
shock develops. Nausea and vomiting may not occur if the pyloric sphincter is intact. Numbness in the legs is not
an associated finding.
The nurse is assisting a client with Crohn's disease to ambulate to the bathroom. After the client has a bowel
movement, the nurse should assess the stool for which characteristic that is expected with this disease?
A. Blood in the stool
B. Chalky gray stool
C. Loose, watery stool
D. Dry, hard, constipated stool - Correct Answer :C. Loose, watery stool
Rationale:
Crohn's disease is characterized by nonbloody diarrhea of usually not more than 4 or 5 stools daily. Over time,
the episodes of diarrhea increase in frequency, duration, and severity. Options 1, 2, and 4 are not characteristics
of the stool in Crohn's disease.
The nurse is assessing a client with a duodenal ulcer. The nurse interprets that which sign or symptom is most
consistent with the typical presentation of duodenal ulcer?
A. Weight loss
B. Nausea and vomiting
C. Pain that is relieved by food intake
D. Pain that radiates down the right arm - Correct Answer :C. Pain that is relieved by food intake
Rationale:
The most typical finding with duodenal ulcer is pain that is relieved by food intake. The pain is often described as
a burning, heavy, sharp, or "hunger pang" pain that often localizes in the midepigastric area. It does not radiate
P 4
