• Med Surg Exam 09/19/2026
Med Surg EXAM 2 Capstone Assessment
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the
client's record, should the nurse question?
A. Digoxin
B. Furosemide
P 1
, • Med Surg Exam 09/19/2026
C. Indomethacin
D. Propranolol hydrochloride - Correct Answer :C. Indomethacin
Rationale:
Indomethacin is a nonsteroidal antiinflammatory drug and can cause ulceration of the esophagus, stomach, or
small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Digoxin is a cardiac
medication. Furosemide is a loop diuretic. Propranolol hydrochloride is a beta-adrenergic blocking agent.
Digoxin, furosemide, and propranolol are not contraindicated in clients with gastric disorders.
The nurse is caring for a client postoperatively after creation of a colostomy. What is an appropriate potential
client problem?
A. Fear
B. Sexual dysfunction
C. Disturbed body image
D. Imbalanced nutrition: more than body requirements - Correct Answer :C. Disturbed body image
Rationale:
Disturbed body image for a client who is postoperative after creation of a colostomy relates to loss of bowel
control, the presence of a stoma, the release of fecal material onto the abdomen, the passage of flatus, odor,
and the need for an appliance (external pouch). There are no data in the question to support sexual dysfunction
or fear. Imbalanced nutrition: less (not more) than body requirements is the more likely client problem.
The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on
assessment of the client, should the nurse report to the health care provider (HCP)?
A. Hypotension
B. Bloody diarrhea
C. Rebound tenderness
D. A hemoglobin level of 12 mg/dL (120 mmol/L) - Correct Answer :C. Rebound tenderness
Rationale:
P 2
, • Med Surg Exam 09/19/2026
Rebound tenderness may indicate peritonitis. Bloody diarrhea is expected to occur in ulcerative colitis. Because
of the blood loss, the client may be hypotensive and the hemoglobin level may be lower than normal. Signs of
peritonitis must be reported to the HCP.
The medication history of a client with peptic ulcer disease reveals intermittent use of several medications. The
nurse would teach the client that which of these medications are not a part of the treatment plan because of its
irritating effects on the lining of the gastrointestinal tract?
A. Nizatidine
B. Sucralfate
C. Ibuprofen
D. Omeprazole - Correct Answer :C. Ibuprofen
Rationale:
Ibuprofen is a nonsteroidal antiinflammatory drug that typically is irritating to the lining of the gastrointestinal
tract and should be avoided by clients with a history of peptic ulcer disease. The other medications listed are
frequently used to treat peptic ulcer disease. Nizatidine is an H2-receptor antagonist that reduces the secretion
of gastric acid. Sucralfate coats the surface of an ulcer to promote healing. Omeprazole is a proton pump
inhibitor that blocks transport of hydrogen ions into the lumen of the gastrointestinal tract.
The nurse should instruct a client with an ileostomy to include which action as part of essential care of the
stoma?
A. Massage the area below the stoma.
B. Take in high-fiber foods such as nuts.
C. Limit fluid intake to prevent diarrhea.
D. Cleanse the peristomal skin meticulously. - Correct Answer :D. Cleanse the peristomal skin meticulously.
Rationale:
The peristomal skin must receive meticulous cleansing because ileostomy drainage has more enzymes and is
more caustic to the skin than colostomy drainage. The area below the ileostomy may be massaged as needed if
the ileostomy becomes blocked by high-fiber foods. Foods such as nuts and those with seeds will pass through
the ileostomy. The client should be taught that these foods will remain undigested. Fluid intake should be at
least 6 to 8 glasses of water per day to prevent dehydration.
P 3
, • Med Surg Exam 09/19/2026
A client with Crohn's disease is experiencing acute pain, and the nurse provides information about measures to
alleviate the pain. Which statement by the client indicates the need for further teaching?
A. "I know I can massage my abdomen."
B. "I will continue using antispasmodic medication."
C. "One of the best things I can do is use relaxation techniques."
D. "The best position for me is to lie supine with my legs straight." - Correct Answer :D. "The best position for
me is to lie supine with my legs straight."
Rationale:
Pain associated with Crohn's disease is alleviated by the use of analgesics and antispasmodics and also by
practicing relaxation techniques, applying local cold or heat to the abdomen, massaging the abdomen, and lying
with the legs flexed. Lying with the legs extended is not useful because it increases the muscle tension in the
abdomen, which could aggravate inflamed intestinal tissues as the abdominal muscles are stretched.
A client with ulcerative colitis has a prescription to begin a salicylate compound medication to reduce
inflammation. What instruction should the nurse give the client regarding when to take this medication?
A. On arising
B. After meals
C. On an empty stomach
D. 30 minutes before meals - Correct Answer :B. After meals
Rationale:
Salicylate compounds, such as sulfasalazine, act by inhibiting prostaglandin synthesis and reducing inflammation.
The nurse teaches the client to take the medication with a full glass of water and increase fluid intake
throughout the day. The medication needs to be taken after meals to reduce gastrointestinal irritation. The
other options are incorrect and could cause gastric irritation.
A client is admitted to the hospital with a diagnosis of acute diverticulitis. What should the nurse expect to be
prescribed for this client?
