NUR 209 Exam 3 | Questions and Answers | Updated
Tests | Fortis College 2026 Updates
QUESTION 1
A patient is admitted with acute pancreatitis. The nurse is monitoring for signs of hypocalcemia. Which of
the following mechanisms best explains the development of hypocalcemia in acute pancreatitis?
A. Impaired renal reabsorption of calcium due to tubular necrosis
B. Sequestration of calcium in the peripancreatic fat by saponification
C. Increased calcitonin release from the thyroid gland
D. Decreased intestinal absorption of calcium due to pancreatic enzyme deficiency
Correct Answer: B. Sequestration of calcium in the peripancreatic fat by saponification
Expert Rationale: In acute pancreatitis, lipase released from damaged pancreatic tissue breaks down
peripancreatic fat into free fatty acids, which then bind with calcium to form calcium soaps
(saponification). This process sequesters calcium, leading to hypocalcemia . Renal failure (A) is not a
direct cause. Calcitonin release (C) is not the primary mechanism. Pancreatic enzyme deficiency (D)
affects digestion, not calcium levels.
QUESTION 2
The nurse is reviewing the medical record for a patient admitted with acute pancreatitis. The nurse notes
that the patient has a positive Cullen's sign. In which area should the nurse assess for this finding?
A. Right upper quadrant
B. Left upper quadrant
C. Periumbilical area
D. Flank area
Correct Answer: C. Periumbilical area
, Expert Rationale: Cullen's sign is a bluish discoloration around the umbilicus (periumbilical area) and
indicates intra-abdominal bleeding, often seen in acute pancreatitis or ruptured ectopic pregnancy . This is
a late sign of severe pancreatitis. Grey-Turner's sign (flank ecchymosis) may also be seen in severe
pancreatitis. Options A, B, and D are incorrect locations.
QUESTION 3
A patient who recently had a laparoscopic Nissen fundoplication for hiatal hernia is 4 hours post-
operative. Which assessment finding is most important for the nurse to address immediately?
A. The patient reports 7/10 (0 to 10 scale) abdominal pain
B. The patient is experiencing intermittent waves of nausea
C. The patient has no breath sounds in the left lung base
D. The patient's temperature is 100.2°F (37.9°C)
Correct Answer: C. The patient has no breath sounds in the left lung base
Expert Rationale: Absent breath sounds indicate a potential pneumothorax, which can occur as a
complication of laparoscopic surgery . This is a life-threatening emergency requiring immediate
intervention. Pain (A), nausea (B), and low-grade fever (D) are expected post-operative findings that
should be managed but are not emergent. The nurse should notify the provider immediately.
QUESTION 4
A patient is post-operative day 1 from a perineal resection due to colon cancer. What is the priority
nursing assessment?
A. Assess the surgical wound for regularity, bleeding, excess drainage, or odor
B. Monitor the patient's oral intake
C. Assess the patient's pain level
D. Monitor the patient's bowel sounds
Correct Answer: A. Assess the surgical wound for regularity, bleeding, excess drainage, or odor
Tests | Fortis College 2026 Updates
QUESTION 1
A patient is admitted with acute pancreatitis. The nurse is monitoring for signs of hypocalcemia. Which of
the following mechanisms best explains the development of hypocalcemia in acute pancreatitis?
A. Impaired renal reabsorption of calcium due to tubular necrosis
B. Sequestration of calcium in the peripancreatic fat by saponification
C. Increased calcitonin release from the thyroid gland
D. Decreased intestinal absorption of calcium due to pancreatic enzyme deficiency
Correct Answer: B. Sequestration of calcium in the peripancreatic fat by saponification
Expert Rationale: In acute pancreatitis, lipase released from damaged pancreatic tissue breaks down
peripancreatic fat into free fatty acids, which then bind with calcium to form calcium soaps
(saponification). This process sequesters calcium, leading to hypocalcemia . Renal failure (A) is not a
direct cause. Calcitonin release (C) is not the primary mechanism. Pancreatic enzyme deficiency (D)
affects digestion, not calcium levels.
QUESTION 2
The nurse is reviewing the medical record for a patient admitted with acute pancreatitis. The nurse notes
that the patient has a positive Cullen's sign. In which area should the nurse assess for this finding?
A. Right upper quadrant
B. Left upper quadrant
C. Periumbilical area
D. Flank area
Correct Answer: C. Periumbilical area
, Expert Rationale: Cullen's sign is a bluish discoloration around the umbilicus (periumbilical area) and
indicates intra-abdominal bleeding, often seen in acute pancreatitis or ruptured ectopic pregnancy . This is
a late sign of severe pancreatitis. Grey-Turner's sign (flank ecchymosis) may also be seen in severe
pancreatitis. Options A, B, and D are incorrect locations.
QUESTION 3
A patient who recently had a laparoscopic Nissen fundoplication for hiatal hernia is 4 hours post-
operative. Which assessment finding is most important for the nurse to address immediately?
A. The patient reports 7/10 (0 to 10 scale) abdominal pain
B. The patient is experiencing intermittent waves of nausea
C. The patient has no breath sounds in the left lung base
D. The patient's temperature is 100.2°F (37.9°C)
Correct Answer: C. The patient has no breath sounds in the left lung base
Expert Rationale: Absent breath sounds indicate a potential pneumothorax, which can occur as a
complication of laparoscopic surgery . This is a life-threatening emergency requiring immediate
intervention. Pain (A), nausea (B), and low-grade fever (D) are expected post-operative findings that
should be managed but are not emergent. The nurse should notify the provider immediately.
QUESTION 4
A patient is post-operative day 1 from a perineal resection due to colon cancer. What is the priority
nursing assessment?
A. Assess the surgical wound for regularity, bleeding, excess drainage, or odor
B. Monitor the patient's oral intake
C. Assess the patient's pain level
D. Monitor the patient's bowel sounds
Correct Answer: A. Assess the surgical wound for regularity, bleeding, excess drainage, or odor
