• Med Surg Exam 09/19/2026
Med Surg EXAM 3 Capstone Assessment
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
The nurse is teaching the postgastrectomy client about measures to prevent dumping syndrome. Which
statement by the client indicates a need for further teaching?
A. "I need to lie down after eating."
B. "I need to drink liquids with meals."
P 1
, • Med Surg Exam 09/19/2026
C. "I need to avoid concentrated sweets."
D. "I need to eat small meals 6 times daily." - Correct Answer :B. "I need to drink liquids with meals."
Rationale:
The client with dumping syndrome should avoid drinking liquids with meals. The client should be placed on a
high-protein, moderate-fat, high-calorie diet and should lie down after eating. The client should avoid
concentrated sweets, and frequent small meals are encouraged.
The nurse is caring for a client with pernicious anemia. Which prescription by the health care provider (HCP)
should the nurse anticipate?
A. Iron
B. Folic acid
C. Vitamin B6
D. Vitamin B12 - Correct Answer :D. Vitamin B12
Rationale:
Pernicious anemia is caused by a deficiency of vitamin B12. Treatment consists of administration of high doses of
oral vitamin B12. Monthly injections of vitamin B12 can also be administered but are less comfortable when
compared to oral administration. Thiamine is most often prescribed for the client with alcoholism, folic acid is
prescribed for folic acid deficiency, and vitamin B6 is ordered when there is pyridoxine deficiency.
A client presents to the emergency department with upper gastrointestinal (GI) bleeding and is in moderate
distress. In planning care, which nursing action should be the priority for this client?
A. Assessment of vital signs
B. Complete abdominal examination
C. Thorough investigation of precipitating events
D. Insertion of a nasogastric tube and Hematest of emesis - Correct Answer :A. Assessment of vital signs
Rationale:
P 2
, • Med Surg Exam 09/19/2026
The priority nursing action is to assess the vital signs. This would indicate the amount of blood loss that has
occurred and also provides a baseline by which to monitor the progress of treatment. The client may not be able
to provide subjective data until the immediate physical needs are met. Although an abdominal examination and
an assessment of the precipitating events may be necessary, these actions are not the priority.
The nurse has given postprocedure instructions to a client who has undergone a colonoscopy. Which statement
by the client indicates the need for further teaching?
A. "It is normal to feel gassy or bloated after the procedure."
B. "The abdominal muscles may be tender from the procedure."
C. "It is all right to drive once I've been home for an hour or so."
D. "Intake should be light at first and then progress to regular intake." - Correct Answer :C. "It is all right to drive
once I've been home for an hour or so."
Rationale:
The client should not drive for several hours after discharge because of the sedative medications used during the
procedure. Important decisions also should be delayed for at least 12 to 24 hours for the same reason. The client
may experience gas, bloating, or abdominal tenderness for a short while after the procedure, and this is normal.
The client should resume intake slowly and progress as tolerated.
The nurse is caring for a client experiencing an exacerbation of Crohn's disease. Which intervention should the
nurse anticipate the health care provider prescribing?
A. Enteral feedings
B. Fluid restrictions
C. Oral corticosteroids
D. Activity restrictions - Correct Answer :C. Oral corticosteroids
Rationale:
Crohn's disease is a form of inflammatory bowel disease that is a chronic inflammation of the gastrointestinal
(GI) tract. It is characterized by periods of remission interspersed with periods of exacerbation. Oral
corticosteroids are used to treat the inflammation of Crohn's disease, so option 3 is the correct one. In addition
P 3
, • Med Surg Exam 09/19/2026
to treating the GI inflammation of Crohn's disease with medications, it is also treated by resting the bowel.
Therefore, option 1 is incorrect. Option 2 is incorrect, as clients with Crohn's disease typically have diarrhea and
would not be on fluid restrictions. Option 4, activity restrictions, is not indicated. The client can do activities as
tolerated but should avoid stress and strain.
The nurse caring for a client diagnosed with inflammatory bowel disease (IBD) recognizes that which
classifications of medications may be prescribed to treat the disease and induce remission? Select all that apply.
A. Antidiarrheal
B. Antimicrobial
C. Corticosteroid
D. Aminosalicylate
E. Biological therapy
F. Immunosuppressant - Correct Answer :B. Antimicrobial
C. Corticosteroid
D. Aminosalicylate
E. Biological therapy
F. Immunosuppressant
Rationale:
Pharmacological treatment for IBD aims to decrease the inflammation to induce and then maintain a remission.
Five major classes of medications used to treat IBD are antimicrobials, corticosteroids, aminosalicylates,
biological and targeted therapy, and immunosuppressants. Medications are chosen based on the location and
severity of inflammation. Depending on the severity of the disease, clients are treated with either a "step-up" or
"step-down" approach. The step-up approach uses less toxic therapies (e.g., aminosalicylates and
antimicrobials) first, and more toxic medications (e.g., biological and targeted therapy) are started when initial
therapies do not work. The step-down approach uses biological and targeted therapy first. Option 1,
antidiarrheals, is incorrect. Although an antidiarrheal may be used to treat the symptoms of IBD, it does not treat
the disease (the inflammation) or induce remission. In addition, antidiarrheals should be used cautiously in IBD
because of the danger of toxic megacolon (colonic dilation greater than 5 cm).
During a home care visit, an adult client complains of chronic constipation. What should the nurse tell the client
to do?