P 4
Med Surg EXAM 2 Capstone Assessment
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the
client's record, should the nurse question?
A. Digoxin
B. Furosemide
P 1
, • Med Surg Exam 09/19/2026
C. Indomethacin
D. Propranolol hydrochloride - Correct Answer :C. Indomethacin
Rationale:
Indomethacin is a nonsteroidal antiinflammatory drug and can cause ulceration of the esophagus, stomach, or
small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Digoxin is a cardiac
medication. Furosemide is a loop diuretic. Propranolol hydrochloride is a beta-adrenergic blocking agent.
Digoxin, furosemide, and propranolol are not contraindicated in clients with gastric disorders.
The nurse is caring for a client postoperatively after creation of a colostomy. What is an appropriate potential
client problem?
A. Fear
B. Sexual dysfunction
C. Disturbed body image
D. Imbalanced nutrition: more than body requirements - Correct Answer :C. Disturbed body image
Rationale:
Disturbed body image for a client who is postoperative after creation of a colostomy relates to loss of bowel
control, the presence of a stoma, the release of fecal material onto the abdomen, the passage of flatus, odor,
and the need for an appliance (external pouch). There are no data in the question to support sexual dysfunction
or fear. Imbalanced nutrition: less (not more) than body requirements is the more likely client problem.
The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on
assessment of the client, should the nurse report to the health care provider (HCP)?
A. Hypotension
B. Bloody diarrhea
C. Rebound tenderness
D. A hemoglobin level of 12 mg/dL (120 mmol/L) - Correct Answer :C. Rebound tenderness
Rationale:
P 2
, • Med Surg Exam 09/19/2026
Rebound tenderness may indicate peritonitis. Bloody diarrhea is expected to occur in ulcerative colitis. Because
of the blood loss, the client may be hypotensive and the hemoglobin level may be lower than normal. Signs of
peritonitis must be reported to the HCP.
The medication history of a client with peptic ulcer disease reveals intermittent use of several medications. The
nurse would teach the client that which of these medications are not a part of the treatment plan because of its
irritating effects on the lining of the gastrointestinal tract?
A. Nizatidine
B. Sucralfate
C. Ibuprofen
D. Omeprazole - Correct Answer :C. Ibuprofen
Rationale:
Ibuprofen is a nonsteroidal antiinflammatory drug that typically is irritating to the lining of the gastrointestinal
tract and should be avoided by clients with a history of peptic ulcer disease. The other medications listed are
frequently used to treat peptic ulcer disease. Nizatidine is an H2-receptor antagonist that reduces the secretion
of gastric acid. Sucralfate coats the surface of an ulcer to promote healing. Omeprazole is a proton pump
inhibitor that blocks transport of hydrogen ions into the lumen of the gastrointestinal tract.
The nurse should instruct a client with an ileostomy to include which action as part of essential care of the
stoma?
A. Massage the area below the stoma.
B. Take in high-fiber foods such as nuts.
C. Limit fluid intake to prevent diarrhea.
D. Cleanse the peristomal skin meticulously. - Correct Answer :D. Cleanse the peristomal skin meticulously.
Rationale:
The peristomal skin must receive meticulous cleansing because ileostomy drainage has more enzymes and is
more caustic to the skin than colostomy drainage. The area below the ileostomy may be massaged as needed if
the ileostomy becomes blocked by high-fiber foods. Foods such as nuts and those with seeds will pass through
the ileostomy. The client should be taught that these foods will remain undigested. Fluid intake should be at
least 6 to 8 glasses of water per day to prevent dehydration.
P 3
, • Med Surg Exam 09/19/2026
A client with Crohn's disease is experiencing acute pain, and the nurse provides information about measures to
alleviate the pain. Which statement by the client indicates the need for further teaching?
A. "I know I can massage my abdomen."
B. "I will continue using antispasmodic medication."
C. "One of the best things I can do is use relaxation techniques."
D. "The best position for me is to lie supine with my legs straight." - Correct Answer :D. "The best position for
me is to lie supine with my legs straight."
Rationale:
Pain associated with Crohn's disease is alleviated by the use of analgesics and antispasmodics and also by
practicing relaxation techniques, applying local cold or heat to the abdomen, massaging the abdomen, and lying
with the legs flexed. Lying with the legs extended is not useful because it increases the muscle tension in the
abdomen, which could aggravate inflamed intestinal tissues as the abdominal muscles are stretched.
A client with ulcerative colitis has a prescription to begin a salicylate compound medication to reduce
inflammation. What instruction should the nurse give the client regarding when to take this medication?
A. On arising
B. After meals
C. On an empty stomach
D. 30 minutes before meals - Correct Answer :B. After meals
Rationale:
Salicylate compounds, such as sulfasalazine, act by inhibiting prostaglandin synthesis and reducing inflammation.
The nurse teaches the client to take the medication with a full glass of water and increase fluid intake
throughout the day. The medication needs to be taken after meals to reduce gastrointestinal irritation. The
other options are incorrect and could cause gastric irritation.
A client is admitted to the hospital with a diagnosis of acute diverticulitis. What should the nurse expect to be
prescribed for this client?
P 4
