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NUR170 / NUR 170 Exam 4: Concepts of
Medical-Surgical Nursing Study Guide
(Latest 2026–2027) Questions & Answers
Actual Elaborations Grade A – Galen College
Subject: Medical-Surgical Nursing (Gastrointestinal, Integumentary, and
Urinary Systems)
Source: Galen College of Nursing - NUR170 / NUR 170 Exam 4
Format: Q&A Fact List and Study Guide
1. What are the symptoms for GERD or a Hiatal Hernia?
A. Heartburn
B. Indigestion
C. Pain
D. Nausea & Vomiting
Correct Answer: A, B, C, D
Rationale:
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1. Gastroesophageal reflux disease (GERD) and hiatal hernias both
involve the backflow of stomach contents into the esophagus.
2. Heartburn (pyrosis) is the classic symptom caused by acid irritating
the esophageal mucosa.
3. Indigestion (dyspepsia), epigastric or chest pain, and
nausea/vomiting are common due to impaired gastric emptying and
esophageal irritation.
2. What are ways to manage the symptoms of GERD or a Hiatal
Hernia?
A. Lifestyle changes (diet = Low residue or bland)
B. Nutrition modifications
C. Medications
Correct Answer: A, B, C
Rationale:
1. Management focuses on reducing acid production, improving
esophageal clearance, and preventing reflux.
2. Lifestyle/Dietary changes (e.g., low-fat, avoiding trigger foods, not
lying down after meals) reduce intra-abdominal pressure and acid
secretion.
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3. Nutritional counseling helps maintain a healthy weight, reducing
pressure on the gastroesophageal junction.
4. Medications like antacids, H2 blockers, and proton pump inhibitors
are used to neutralize or reduce gastric acid.
3. Which patients are at risk for GERD?
A. Obese individuals
B. Older adults
C. Pregnant women
D. Those wearing tight clothing
Correct Answer: A, B, C, D
Rationale:
1. Obesity increases intra-abdominal pressure, forcing stomach
contents upward.
2. Older adults experience decreased lower esophageal sphincter (LES)
tone and slowed gastric emptying.
3. Pregnancy causes hormonal changes that relax the LES and increased
abdominal pressure from the growing uterus.
4. Tight clothing physically increases intra-abdominal pressure,
promoting reflux.
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4. Patients with GERD are at risk for what?
A. Aspiration
Correct Answer: A. Aspiration
Rationale:
1. The primary mechanism of GERD is the regurgitation of gastric
contents into the esophagus.
2. If reflux is severe or occurs during sleep, these contents can be
inhaled into the lungs.
3. Aspiration of acidic stomach contents can cause chemical
pneumonitis, aspiration pneumonia, and bronchospasm.
5. Can a patient have GERD and not have a hernia?
A. Yes
Correct Answer: A. Yes
Rationale:
1. GERD is caused by a dysfunctional lower esophageal sphincter (LES)
and impaired esophageal motility.
2. A hiatal hernia (protrusion of the stomach into the chest) worsens
GERD but is not required for its diagnosis.
3. Many patients have symptomatic GERD due to LES incompetence
alone, without an anatomical hernia.
NUR170 / NUR 170 Exam 4: Concepts of
Medical-Surgical Nursing Study Guide
(Latest 2026–2027) Questions & Answers
Actual Elaborations Grade A – Galen College
Subject: Medical-Surgical Nursing (Gastrointestinal, Integumentary, and
Urinary Systems)
Source: Galen College of Nursing - NUR170 / NUR 170 Exam 4
Format: Q&A Fact List and Study Guide
1. What are the symptoms for GERD or a Hiatal Hernia?
A. Heartburn
B. Indigestion
C. Pain
D. Nausea & Vomiting
Correct Answer: A, B, C, D
Rationale:
, 2|Page
1. Gastroesophageal reflux disease (GERD) and hiatal hernias both
involve the backflow of stomach contents into the esophagus.
2. Heartburn (pyrosis) is the classic symptom caused by acid irritating
the esophageal mucosa.
3. Indigestion (dyspepsia), epigastric or chest pain, and
nausea/vomiting are common due to impaired gastric emptying and
esophageal irritation.
2. What are ways to manage the symptoms of GERD or a Hiatal
Hernia?
A. Lifestyle changes (diet = Low residue or bland)
B. Nutrition modifications
C. Medications
Correct Answer: A, B, C
Rationale:
1. Management focuses on reducing acid production, improving
esophageal clearance, and preventing reflux.
2. Lifestyle/Dietary changes (e.g., low-fat, avoiding trigger foods, not
lying down after meals) reduce intra-abdominal pressure and acid
secretion.
, 3|Page
3. Nutritional counseling helps maintain a healthy weight, reducing
pressure on the gastroesophageal junction.
4. Medications like antacids, H2 blockers, and proton pump inhibitors
are used to neutralize or reduce gastric acid.
3. Which patients are at risk for GERD?
A. Obese individuals
B. Older adults
C. Pregnant women
D. Those wearing tight clothing
Correct Answer: A, B, C, D
Rationale:
1. Obesity increases intra-abdominal pressure, forcing stomach
contents upward.
2. Older adults experience decreased lower esophageal sphincter (LES)
tone and slowed gastric emptying.
3. Pregnancy causes hormonal changes that relax the LES and increased
abdominal pressure from the growing uterus.
4. Tight clothing physically increases intra-abdominal pressure,
promoting reflux.
, 4|Page
4. Patients with GERD are at risk for what?
A. Aspiration
Correct Answer: A. Aspiration
Rationale:
1. The primary mechanism of GERD is the regurgitation of gastric
contents into the esophagus.
2. If reflux is severe or occurs during sleep, these contents can be
inhaled into the lungs.
3. Aspiration of acidic stomach contents can cause chemical
pneumonitis, aspiration pneumonia, and bronchospasm.
5. Can a patient have GERD and not have a hernia?
A. Yes
Correct Answer: A. Yes
Rationale:
1. GERD is caused by a dysfunctional lower esophageal sphincter (LES)
and impaired esophageal motility.
2. A hiatal hernia (protrusion of the stomach into the chest) worsens
GERD but is not required for its diagnosis.
3. Many patients have symptomatic GERD due to LES incompetence
alone, without an anatomical hernia.
