Med Surg Exam 4 Questions with Correct Answers Latest Update 2026/2027
A patient with an intestinal obstruction has a nasogastric (NG) tube to suction but reports of
nausea and abdominal distention. The nurse irrigates the tube as necessary as ordered, but the
irrigating fluid does not return. What should be the priority action by the nurse?
Notify the provider.
Auscultate for bowel sounds.
Reposition the tube and check for placement.
Remove the tube and replace it with a new one. - Answers Correct Answer:
Reposition the tube and check for placement.
Rationale:
The tube may be resting against the stomach wall. The first action by the nurse is to reposition
the tube and check it again for placement. The provider does not need to be notified unless the
nurse cannot restore the tube function. The patient does not have bowel sounds, which is why
the NG tube is in place. The NG tube would not be removed and replaced unless it was no longer
in the stomach or the obstruction of the tube could not be relieved.
Two days after a bowel resection for an abdominal mass, a patient reports gas pains and
abdominal distention. The nurse plans care for the patient based on the knowledge that the
symptoms are occurring as a result what event?
Impaired peristalsis
Irritation of the bowel
Nasogastric suctioning
Inflammation of the incision site - Answers Correct Answer:
Impaired peristalsis
Rationale:
Until peristalsis returns to normal after anesthesia, the patient may experience slowed
,gastrointestinal motility, leading to gas pains and abdominal distention. Irritation of the bowel,
nasogastric suctioning, and inflammation of the surgical site do not cause gas pains or
abdominal distention.
A patient is planned for discharge home today after ostomy surgery for colon cancer. The nurse
should assign the patient to which staff member?
An UAP on the unit who has hospice experience
An LPN that has worked on the unit for 10 years
An RN with 6 months of experience on the surgical unit
An RN who has floated to the surgical unit from pediatrics - Answers Correct Answer:
An RN with 6 months of experience on the surgical unit
Rationale:
The patient needs ostomy care directions and reinforcement at discharge and should be
assigned to a registered nurse with experience in providing discharge teaching for ostomy care.
Teaching should not be delegated to a LPN/VN or UAP.
The nurse is conducting discharge teaching for a patient with metastatic lung cancer who was
admitted with a bowel impaction. Which instructions would be most helpful to prevent further
episodes of constipation?
Maintain a high intake of fluid and fiber in the diet.
Discontinue intake of medications causing constipation.
Eat several small meals per day to maintain bowel motility.
Sit upright during meals to increase bowel motility by gravity. - Answers Correct Answer:
Maintain a high intake of fluid and fiber in the diet.
Rationale:
Increased fluid intake and a high-fiber diet reduce the incidence of constipation caused by
immobility, medications, and other factors. Fluid and fiber provide bulk that in turn increases
,peristalsis and bowel motility. Analgesics taken for lung cancer probably cannot be
discontinued. Eating several small meals per day and position do not facilitate bowel motility.
A patient is given a bisacodyl suppository and asks the nurse how long it will take to work. What
is the best response by the nurse?
2 to 5 minutes
15 to 60 minutes
2 to 4 hours
6 to 8 hours - Answers Correct Answer:
15 to 60 minutes
Rationale:
Bisacodyl suppositories usually are effective within 15 to 60 minutes of administration, so the
nurse should plan accordingly to assist the patient to use the bedpan or commode.
The nurse is developing a plan of care for a patient with an abdominal mass and suspected
bowel obstruction. Which factor in the patient's history does the nurse recognize as increasing
the patient's risk for colorectal cancer?
Osteoarthritis
History of colorectal polyps
History of lactose intolerance
Use of herbs as dietary supplements - Answers Correct Answer:
History of colorectal polyps
Rationale:
A history of colorectal polyps places this patient at risk for colorectal cancer. This tissue can
degenerate over time and become malignant. Osteoarthritis, lactose intolerance, and the use of
herbs do not pose additional risk to the patient.
, The nurse is admitting a patient with severe dehydration and frequent watery diarrhea. A 10-day
outpatient course of antibiotic therapy for bacterial pneumonia has just been completed. What
is the most important for the nurse to take which action?
Wear a mask to prevent transmission of infection.
Have visitors use the alcohol-based hand sanitizer.
Wipe down equipment with ammonia-based disinfectant.
Don gloves and gown before entering the patient's room. - Answers Correct Answer:
Don gloves and gown before entering the patient's room.
Rationale:
Clostridium difficile is an antibiotic-associated diarrhea transmitted by contact, and the spores
are extremely difficult to kill. Patients with suspected or confirmed infection with C. difficile
should be placed in a private room, and gloves and gowns should be worn by visitors and health
care providers. Alcohol-based hand cleaners and ammonia-based disinfectants are ineffective
and do not kill all the spores. Equipment cannot be shared with other patients, and a disposable
stethoscope and individual patient thermometer are kept in the room. Objects should be
disinfected with a 10% solution of household bleach.
A patient with ulcerative colitis is scheduled for a total proctocolectomy with permanent
ileostomy. The wound, ostomy, and continence nurse is selecting the site where the ostomy will
be placed. What should be included in site consideration?
Protruding areas make the best sites.
The patient must be able to see the site.
The site should be outside the rectus muscle area.
The appliance will need to be placed at the waist line. - Answers Correct Answer:
The patient must be able to see the site.
