PNR 206/PNR206 Exam 4 V3 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a client with a new diagnosis of Gastroesophageal Reflux Disease
(GERD). Which instruction should the nurse provide regarding lifestyle modifications?
A. Drink a glass of milk before bedtime to coat the stomach.
B. Lie flat on the right side immediately after eating.
C. Consume three large meals a day rather than small snacks.
D. Remain upright for at least 2 hours after eating a meal.
Answer: D
Rationale: Remaining upright after meals helps prevent the reflux of gastric contents into
the esophagus due to gravity. Clients are encouraged to eat smaller, more frequent meals to
reduce gastric pressure. Avoiding food or fluids 2 to 3 hours before bedtime is also a
standard recommendation to minimize nocturnal symptoms.
2. A client is admitted with suspected acute pancreatitis. Which laboratory result would the
nurse expect to find elevated?
A. Serum Calcium
B. Hemoglobin
C. Serum Lipase
,D. Platelet count
Answer: C
Rationale: Serum lipase and amylase are the primary enzymes released during pancreatic
inflammation. Lipase is generally considered more specific for diagnosing pancreatitis
because it remains elevated longer than amylase. Serum calcium levels often drop in severe
pancreatitis, which is a sign of poor prognosis known as hypocalcemia.
3. The nurse is preparing to administer Lactulose to a client with hepatic encephalopathy.
What is the primary therapeutic effect of this medication?
A. Reduction of blood glucose levels
B. Reduction of serum ammonia levels
C. Promotion of potassium excretion
D. Stimulation of bile production
Answer: B
Rationale: Lactulose works by drawing ammonia into the colon and promoting its
excretion through loose stools. This is critical in hepatic encephalopathy because high
ammonia levels are toxic to the brain. The nurse should monitor the number and
consistency of stools to ensure the medication is achieving its goal without causing
excessive dehydration.
, 4. A client undergoes a liver biopsy. In which position should the nurse place the client
immediately following the procedure?
A. Right side-lying with a folded towel under the puncture site
B. Left side-lying with a pillow under the head
C. High-Fowler’s position
D. Prone position for 4 hours
Answer: A
Rationale: Placing the client on their right side after a liver biopsy provides pressure on
the puncture site to prevent bleeding. The liver is a highly vascular organ, and the risk of
hemorrhage is significant post-procedure. The client typically remains in this position for
at least 2 hours to ensure hemostasis.
5. Which clinical manifestation is a hallmark sign of a small bowel obstruction?
A. Steady, localized pain in the left lower quadrant
B. Ribbon-like stools
C. Projectile vomiting
D. Absence of bowel sounds in all four quadrants
Answer: C
Rationale: Projectile vomiting of gastric and intestinal contents is very common in small
bowel obstructions because fluids and gases cannot pass through. Ribbon-like stools are
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a client with a new diagnosis of Gastroesophageal Reflux Disease
(GERD). Which instruction should the nurse provide regarding lifestyle modifications?
A. Drink a glass of milk before bedtime to coat the stomach.
B. Lie flat on the right side immediately after eating.
C. Consume three large meals a day rather than small snacks.
D. Remain upright for at least 2 hours after eating a meal.
Answer: D
Rationale: Remaining upright after meals helps prevent the reflux of gastric contents into
the esophagus due to gravity. Clients are encouraged to eat smaller, more frequent meals to
reduce gastric pressure. Avoiding food or fluids 2 to 3 hours before bedtime is also a
standard recommendation to minimize nocturnal symptoms.
2. A client is admitted with suspected acute pancreatitis. Which laboratory result would the
nurse expect to find elevated?
A. Serum Calcium
B. Hemoglobin
C. Serum Lipase
,D. Platelet count
Answer: C
Rationale: Serum lipase and amylase are the primary enzymes released during pancreatic
inflammation. Lipase is generally considered more specific for diagnosing pancreatitis
because it remains elevated longer than amylase. Serum calcium levels often drop in severe
pancreatitis, which is a sign of poor prognosis known as hypocalcemia.
3. The nurse is preparing to administer Lactulose to a client with hepatic encephalopathy.
What is the primary therapeutic effect of this medication?
A. Reduction of blood glucose levels
B. Reduction of serum ammonia levels
C. Promotion of potassium excretion
D. Stimulation of bile production
Answer: B
Rationale: Lactulose works by drawing ammonia into the colon and promoting its
excretion through loose stools. This is critical in hepatic encephalopathy because high
ammonia levels are toxic to the brain. The nurse should monitor the number and
consistency of stools to ensure the medication is achieving its goal without causing
excessive dehydration.
, 4. A client undergoes a liver biopsy. In which position should the nurse place the client
immediately following the procedure?
A. Right side-lying with a folded towel under the puncture site
B. Left side-lying with a pillow under the head
C. High-Fowler’s position
D. Prone position for 4 hours
Answer: A
Rationale: Placing the client on their right side after a liver biopsy provides pressure on
the puncture site to prevent bleeding. The liver is a highly vascular organ, and the risk of
hemorrhage is significant post-procedure. The client typically remains in this position for
at least 2 hours to ensure hemostasis.
5. Which clinical manifestation is a hallmark sign of a small bowel obstruction?
A. Steady, localized pain in the left lower quadrant
B. Ribbon-like stools
C. Projectile vomiting
D. Absence of bowel sounds in all four quadrants
Answer: C
Rationale: Projectile vomiting of gastric and intestinal contents is very common in small
bowel obstructions because fluids and gases cannot pass through. Ribbon-like stools are
