GALEN MEDSURG EXAM QUESTIONS WITH COMPLETE
SOLUTIONS WITH RATIONALE GUARANTEED PASS BRAND NEW
2025
A client is provided with materials to obtain three fecal occult blood
tests (Hem occult). What health teaching does the nurse provide?
Select all that apply.
A. "Avoid red meat and raw vegetables for a week before getting the
samples."
B. "Drink a gallon of GoLYTELY before you collect the first sample."
C. "Do not take food or fluids for 24 hours before the test."
D. "Do not take ibuprofen for a week before obtaining the samples."
E. "Avoid vitamin C tablets, foods, and juices a week before getting the
samples." - ANSWER - > Answer: A, D, E
Rationale: To avoid obtaining false-positive results associated with fecal
occult blood tests (Hem occult), patients must avoid certain foods
before the test, such as raw fruits and vegetables and red meat.
Vitamin C-rich foods, juices, and tablets must also be avoided.
Anticoagulants, such as warfarin (Coumadin), and nonsteroidal anti-
inflammatory drugs should be discontinued for 7 days before testing
begins.
What is a common gastrointestinal problem that older adults
experience more frequently as they age?
Decreased hydrochloric acid
Excess lipase production
Increased liver enzymes
Increased peristalsis - ANSWER - > Atrophy of the gastric mucosa
causes a decreased ratio of gastrin-secreting cells to somatostatin-
,secreting cells. This results in a decrease in hydrochloric acid, causing
decreased absorption of iron and vitamin B12. In the pancreas,
calcification of pancreatic vessels occurs, with a decrease in lipase
production. The decrease in lipase results in decreased fat absorption
and digestion. Steatorrhea and diarrhea can subsequently occur. The
number and size of hepatic cells are decreased, which results in
decreased enzyme activity; decreased liver enzyme activity depresses
drug metabolism, and therefore may cause accumulation of drugs to
toxic levels. In the large intestine, peristalsis is decreased and nerve
impulses are dulled, which can result in postponement of bowel
movements in older adults.
A client is admitted to the hospital with severe right upper quadrant
(RUQ) abdominal pain. Which assessment technique does the nurse use
for this client?
Assesses the abdomen in the following sequence: inspection,
palpation, percussion, auscultation
Examines the RUQ of the abdomen last
Has the client lie in a supine position with legs straight and arms at the
sides - ANSWER - > Views the abdomen by looking directly down while
standing over the client's abdominal area
cussion, and then palpation. This sequence prevents the increase in
intestinal activity and bowel sounds caused by palpation and
percussion. The client would be positioned supine with the knees bent,
while keeping the arms at the sides to prevent tensing of the abdominal
muscles. It is best to inspect the abdomen by sIf the client reports pain
in the RUQ, the nurse would examine this area last in the examination
sequence. This sequence prevents the client from tensing abdominal
muscles because of the pain, which would make the examination
difficult. The sequence for examining the abdomen is inspection,
auscultation, pertanding at the side of the bed and then looking down
on the abdomen, and also from the side at eye level.
,A client is admitted to the hospital with elevated serum amylase and
lipase levels and a decreased calcium level. Which gastrointestinal
health problem is indicated by these laboratory findings?
Acute pancreatitis
Cirrhosis
Crohn's disease
Diarrhea - ANSWER - > These laboratory values are commonly found in
clients with acute pancreatitis. They are not indicative of cirrhosis of
the liver or Crohn's disease. These laboratory values are not found in a
client with diarrhea.
The nurse is assessing a client who has come to the emergency
department with acute abdominal pain. The client is very thin and the
nurse observes visible peristaltic movements when inspecting the
abdomen. What does the nurse suspect?
Acute diarrhea
Aortic aneurysm
Intestinal obstruction
Pancreatitis - ANSWER - > Peristaltic movements are rarely seen except
in thin clients and should be reported since the finding may indicate an
intestinal obstruction. Acute diarrhea does not cause visible peristaltic
movements. Aortic aneurysm may cause a bulging, pulsatile mass.