Rationale:
A patient with an intestinal obstruction has a nasogastric (NG) tube to suction but reports of
nausea and abdominal distention. The nurse irrigates the tube as necessary as ordered, but the
irrigating fluid does not return. What should be the priority action by the nurse?
Notify the provider.
Auscultate for bowel sounds.
Reposition the tube and check for placement.
Remove the tube and replace it with a new one. - Answers Correct Answer:
Reposition the tube and check for placement.
Rationale:
The tube may be resting against the stomach wall. The first action by the nurse is to reposition
the tube and check it again for placement. The provider does not need to be notified unless the
nurse cannot restore the tube function. The patient does not have bowel sounds, which is why
the NG tube is in place. The NG tube would not be removed and replaced unless it was no longer
in the stomach or the obstruction of the tube could not be relieved.
Two days after a bowel resection for an abdominal mass, a patient reports gas pains and
abdominal distention. The nurse plans care for the patient based on the knowledge that the
symptoms are occurring as a result what event?
Impaired peristalsis
Irritation of the bowel
Nasogastric suctioning
Inflammation of the incision site - Answers Correct Answer:
Impaired peristalsis
Rationale:
Until peristalsis returns to normal after anesthesia, the patient may experience slowed
,gastrointestinal motility, leading to gas pains and abdominal distention. Irritation of the bowel,
nasogastric suctioning, and inflammation of the surgical site do not cause gas pains or
abdominal distention.
A patient is planned for discharge home today after ostomy surgery for colon cancer. The nurse
should assign the patient to which staff member?
An UAP on the unit who has hospice experience
An LPN that has worked on the unit for 10 years
An RN with 6 months of experience on the surgical unit
An RN who has floated to the surgical unit from pediatrics - Answers Correct Answer:
An RN with 6 months of experience on the surgical unit
Rationale:
The patient needs ostomy care directions and reinforcement at discharge and should be
assigned to a registered nurse with experience in providing discharge teaching for ostomy care.
Teaching should not be delegated to a LPN/VN or UAP.
The nurse is conducting discharge teaching for a patient with metastatic lung cancer who was
admitted with a bowel impaction. Which instructions would be most helpful to prevent further
episodes of constipation?
Maintain a high intake of fluid and fiber in the diet.
Discontinue intake of medications causing constipation.
Eat several small meals per day to maintain bowel motility.
Sit upright during meals to increase bowel motility by gravity. - Answers Correct Answer:
Maintain a high intake of fluid and fiber in the diet.
Rationale:
Increased fluid intake and a high-fiber diet reduce the incidence of constipation caused by
immobility, medications, and other factors. Fluid and fiber provide bulk that in turn increases
,peristalsis and bowel motility. Analgesics taken for lung cancer probably cannot be
discontinued. Eating several small meals per day and position do not facilitate bowel motility.
A patient is given a bisacodyl suppository and asks the nurse how long it will take to work. What
is the best response by the nurse?
2 to 5 minutes
15 to 60 minutes
2 to 4 hours
6 to 8 hours - Answers Correct Answer:
15 to 60 minutes
Rationale:
Bisacodyl suppositories usually are effective within 15 to 60 minutes of administration, so the
nurse should plan accordingly to assist the patient to use the bedpan or commode.
The nurse is developing a plan of care for a patient with an abdominal mass and suspected
bowel obstruction. Which factor in the patient's history does the nurse recognize as increasing
the patient's risk for colorectal cancer?
Osteoarthritis
History of colorectal polyps
History of lactose intolerance
Use of herbs as dietary supplements - Answers Correct Answer:
History of colorectal polyps
Rationale:
A history of colorectal polyps places this patient at risk for colorectal cancer. This tissue can
degenerate over time and become malignant. Osteoarthritis, lactose intolerance, and the use of
herbs do not pose additional risk to the patient.
, The nurse is admitting a patient with severe dehydration and frequent watery diarrhea. A 10-day
outpatient course of antibiotic therapy for bacterial pneumonia has just been completed. What
is the most important for the nurse to take which action?
Wear a mask to prevent transmission of infection.
Have visitors use the alcohol-based hand sanitizer.
Wipe down equipment with ammonia-based disinfectant.
Don gloves and gown before entering the patient's room. - Answers Correct Answer:
Don gloves and gown before entering the patient's room.
Rationale:
Clostridium difficile is an antibiotic-associated diarrhea transmitted by contact, and the spores
are extremely difficult to kill. Patients with suspected or confirmed infection with C. difficile
should be placed in a private room, and gloves and gowns should be worn by visitors and health
care providers. Alcohol-based hand cleaners and ammonia-based disinfectants are ineffective
and do not kill all the spores. Equipment cannot be shared with other patients, and a disposable
stethoscope and individual patient thermometer are kept in the room. Objects should be
disinfected with a 10% solution of household bleach.
A patient with ulcerative colitis is scheduled for a total proctocolectomy with permanent
ileostomy. The wound, ostomy, and continence nurse is selecting the site where the ostomy will
be placed. What should be included in site consideration?
Protruding areas make the best sites.
The patient must be able to see the site.
The site should be outside the rectus muscle area.
The appliance will need to be placed at the waist line. - Answers Correct Answer:
The patient must be able to see the site.
Rationale:
