NSG 320 Exam 3 Adult Health
Nursing I Review 2026/2027 –
Practice Questions, Answers &
Detailed Rationales Guaranteed
Pass (GRADED A+)
1. A client with gastroesophageal reflux disease (GERD) asks
why the symptoms worsen after lying down. Which
explanation should the nurse provide?
A. Lying down increases intestinal motility.
B. Lying down increases pancreatic enzyme secretion.
C. The recumbent position promotes movement of gastric
contents into the esophagus.
D. The recumbent position causes increased bile production.
Answer: _C. The recumbent position promotes movement of
gastric contents into the esophagus._
Rationale: Gravity normally helps keep gastric contents in the
stomach. Lying down after eating can promote reflux, so clients
with GERD are generally taught to remain upright after meals
and elevate the head of the bed.
,2. Which medication is classified as a proton pump inhibitor
(PPI)?
A. Famotidine
B. Sucralfate
C. Metoclopramide
D. Omeprazole
Answer: _D. Omeprazole_
Rationale: Omeprazole is a PPI that suppresses gastric acid
secretion and is commonly used for GERD and peptic ulcer
disease.
3. Which instruction is most appropriate for a client taking a
PPI such as omeprazole?
A. Take it only when heartburn occurs.
B. Take it immediately after meals.
C. Take it before meals as prescribed.
D. Crush the medication and mix it with milk.
Answer: _C. Take it before meals as prescribed._
Rationale: PPIs are generally administered before meals so that
medication is present when meal-stimulated proton pumps
become active.
,4. A client with peptic ulcer disease suddenly develops severe
abdominal pain and a rigid abdomen. Which complication
should the nurse suspect?
A. Constipation
B. Perforation
C. Dumping syndrome
D. Gastroesophageal reflux
Answer: _B. Perforation_
Rationale: Sudden severe abdominal pain accompanied by a
rigid or board-like abdomen is concerning for perforation and
peritonitis and requires immediate evaluation.
5. Which finding is most concerning in a client with a history
of esophageal varices?
A. Mild nausea
B. Increased appetite
C. Hematemesis
D. Occasional heartburn
Answer: _C. Hematemesis_
Rationale: Esophageal varices can rupture because of portal
hypertension, causing life-threatening upper gastrointestinal
hemorrhage. Vomiting blood requires immediate intervention.
, 6. Which assessment finding is commonly associated with
advanced cirrhosis?
A. Bradycardia
B. Ascites
C. Increased muscle mass
D. Increased platelet production
Answer: _B. Ascites_
Rationale: Cirrhosis can cause portal hypertension and
decreased albumin production, contributing to fluid
accumulation in the peritoneal cavity.
7. A client with cirrhosis is prescribed lactulose. Which
outcome indicates that the medication is producing the
intended effect?
A. Complete absence of bowel movements
B. Increased serum ammonia level
C. Improved level of consciousness with regular bowel
movements
D. Increased abdominal distention
Answer: _C. Improved level of consciousness with regular
bowel movements_
Rationale: Lactulose decreases intestinal ammonia absorption
by promoting its excretion in stool. Improvement in mental
status is an important indicator of effectiveness in hepatic
encephalopathy.
Nursing I Review 2026/2027 –
Practice Questions, Answers &
Detailed Rationales Guaranteed
Pass (GRADED A+)
1. A client with gastroesophageal reflux disease (GERD) asks
why the symptoms worsen after lying down. Which
explanation should the nurse provide?
A. Lying down increases intestinal motility.
B. Lying down increases pancreatic enzyme secretion.
C. The recumbent position promotes movement of gastric
contents into the esophagus.
D. The recumbent position causes increased bile production.
Answer: _C. The recumbent position promotes movement of
gastric contents into the esophagus._
Rationale: Gravity normally helps keep gastric contents in the
stomach. Lying down after eating can promote reflux, so clients
with GERD are generally taught to remain upright after meals
and elevate the head of the bed.
,2. Which medication is classified as a proton pump inhibitor
(PPI)?
A. Famotidine
B. Sucralfate
C. Metoclopramide
D. Omeprazole
Answer: _D. Omeprazole_
Rationale: Omeprazole is a PPI that suppresses gastric acid
secretion and is commonly used for GERD and peptic ulcer
disease.
3. Which instruction is most appropriate for a client taking a
PPI such as omeprazole?
A. Take it only when heartburn occurs.
B. Take it immediately after meals.
C. Take it before meals as prescribed.
D. Crush the medication and mix it with milk.
Answer: _C. Take it before meals as prescribed._
Rationale: PPIs are generally administered before meals so that
medication is present when meal-stimulated proton pumps
become active.
,4. A client with peptic ulcer disease suddenly develops severe
abdominal pain and a rigid abdomen. Which complication
should the nurse suspect?
A. Constipation
B. Perforation
C. Dumping syndrome
D. Gastroesophageal reflux
Answer: _B. Perforation_
Rationale: Sudden severe abdominal pain accompanied by a
rigid or board-like abdomen is concerning for perforation and
peritonitis and requires immediate evaluation.
5. Which finding is most concerning in a client with a history
of esophageal varices?
A. Mild nausea
B. Increased appetite
C. Hematemesis
D. Occasional heartburn
Answer: _C. Hematemesis_
Rationale: Esophageal varices can rupture because of portal
hypertension, causing life-threatening upper gastrointestinal
hemorrhage. Vomiting blood requires immediate intervention.
, 6. Which assessment finding is commonly associated with
advanced cirrhosis?
A. Bradycardia
B. Ascites
C. Increased muscle mass
D. Increased platelet production
Answer: _B. Ascites_
Rationale: Cirrhosis can cause portal hypertension and
decreased albumin production, contributing to fluid
accumulation in the peritoneal cavity.
7. A client with cirrhosis is prescribed lactulose. Which
outcome indicates that the medication is producing the
intended effect?
A. Complete absence of bowel movements
B. Increased serum ammonia level
C. Improved level of consciousness with regular bowel
movements
D. Increased abdominal distention
Answer: _C. Improved level of consciousness with regular
bowel movements_
Rationale: Lactulose decreases intestinal ammonia absorption
by promoting its excretion in stool. Improvement in mental
status is an important indicator of effectiveness in hepatic
encephalopathy.
