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NUR 170 EXAM 4 VERSION A — MEDICAL-
SURGICAL NURSING CONCEPTS QUESTIONS
WITH VERIFIED SOLUTIONS AND
RATIONALES
1. The nurse is assessing a client with gastroenteritis. Which finding is most
concerning and requires immediate intervention?
A. Nausea and vomiting for 12 hours
B. Dry mucous membranes and tachycardia
C. Three loose stools in the past 24 hours
D. Abdominal cramping relieved by defecation
Correct Answer: B
Rationale: Dry mucous membranes and tachycardia indicate dehydration, a
serious complication of gastroenteritis. While nausea, vomiting, and diarrhea are
expected, signs of hypovolemia require prompt rehydration to prevent electrolyte
imbalances and shock .
2. A client with Crohn's disease is at risk for which serious complication?
A. Toxic megacolon
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B. Fistula formation
C. Hemorrhoids
D. Gastric ulcers
Correct Answer: B
Rationale: Crohn's disease causes transmural inflammation that can lead to fistula
formation between loops of bowel or to other organs. Toxic megacolon is more
commonly associated with ulcerative colitis .
3. The nurse is teaching a client with ulcerative colitis about dietary modifications.
Which statement indicates correct understanding?
A. "I should eat a high-fiber diet during flare-ups."
B. "I need to increase my intake of raw vegetables."
C. "I should avoid caffeine and spicy foods."
D. "I can eat anything as long as I take my medications."
Correct Answer: C
Rationale: Clients with ulcerative colitis should avoid caffeine and spicy foods that
can irritate the inflamed bowel. During flare-ups, a low-fiber diet is often
recommended to reduce irritation .
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4. A client with irritable bowel syndrome (IBS) reports that symptoms rarely occur
at night. This finding is most consistent with which condition?
A. Crohn's disease
B. Ulcerative colitis
C. Irritable bowel syndrome
D. Gastroenteritis
Correct Answer: C
Rationale: IBS symptoms rarely occur at night, which is a distinguishing feature
from inflammatory bowel diseases like Crohn's and ulcerative colitis that can
cause nocturnal symptoms .
5. The nurse is caring for a client who had a gastrectomy. Which complication
should the nurse monitor for?
A. Dumping syndrome
B. Toxic megacolon
C. Fistula formation
D. Steatorrhea
Correct Answer: A
Rationale: Dumping syndrome occurs when food moves too quickly from the
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stomach into the small intestine after gastrectomy, causing symptoms such as
vertigo, tachycardia, syncope, sweating, and palpitations within 30 minutes of
eating .
6. A client with gastroesophageal reflux disease (GERD) asks about lifestyle
changes. Which instruction is appropriate?
A. "Lie down immediately after eating."
B. "Eat large meals three times per day."
C. "Avoid eating 2-3 hours before bedtime."
D. "Increase your caffeine intake to improve digestion."
Correct Answer: C
Rationale: Clients with GERD should avoid eating 2-3 hours before bedtime to
reduce reflux. They should also eat smaller meals and avoid trigger foods like
caffeine .
7. The nurse is preparing to administer diphenoxylate with atropine to a client
with gastroenteritis. Which assessment finding would cause the nurse to question
this order?
A. The client is 78 years old
NUR 170 EXAM 4 VERSION A — MEDICAL-
SURGICAL NURSING CONCEPTS QUESTIONS
WITH VERIFIED SOLUTIONS AND
RATIONALES
1. The nurse is assessing a client with gastroenteritis. Which finding is most
concerning and requires immediate intervention?
A. Nausea and vomiting for 12 hours
B. Dry mucous membranes and tachycardia
C. Three loose stools in the past 24 hours
D. Abdominal cramping relieved by defecation
Correct Answer: B
Rationale: Dry mucous membranes and tachycardia indicate dehydration, a
serious complication of gastroenteritis. While nausea, vomiting, and diarrhea are
expected, signs of hypovolemia require prompt rehydration to prevent electrolyte
imbalances and shock .
2. A client with Crohn's disease is at risk for which serious complication?
A. Toxic megacolon
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B. Fistula formation
C. Hemorrhoids
D. Gastric ulcers
Correct Answer: B
Rationale: Crohn's disease causes transmural inflammation that can lead to fistula
formation between loops of bowel or to other organs. Toxic megacolon is more
commonly associated with ulcerative colitis .
3. The nurse is teaching a client with ulcerative colitis about dietary modifications.
Which statement indicates correct understanding?
A. "I should eat a high-fiber diet during flare-ups."
B. "I need to increase my intake of raw vegetables."
C. "I should avoid caffeine and spicy foods."
D. "I can eat anything as long as I take my medications."
Correct Answer: C
Rationale: Clients with ulcerative colitis should avoid caffeine and spicy foods that
can irritate the inflamed bowel. During flare-ups, a low-fiber diet is often
recommended to reduce irritation .
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4. A client with irritable bowel syndrome (IBS) reports that symptoms rarely occur
at night. This finding is most consistent with which condition?
A. Crohn's disease
B. Ulcerative colitis
C. Irritable bowel syndrome
D. Gastroenteritis
Correct Answer: C
Rationale: IBS symptoms rarely occur at night, which is a distinguishing feature
from inflammatory bowel diseases like Crohn's and ulcerative colitis that can
cause nocturnal symptoms .
5. The nurse is caring for a client who had a gastrectomy. Which complication
should the nurse monitor for?
A. Dumping syndrome
B. Toxic megacolon
C. Fistula formation
D. Steatorrhea
Correct Answer: A
Rationale: Dumping syndrome occurs when food moves too quickly from the
, 4|Page
stomach into the small intestine after gastrectomy, causing symptoms such as
vertigo, tachycardia, syncope, sweating, and palpitations within 30 minutes of
eating .
6. A client with gastroesophageal reflux disease (GERD) asks about lifestyle
changes. Which instruction is appropriate?
A. "Lie down immediately after eating."
B. "Eat large meals three times per day."
C. "Avoid eating 2-3 hours before bedtime."
D. "Increase your caffeine intake to improve digestion."
Correct Answer: C
Rationale: Clients with GERD should avoid eating 2-3 hours before bedtime to
reduce reflux. They should also eat smaller meals and avoid trigger foods like
caffeine .
7. The nurse is preparing to administer diphenoxylate with atropine to a client
with gastroenteritis. Which assessment finding would cause the nurse to question
this order?
A. The client is 78 years old
