,NR 324 Adult Health I Exam 4 Prep Med-Surg
chamberlain collage of nursing 150 Q&A +
Clinical Cases + Detailed Rationales 2026/2027
1. A nurse is reviewing the plan of care for a client with GERD. Which intervention should be
included?
A. Encourage the client to lie down after meals
B. Elevate the head of the bed on blocks
C. Encourage large, high-fat meals
D. Administer antacids with meals
Correct Answer: B
Rationale: Elevating the head of the bed on blocks helps prevent reflux by gravity. Clients should
avoid lying down for 2–3 hours after meals, eat small frequent meals, and avoid high-fat foods
that relax the lower esophageal sphincter.
2. A client with a gastric ulcer is at risk of developing which complication?
A. Peritonitis
B. Pancreatitis
C. Cholecystitis
D. Hepatitis
Correct Answer: A
,Rationale: A patient with a gastric ulcer is at risk of developing peritonitis if the ulcer perforates.
Gastric ulcers are also characterized by rapid weight loss, pain that worsens with eating, blood
in vomit, and heartburn.
3. Which statement about the pain pattern of a duodenal ulcer is most accurate?
A. Pain occurs 30 minutes after eating
B. Pain is relieved by eating
C. Pain is worse with food
D. Pain occurs only in the morning
Correct Answer: B
Rationale: Duodenal ulcers are characterized by pain relief once the patient eats, and pain
typically occurs at night. Gastric ulcers cause pain that worsens when the patient eats.
4. A nurse is teaching a client about TPN. Which complication should the nurse include?
A. Hyperglycemia
B. Hypoglycemia
C. Bradycardia
D. Constipation
Correct Answer: A
Rationale: TPN contains high concentrations of dextrose, which can cause hyperglycemia. The
nurse should monitor blood glucose levels closely during TPN therapy. Other complications
include fluid imbalance, electrolyte imbalance, and infection of the central line insertion site.
, 5. A client is admitted with acute pancreatitis and reports severe abdominal pain. Which
laboratory result would the nurse expect to be most significantly elevated?
A. Serum Bilirubin
B. Serum Creatinine
C. Serum Potassium
D. Serum Amylase
Correct Answer: D
Rationale: Serum amylase and lipase are the primary biochemical markers used to diagnose
acute pancreatitis because they are released by the damaged pancreas into the bloodstream.
6. A client with cirrhosis presents with hepatic encephalopathy. Which medication does the
nurse expect to administer?
A. Lactulose
B. Furosemide
C. Spironolactone
D. Propranolol
Correct Answer: A
Rationale: Lactulose is administered to reduce ammonia levels, which helps improve the
neurological status and mental clarity of patients suffering from hepatic encephalopathy.
7. Following a liver biopsy, how should the nurse position the client?
A. Supine
chamberlain collage of nursing 150 Q&A +
Clinical Cases + Detailed Rationales 2026/2027
1. A nurse is reviewing the plan of care for a client with GERD. Which intervention should be
included?
A. Encourage the client to lie down after meals
B. Elevate the head of the bed on blocks
C. Encourage large, high-fat meals
D. Administer antacids with meals
Correct Answer: B
Rationale: Elevating the head of the bed on blocks helps prevent reflux by gravity. Clients should
avoid lying down for 2–3 hours after meals, eat small frequent meals, and avoid high-fat foods
that relax the lower esophageal sphincter.
2. A client with a gastric ulcer is at risk of developing which complication?
A. Peritonitis
B. Pancreatitis
C. Cholecystitis
D. Hepatitis
Correct Answer: A
,Rationale: A patient with a gastric ulcer is at risk of developing peritonitis if the ulcer perforates.
Gastric ulcers are also characterized by rapid weight loss, pain that worsens with eating, blood
in vomit, and heartburn.
3. Which statement about the pain pattern of a duodenal ulcer is most accurate?
A. Pain occurs 30 minutes after eating
B. Pain is relieved by eating
C. Pain is worse with food
D. Pain occurs only in the morning
Correct Answer: B
Rationale: Duodenal ulcers are characterized by pain relief once the patient eats, and pain
typically occurs at night. Gastric ulcers cause pain that worsens when the patient eats.
4. A nurse is teaching a client about TPN. Which complication should the nurse include?
A. Hyperglycemia
B. Hypoglycemia
C. Bradycardia
D. Constipation
Correct Answer: A
Rationale: TPN contains high concentrations of dextrose, which can cause hyperglycemia. The
nurse should monitor blood glucose levels closely during TPN therapy. Other complications
include fluid imbalance, electrolyte imbalance, and infection of the central line insertion site.
, 5. A client is admitted with acute pancreatitis and reports severe abdominal pain. Which
laboratory result would the nurse expect to be most significantly elevated?
A. Serum Bilirubin
B. Serum Creatinine
C. Serum Potassium
D. Serum Amylase
Correct Answer: D
Rationale: Serum amylase and lipase are the primary biochemical markers used to diagnose
acute pancreatitis because they are released by the damaged pancreas into the bloodstream.
6. A client with cirrhosis presents with hepatic encephalopathy. Which medication does the
nurse expect to administer?
A. Lactulose
B. Furosemide
C. Spironolactone
D. Propranolol
Correct Answer: A
Rationale: Lactulose is administered to reduce ammonia levels, which helps improve the
neurological status and mental clarity of patients suffering from hepatic encephalopathy.
7. Following a liver biopsy, how should the nurse position the client?
A. Supine