P 4
Med Surg EXAM 3 Capstone Assessment
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
The nurse is teaching the postgastrectomy client about measures to prevent dumping syndrome. Which
statement by the client indicates a need for further teaching?
A. "I need to lie down after eating."
B. "I need to drink liquids with meals."
P 1
, • Med Surg Exam 09/19/2026
C. "I need to avoid concentrated sweets."
D. "I need to eat small meals 6 times daily." - Correct Answer :B. "I need to drink liquids with meals."
Rationale:
The client with dumping syndrome should avoid drinking liquids with meals. The client should be placed on a
high-protein, moderate-fat, high-calorie diet and should lie down after eating. The client should avoid
concentrated sweets, and frequent small meals are encouraged.
The nurse is caring for a client with pernicious anemia. Which prescription by the health care provider (HCP)
should the nurse anticipate?
A. Iron
B. Folic acid
C. Vitamin B6
D. Vitamin B12 - Correct Answer :D. Vitamin B12
Rationale:
Pernicious anemia is caused by a deficiency of vitamin B12. Treatment consists of administration of high doses of
oral vitamin B12. Monthly injections of vitamin B12 can also be administered but are less comfortable when
compared to oral administration. Thiamine is most often prescribed for the client with alcoholism, folic acid is
prescribed for folic acid deficiency, and vitamin B6 is ordered when there is pyridoxine deficiency.
A client presents to the emergency department with upper gastrointestinal (GI) bleeding and is in moderate
distress. In planning care, which nursing action should be the priority for this client?
A. Assessment of vital signs
B. Complete abdominal examination
C. Thorough investigation of precipitating events
D. Insertion of a nasogastric tube and Hematest of emesis - Correct Answer :A. Assessment of vital signs
Rationale:
P 2
, • Med Surg Exam 09/19/2026
The priority nursing action is to assess the vital signs. This would indicate the amount of blood loss that has
occurred and also provides a baseline by which to monitor the progress of treatment. The client may not be able
to provide subjective data until the immediate physical needs are met. Although an abdominal examination and
an assessment of the precipitating events may be necessary, these actions are not the priority.
The nurse has given postprocedure instructions to a client who has undergone a colonoscopy. Which statement
by the client indicates the need for further teaching?
A. "It is normal to feel gassy or bloated after the procedure."
B. "The abdominal muscles may be tender from the procedure."
C. "It is all right to drive once I've been home for an hour or so."
D. "Intake should be light at first and then progress to regular intake." - Correct Answer :C. "It is all right to drive
once I've been home for an hour or so."
Rationale:
The client should not drive for several hours after discharge because of the sedative medications used during the
procedure. Important decisions also should be delayed for at least 12 to 24 hours for the same reason. The client
may experience gas, bloating, or abdominal tenderness for a short while after the procedure, and this is normal.
The client should resume intake slowly and progress as tolerated.
The nurse is caring for a client experiencing an exacerbation of Crohn's disease. Which intervention should the
nurse anticipate the health care provider prescribing?
A. Enteral feedings
B. Fluid restrictions
C. Oral corticosteroids
D. Activity restrictions - Correct Answer :C. Oral corticosteroids
Rationale:
Crohn's disease is a form of inflammatory bowel disease that is a chronic inflammation of the gastrointestinal
(GI) tract. It is characterized by periods of remission interspersed with periods of exacerbation. Oral
corticosteroids are used to treat the inflammation of Crohn's disease, so option 3 is the correct one. In addition
P 3
, • Med Surg Exam 09/19/2026
to treating the GI inflammation of Crohn's disease with medications, it is also treated by resting the bowel.
Therefore, option 1 is incorrect. Option 2 is incorrect, as clients with Crohn's disease typically have diarrhea and
would not be on fluid restrictions. Option 4, activity restrictions, is not indicated. The client can do activities as
tolerated but should avoid stress and strain.
The nurse caring for a client diagnosed with inflammatory bowel disease (IBD) recognizes that which
classifications of medications may be prescribed to treat the disease and induce remission? Select all that apply.
A. Antidiarrheal
B. Antimicrobial
C. Corticosteroid
D. Aminosalicylate
E. Biological therapy
F. Immunosuppressant - Correct Answer :B. Antimicrobial
C. Corticosteroid
D. Aminosalicylate
E. Biological therapy
F. Immunosuppressant
Rationale:
Pharmacological treatment for IBD aims to decrease the inflammation to induce and then maintain a remission.
Five major classes of medications used to treat IBD are antimicrobials, corticosteroids, aminosalicylates,
biological and targeted therapy, and immunosuppressants. Medications are chosen based on the location and
severity of inflammation. Depending on the severity of the disease, clients are treated with either a "step-up" or
"step-down" approach. The step-up approach uses less toxic therapies (e.g., aminosalicylates and
antimicrobials) first, and more toxic medications (e.g., biological and targeted therapy) are started when initial
therapies do not work. The step-down approach uses biological and targeted therapy first. Option 1,
antidiarrheals, is incorrect. Although an antidiarrheal may be used to treat the symptoms of IBD, it does not treat
the disease (the inflammation) or induce remission. In addition, antidiarrheals should be used cautiously in IBD
because of the danger of toxic megacolon (colonic dilation greater than 5 cm).
During a home care visit, an adult client complains of chronic constipation. What should the nurse tell the client
to do?
P 4
