NRSG 201 Exam 4 V1 | NRSG 201 Med Surg 1 |
Actual Q&A with Rationale (NRSG201 Exam 4) | Ivy
Tech
1. A patient with Gastroesophageal Reflux Disease (GERD) is being discharged. Which
statement by the patient indicates a need for further teaching regarding lifestyle
modifications?
A. I will wait at least 2 hours after eating before I lie down.
B. I will avoid wearing tight-fitting clothing around my waist.
C. I will drink a glass of milk right before bed to soothe my esophagus.
D. I will elevate the head of my bed using 6-inch blocks.
Correct Answer: C
Explanation: Drinking milk before bed increases gastric acid secretion and should be
avoided. Patients with GERD should avoid eating or drinking within 3 hours of bedtime.
This teaching is vital to prevent nocturnal reflux symptoms.
2. A nurse is assessing a patient with suspected Peptic Ulcer Disease (PUD). Which finding is
most characteristic of a duodenal ulcer rather than a gastric ulcer?
A. Pain occurring 30 to 60 minutes after a meal.
B. Pain that is relieved by the ingestion of food.
C. Hematemesis rather than melena.
,D. Weight loss and malnourished appearance.
Correct Answer: B
Explanation: Duodenal ulcer pain is typically relieved by food or antacids, whereas gastric
ulcer pain is often aggravated by food. This occurs because the food buffers the acid in the
duodenum. Patients with duodenal ulcers may even experience weight gain because eating
provides relief.
3. The nurse is providing discharge instructions to a patient who underwent a subtotal
gastrectomy. Which dietary instruction should the nurse include to prevent dumping
syndrome?
A. Drink at least 8 ounces of water with every meal.
B. Lie down for 30 minutes after eating a meal.
C. Eat three large, high-carbohydrate meals per day.
D. Increase intake of simple sugars and sweets.
Correct Answer: B
Explanation: Lying down after meals slows the movement of food into the small intestine,
which helps prevent dumping syndrome. Patients should also eat small, frequent meals
that are high in protein and low in carbohydrates. Avoiding fluids with meals is another key
strategy to slow gastric emptying.
, 4. A patient is admitted with suspected acute appendicitis. Which nursing action is
contraindicated for this patient?
A. Maintaining NPO status.
B. Applying a cold pack to the abdomen.
C. Administering IV fluids as ordered.
D. Applying a heating pad to the lower right quadrant.
Correct Answer: D
Explanation: Heat should never be applied to the abdomen of a patient with suspected
appendicitis because it increases circulation and can lead to rupture. If the appendix
ruptures, it can cause life-threatening peritonitis. The nurse must monitor for sudden relief
of pain, which may indicate a rupture has occurred.
5. A patient presents with a rigid, board-like abdomen, severe pain, and a fever of 102.5°F.
Which condition does the nurse suspect?
A. Peritonitis.
B. Acute cholecystitis.
C. Diverticulosis.
D. Ulcerative colitis.
Correct Answer: A
Actual Q&A with Rationale (NRSG201 Exam 4) | Ivy
Tech
1. A patient with Gastroesophageal Reflux Disease (GERD) is being discharged. Which
statement by the patient indicates a need for further teaching regarding lifestyle
modifications?
A. I will wait at least 2 hours after eating before I lie down.
B. I will avoid wearing tight-fitting clothing around my waist.
C. I will drink a glass of milk right before bed to soothe my esophagus.
D. I will elevate the head of my bed using 6-inch blocks.
Correct Answer: C
Explanation: Drinking milk before bed increases gastric acid secretion and should be
avoided. Patients with GERD should avoid eating or drinking within 3 hours of bedtime.
This teaching is vital to prevent nocturnal reflux symptoms.
2. A nurse is assessing a patient with suspected Peptic Ulcer Disease (PUD). Which finding is
most characteristic of a duodenal ulcer rather than a gastric ulcer?
A. Pain occurring 30 to 60 minutes after a meal.
B. Pain that is relieved by the ingestion of food.
C. Hematemesis rather than melena.
,D. Weight loss and malnourished appearance.
Correct Answer: B
Explanation: Duodenal ulcer pain is typically relieved by food or antacids, whereas gastric
ulcer pain is often aggravated by food. This occurs because the food buffers the acid in the
duodenum. Patients with duodenal ulcers may even experience weight gain because eating
provides relief.
3. The nurse is providing discharge instructions to a patient who underwent a subtotal
gastrectomy. Which dietary instruction should the nurse include to prevent dumping
syndrome?
A. Drink at least 8 ounces of water with every meal.
B. Lie down for 30 minutes after eating a meal.
C. Eat three large, high-carbohydrate meals per day.
D. Increase intake of simple sugars and sweets.
Correct Answer: B
Explanation: Lying down after meals slows the movement of food into the small intestine,
which helps prevent dumping syndrome. Patients should also eat small, frequent meals
that are high in protein and low in carbohydrates. Avoiding fluids with meals is another key
strategy to slow gastric emptying.
, 4. A patient is admitted with suspected acute appendicitis. Which nursing action is
contraindicated for this patient?
A. Maintaining NPO status.
B. Applying a cold pack to the abdomen.
C. Administering IV fluids as ordered.
D. Applying a heating pad to the lower right quadrant.
Correct Answer: D
Explanation: Heat should never be applied to the abdomen of a patient with suspected
appendicitis because it increases circulation and can lead to rupture. If the appendix
ruptures, it can cause life-threatening peritonitis. The nurse must monitor for sudden relief
of pain, which may indicate a rupture has occurred.
5. A patient presents with a rigid, board-like abdomen, severe pain, and a fever of 102.5°F.
Which condition does the nurse suspect?
A. Peritonitis.
B. Acute cholecystitis.
C. Diverticulosis.
D. Ulcerative colitis.
Correct Answer: A