Pancreatitis is characterized by severe pain.
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
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
SOLUTIONS WITH RATIONALE GUARANTEED PASS BRAND NEW
2025
A client is provided with materials to obtain three fecal occult blood
tests (Hem occult). What health teaching does the nurse provide?
Select all that apply.
A. "Avoid red meat and raw vegetables for a week before getting the
samples."
B. "Drink a gallon of GoLYTELY before you collect the first sample."
C. "Do not take food or fluids for 24 hours before the test."
D. "Do not take ibuprofen for a week before obtaining the samples."
E. "Avoid vitamin C tablets, foods, and juices a week before getting the
samples." - ANSWER - > Answer: A, D, E
Rationale: To avoid obtaining false-positive results associated with fecal
occult blood tests (Hem occult), patients must avoid certain foods
before the test, such as raw fruits and vegetables and red meat.
Vitamin C-rich foods, juices, and tablets must also be avoided.
Anticoagulants, such as warfarin (Coumadin), and nonsteroidal anti-
inflammatory drugs should be discontinued for 7 days before testing
begins.
What is a common gastrointestinal problem that older adults
experience more frequently as they age?
Decreased hydrochloric acid
Excess lipase production
Increased liver enzymes
Increased peristalsis - ANSWER - > Atrophy of the gastric mucosa
causes a decreased ratio of gastrin-secreting cells to somatostatin-
,secreting cells. This results in a decrease in hydrochloric acid, causing
decreased absorption of iron and vitamin B12. In the pancreas,
calcification of pancreatic vessels occurs, with a decrease in lipase
production. The decrease in lipase results in decreased fat absorption
and digestion. Steatorrhea and diarrhea can subsequently occur. The
number and size of hepatic cells are decreased, which results in
decreased enzyme activity; decreased liver enzyme activity depresses
drug metabolism, and therefore may cause accumulation of drugs to
toxic levels. In the large intestine, peristalsis is decreased and nerve
impulses are dulled, which can result in postponement of bowel
movements in older adults.
A client is admitted to the hospital with severe right upper quadrant
(RUQ) abdominal pain. Which assessment technique does the nurse use
for this client?
Assesses the abdomen in the following sequence: inspection,
palpation, percussion, auscultation
Examines the RUQ of the abdomen last
Has the client lie in a supine position with legs straight and arms at the
sides - ANSWER - > Views the abdomen by looking directly down while
standing over the client's abdominal area
cussion, and then palpation. This sequence prevents the increase in
intestinal activity and bowel sounds caused by palpation and
percussion. The client would be positioned supine with the knees bent,
while keeping the arms at the sides to prevent tensing of the abdominal
muscles. It is best to inspect the abdomen by sIf the client reports pain
in the RUQ, the nurse would examine this area last in the examination
sequence. This sequence prevents the client from tensing abdominal
muscles because of the pain, which would make the examination
difficult. The sequence for examining the abdomen is inspection,
auscultation, pertanding at the side of the bed and then looking down
on the abdomen, and also from the side at eye level.
,A client is admitted to the hospital with elevated serum amylase and
lipase levels and a decreased calcium level. Which gastrointestinal
health problem is indicated by these laboratory findings?
Acute pancreatitis
Cirrhosis
Crohn's disease
Diarrhea - ANSWER - > These laboratory values are commonly found in
clients with acute pancreatitis. They are not indicative of cirrhosis of
the liver or Crohn's disease. These laboratory values are not found in a
client with diarrhea.
The nurse is assessing a client who has come to the emergency
department with acute abdominal pain. The client is very thin and the
nurse observes visible peristaltic movements when inspecting the
abdomen. What does the nurse suspect?
Acute diarrhea
Aortic aneurysm
Intestinal obstruction
Pancreatitis - ANSWER - > Peristaltic movements are rarely seen except
in thin clients and should be reported since the finding may indicate an
intestinal obstruction. Acute diarrhea does not cause visible peristaltic
movements. Aortic aneurysm may cause a bulging, pulsatile mass.
Pancreatitis is characterized by severe pain.
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
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
