NSG 123 MEDICAL SURGICAL
NURSING EXAM 2 QUESTIONS
AND ANSWERS
🩺 Comprehensive Med-Surg Nursing Exam –
Gastrointestinal and Hepatic System
1. What is the most common cause of cholelithiasis (gallstones) in the United
States?
A. Pigment stones
B. Calcium stones
✅ C. Cholesterol stones
D. Mixed stones
💡 Rationale:
Cholesterol stones account for about 75% of gallbladder diseases in the U.S., resulting from
excess cholesterol saturation in bile.
2. Which symptom is most characteristic of cholelithiasis?
A. Left lower quadrant pain
✅ B. Right upper quadrant or shoulder pain after meals
C. Midline abdominal pain relieved by eating
D. Pain associated with urination
💡 Rationale:
Right upper quadrant or shoulder pain after fatty meals is typical due to gallbladder contraction
stimulating bile release.
1
,3. Which dietary recommendation should a caregiver provide for a patient
recovering from an acute episode of cholelithiasis?
A. High-fat diet
✅ B. Low-fat liquid diet initially
C. High-protein and dairy diet
D. High-fiber, spicy diet
💡 Rationale:
A low-fat liquid diet minimizes bile stimulation and supports recovery after gallstone attacks.
4. What is the therapeutic goal of Chenodiol (Chenodal) in gallstone
management?
A. Stimulate bile secretion
✅ B. Reduce hepatic cholesterol synthesis to dissolve stones
C. Prevent infection of bile ducts
D. Enhance gallbladder contraction
💡 Rationale:
Chenodiol reduces cholesterol content in bile, gradually dissolving cholesterol-based gallstones.
5. What is the primary purpose of adding fat emulsions to total parenteral
nutrition (TPN)?
A. Improve taste
✅ B. Provide essential fatty acids and calories
C. Reduce carbohydrate content
D. Increase protein metabolism
💡 Rationale:
Fat emulsions supply vital fatty acids and additional calories, preventing deficiencies and
maintaining metabolic balance.
6. Why may a patient experience right shoulder pain after laparoscopic
cholecystectomy?
2
, A. From anesthesia effects
✅ B. From carbon dioxide used to inflate the abdominal cavity
C. From infection of incision sites
D. From lying flat postoperatively
💡 Rationale:
Residual CO₂ irritates the diaphragm, causing referred pain to the right shoulder or scapula.
7. Which nursing action reduces bloating and shoulder pain after laparoscopic
cholecystectomy?
A. Enforce bed rest
✅ B. Encourage ambulation and use of a heating pad
C. Restrict fluid intake
D. Apply ice packs only
💡 Rationale:
Early ambulation helps expel retained CO₂ gas, while heat application relieves discomfort and
muscle tension.
8. What is the priority preoperative assessment for a patient undergoing open
cholecystectomy?
A. Skin integrity
B. Bowel pattern
✅ C. Respiratory status and history of smoking
D. Dietary habits
💡 Rationale:
High abdominal incisions may compromise breathing; assessing respiratory status prevents
postoperative complications.
9. Which finding should a caregiver monitor after cholecystostomy as a sign of
bile duct obstruction?
A. Green stool
✅ B. Clay-colored stool and jaundice
3
NURSING EXAM 2 QUESTIONS
AND ANSWERS
🩺 Comprehensive Med-Surg Nursing Exam –
Gastrointestinal and Hepatic System
1. What is the most common cause of cholelithiasis (gallstones) in the United
States?
A. Pigment stones
B. Calcium stones
✅ C. Cholesterol stones
D. Mixed stones
💡 Rationale:
Cholesterol stones account for about 75% of gallbladder diseases in the U.S., resulting from
excess cholesterol saturation in bile.
2. Which symptom is most characteristic of cholelithiasis?
A. Left lower quadrant pain
✅ B. Right upper quadrant or shoulder pain after meals
C. Midline abdominal pain relieved by eating
D. Pain associated with urination
💡 Rationale:
Right upper quadrant or shoulder pain after fatty meals is typical due to gallbladder contraction
stimulating bile release.
1
,3. Which dietary recommendation should a caregiver provide for a patient
recovering from an acute episode of cholelithiasis?
A. High-fat diet
✅ B. Low-fat liquid diet initially
C. High-protein and dairy diet
D. High-fiber, spicy diet
💡 Rationale:
A low-fat liquid diet minimizes bile stimulation and supports recovery after gallstone attacks.
4. What is the therapeutic goal of Chenodiol (Chenodal) in gallstone
management?
A. Stimulate bile secretion
✅ B. Reduce hepatic cholesterol synthesis to dissolve stones
C. Prevent infection of bile ducts
D. Enhance gallbladder contraction
💡 Rationale:
Chenodiol reduces cholesterol content in bile, gradually dissolving cholesterol-based gallstones.
5. What is the primary purpose of adding fat emulsions to total parenteral
nutrition (TPN)?
A. Improve taste
✅ B. Provide essential fatty acids and calories
C. Reduce carbohydrate content
D. Increase protein metabolism
💡 Rationale:
Fat emulsions supply vital fatty acids and additional calories, preventing deficiencies and
maintaining metabolic balance.
6. Why may a patient experience right shoulder pain after laparoscopic
cholecystectomy?
2
, A. From anesthesia effects
✅ B. From carbon dioxide used to inflate the abdominal cavity
C. From infection of incision sites
D. From lying flat postoperatively
💡 Rationale:
Residual CO₂ irritates the diaphragm, causing referred pain to the right shoulder or scapula.
7. Which nursing action reduces bloating and shoulder pain after laparoscopic
cholecystectomy?
A. Enforce bed rest
✅ B. Encourage ambulation and use of a heating pad
C. Restrict fluid intake
D. Apply ice packs only
💡 Rationale:
Early ambulation helps expel retained CO₂ gas, while heat application relieves discomfort and
muscle tension.
8. What is the priority preoperative assessment for a patient undergoing open
cholecystectomy?
A. Skin integrity
B. Bowel pattern
✅ C. Respiratory status and history of smoking
D. Dietary habits
💡 Rationale:
High abdominal incisions may compromise breathing; assessing respiratory status prevents
postoperative complications.
9. Which finding should a caregiver monitor after cholecystostomy as a sign of
bile duct obstruction?
A. Green stool
✅ B. Clay-colored stool and jaundice
3
