NUR 417 COMPREHENSIVE EXAMS 2 AND
FINAL EXAM 2026
◉ Which assessment would the nurse perform first for a patient
who just vomited bright red blood?
1. Measuring the quantity of emesis
2. Palpating the abdomen for distention
3. Auscultating the chest for breath sounds
4. Taking the blood pressure (BP) and pulse. Answer: 4. Taking the
blood pressure (BP) and pulse
The nurse is concerned about blood loss and possible hypovolemic
shock in a patient with acute gastrointestinal bleeding. BP and pulse
are the best indicators of these complications. The other information
is important to obtain, but BP and pulse rate are the best indicators
for assessing intravascular volume.
◉ Which prescribed action will the nurse implement first for a
patient who has vomited 1100 mL of blood?
1. Give an IV H2 receptor antagonist.
2. Draw blood for type and crossmatch.
,3. Administer 1 L of lactated Ringer's solution.
4. Insert a nasogastric (NG) tube and connect to suction.. Answer: 3.
Administer 1 L of lactated Ringer's solution.
Because the patient has vomited a large amount of blood, correction
of hypovolemia and prevention of hypovolemic shock are the
priorities. The other actions also are important to implement quickly
but are not the highest priorities.
◉ The nurse is administering IV fluid boluses and nasogastric
irrigation to a patient with acute gastrointestinal (GI) bleeding.
Which assessment finding is most important for the nurse to
communicate to the health care provider?
1. The bowel sounds are hyperactive in all four quadrants.
2. The patient's lungs have crackles audible to the midchest.
3. The nasogastric (NG) suction is returning coffee-ground material.
4. The patient's blood pressure (BP) has increased to 142/84 mm
Hg.. Answer: 2. The patient's lungs have crackles audible to the
midchest.
The patient's lung sounds indicate that pulmonary edema may be
developing because of the rapid infusion of IV fluid and that the fluid
infusion rate would be slowed. The return of coffee-ground material
in an NG tube is expected for a patient with upper GI bleeding. The
,BP is slightly elevated but would not be an indication to contact the
health care provider immediately. Hyperactive bowel sounds are
common when a patient has GI bleeding.
◉ An 80-yr-old patient who is hospitalized with peptic ulcer disease
develops new-onset auditory hallucinations. Which prescribed
medication will the nurse discuss with the health care provider
before administration?
1. Sucralfate (Carafate)
2. Aluminum hydroxide
3. Omeprazole (Prilosec)
4. Metoclopramide (Reglan). Answer: 4. Metoclopramide (Reglan)
Metoclopramide can cause central nervous system side effects
ranging from anxiety to hallucinations. Hallucinations are not a side
effect of proton pump inhibitors, mucosal protectants, or antacids.
◉ After change-of-shift report, which patient would the nurse assess
first?
1. A 42-yr-old patient who has acute gastritis and ongoing epigastric
pain
, 2. A 70-yr-old patient with a hiatal hernia who experiences frequent
heartburn
3. A 60-yr-old patient with nausea and vomiting who is lethargic
with dry mucosa
4. A 53-yr-old patient who has dumping syndrome after a recent
partial gastrectomy. Answer: 3. A 60-yr-old patient with nausea and
vomiting who is lethargic with dry mucosa
A patient with nausea and vomiting who is lethargic with dry
mucosa is at high risk for problems such as aspiration, dehydration,
and fluid and electrolyte disturbances. The other patients will also
need to be assessed, but the information about them indicates
symptoms that are typical for their diagnoses and are not life
threatening.
◉ A patient reports gas pains and abdominal distention 2 days after
a small bowel resection. Which action would the nurse take?
1. Administer morphine sulfate.
2. Encourage the patient to ambulate.
3. Offer the prescribed promethazine.
4. Instill a mineral oil retention enema.. Answer: 2. Encourage the
patient to ambulate.
FINAL EXAM 2026
◉ Which assessment would the nurse perform first for a patient
who just vomited bright red blood?
1. Measuring the quantity of emesis
2. Palpating the abdomen for distention
3. Auscultating the chest for breath sounds
4. Taking the blood pressure (BP) and pulse. Answer: 4. Taking the
blood pressure (BP) and pulse
The nurse is concerned about blood loss and possible hypovolemic
shock in a patient with acute gastrointestinal bleeding. BP and pulse
are the best indicators of these complications. The other information
is important to obtain, but BP and pulse rate are the best indicators
for assessing intravascular volume.
◉ Which prescribed action will the nurse implement first for a
patient who has vomited 1100 mL of blood?
1. Give an IV H2 receptor antagonist.
2. Draw blood for type and crossmatch.
,3. Administer 1 L of lactated Ringer's solution.
4. Insert a nasogastric (NG) tube and connect to suction.. Answer: 3.
Administer 1 L of lactated Ringer's solution.
Because the patient has vomited a large amount of blood, correction
of hypovolemia and prevention of hypovolemic shock are the
priorities. The other actions also are important to implement quickly
but are not the highest priorities.
◉ The nurse is administering IV fluid boluses and nasogastric
irrigation to a patient with acute gastrointestinal (GI) bleeding.
Which assessment finding is most important for the nurse to
communicate to the health care provider?
1. The bowel sounds are hyperactive in all four quadrants.
2. The patient's lungs have crackles audible to the midchest.
3. The nasogastric (NG) suction is returning coffee-ground material.
4. The patient's blood pressure (BP) has increased to 142/84 mm
Hg.. Answer: 2. The patient's lungs have crackles audible to the
midchest.
The patient's lung sounds indicate that pulmonary edema may be
developing because of the rapid infusion of IV fluid and that the fluid
infusion rate would be slowed. The return of coffee-ground material
in an NG tube is expected for a patient with upper GI bleeding. The
,BP is slightly elevated but would not be an indication to contact the
health care provider immediately. Hyperactive bowel sounds are
common when a patient has GI bleeding.
◉ An 80-yr-old patient who is hospitalized with peptic ulcer disease
develops new-onset auditory hallucinations. Which prescribed
medication will the nurse discuss with the health care provider
before administration?
1. Sucralfate (Carafate)
2. Aluminum hydroxide
3. Omeprazole (Prilosec)
4. Metoclopramide (Reglan). Answer: 4. Metoclopramide (Reglan)
Metoclopramide can cause central nervous system side effects
ranging from anxiety to hallucinations. Hallucinations are not a side
effect of proton pump inhibitors, mucosal protectants, or antacids.
◉ After change-of-shift report, which patient would the nurse assess
first?
1. A 42-yr-old patient who has acute gastritis and ongoing epigastric
pain
, 2. A 70-yr-old patient with a hiatal hernia who experiences frequent
heartburn
3. A 60-yr-old patient with nausea and vomiting who is lethargic
with dry mucosa
4. A 53-yr-old patient who has dumping syndrome after a recent
partial gastrectomy. Answer: 3. A 60-yr-old patient with nausea and
vomiting who is lethargic with dry mucosa
A patient with nausea and vomiting who is lethargic with dry
mucosa is at high risk for problems such as aspiration, dehydration,
and fluid and electrolyte disturbances. The other patients will also
need to be assessed, but the information about them indicates
symptoms that are typical for their diagnoses and are not life
threatening.
◉ A patient reports gas pains and abdominal distention 2 days after
a small bowel resection. Which action would the nurse take?
1. Administer morphine sulfate.
2. Encourage the patient to ambulate.
3. Offer the prescribed promethazine.
4. Instill a mineral oil retention enema.. Answer: 2. Encourage the
patient to ambulate.
