NUR 242 – MEDICAL-SURGICAL NURSING
EXAM 2 GALEN COLLEGE OF NURSING
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A nurse is caring for a patient with acute pancreatitis. Which laboratory value
should the nurse expect to be most elevated?
A. Alanine aminotransferase (ALT)
B. Serum amylase
C. Serum albumin
D. Total bilirubin
Correct Answer: B
Rationale: Acute pancreatitis causes pancreatic enzyme leakage into the
bloodstream, leading to elevated serum amylase (and lipase). ALT and bilirubin
may rise with biliary disease, while albumin reflects nutritional status.
Question 2
A patient with cirrhosis develops ascites. Which nursing intervention is most
appropriate to assess the effectiveness of treatment?
A. Monitor serum ammonia levels
B. Measure abdominal girth daily
C. Check bowel sounds every shift
D. Assess level of consciousness
Correct Answer: B
Rationale: Daily abdominal girth measurement provides an objective assessment
of ascites volume and response to therapy. Ammonia and LOC relate more to
hepatic encephalopathy.
,Question 3
A nurse is teaching a patient with GERD about lifestyle modifications. Which
statement indicates understanding?
A. “I will lie flat for 30 minutes after meals.”
B. “I will eat larger meals less often.”
C. “I will avoid eating late in the evening.”
D. “I will increase my intake of citrus fruits.”
Correct Answer: C
Rationale: Avoiding late evening meals reduces reflux by preventing gastric acid
exposure when lying down. Large meals, citrus foods, and lying flat worsen GERD
symptoms.
Question 4
A patient with Crohn’s disease is admitted with abdominal pain and diarrhea.
Which complication is the nurse most concerned about?
A. Iron overload
B. Bowel obstruction
C. Gastric ulceration
D. Hemorrhoids
Correct Answer: B
Rationale: Crohn’s disease causes transmural inflammation, increasing the risk for
strictures and bowel obstruction. Ulcerative colitis is more associated with
bleeding.
Question 5
Which finding is most concerning in a patient with upper gastrointestinal bleeding?
A. Black, tarry stools
B. Hemoglobin of 10 g/dL
,C. Heart rate of 124 bpm
D. Epigastric pain
Correct Answer: C
Rationale: Tachycardia indicates possible hypovolemia and impending shock.
Melena and pain are expected findings but less immediately life-threatening.
Question 6
A nurse is caring for a patient with hepatitis B. Which action is most important to
prevent transmission?
A. Use contact precautions
B. Perform strict hand hygiene
C. Avoid shared personal items
D. Place patient in a private room
Correct Answer: C
Rationale: Hepatitis B is transmitted through blood and body fluids. Avoiding
shared items such as razors and toothbrushes prevents transmission.
Question 7
A patient with peptic ulcer disease asks why proton pump inhibitors are prescribed.
The nurse explains that these medications:
A. Neutralize stomach acid
B. Protect the gastric mucosa
C. Decrease gastric acid secretion
D. Kill Helicobacter pylori
Correct Answer: C
Rationale: Proton pump inhibitors reduce gastric acid secretion by inhibiting the
proton pump in parietal cells.
, Question 8
Which assessment finding suggests a complication of gallbladder disease?
A. Right upper quadrant pain after fatty meals
B. Clay-colored stools
C. Nausea and vomiting
D. Bloating after eating
Correct Answer: B
Rationale: Clay-colored stools indicate biliary obstruction, suggesting impaired
bile flow and a more serious complication.
Question 9
A nurse is caring for a patient with an NG tube connected to suction. Which
assessment finding requires immediate intervention?
A. Greenish drainage
B. Decreased bowel sounds
C. Dry oral mucosa
D. Tube dislodgement
Correct Answer: D
Rationale: A dislodged NG tube can lead to aspiration and ineffective gastric
decompression, requiring prompt action.
Question 10
A patient with ulcerative colitis is at increased risk for which complication?
A. Small bowel obstruction
B. Colon cancer
C. Gallstones
D. Pancreatitis
EXAM 2 GALEN COLLEGE OF NURSING
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A nurse is caring for a patient with acute pancreatitis. Which laboratory value
should the nurse expect to be most elevated?
A. Alanine aminotransferase (ALT)
B. Serum amylase
C. Serum albumin
D. Total bilirubin
Correct Answer: B
Rationale: Acute pancreatitis causes pancreatic enzyme leakage into the
bloodstream, leading to elevated serum amylase (and lipase). ALT and bilirubin
may rise with biliary disease, while albumin reflects nutritional status.
Question 2
A patient with cirrhosis develops ascites. Which nursing intervention is most
appropriate to assess the effectiveness of treatment?
A. Monitor serum ammonia levels
B. Measure abdominal girth daily
C. Check bowel sounds every shift
D. Assess level of consciousness
Correct Answer: B
Rationale: Daily abdominal girth measurement provides an objective assessment
of ascites volume and response to therapy. Ammonia and LOC relate more to
hepatic encephalopathy.
,Question 3
A nurse is teaching a patient with GERD about lifestyle modifications. Which
statement indicates understanding?
A. “I will lie flat for 30 minutes after meals.”
B. “I will eat larger meals less often.”
C. “I will avoid eating late in the evening.”
D. “I will increase my intake of citrus fruits.”
Correct Answer: C
Rationale: Avoiding late evening meals reduces reflux by preventing gastric acid
exposure when lying down. Large meals, citrus foods, and lying flat worsen GERD
symptoms.
Question 4
A patient with Crohn’s disease is admitted with abdominal pain and diarrhea.
Which complication is the nurse most concerned about?
A. Iron overload
B. Bowel obstruction
C. Gastric ulceration
D. Hemorrhoids
Correct Answer: B
Rationale: Crohn’s disease causes transmural inflammation, increasing the risk for
strictures and bowel obstruction. Ulcerative colitis is more associated with
bleeding.
Question 5
Which finding is most concerning in a patient with upper gastrointestinal bleeding?
A. Black, tarry stools
B. Hemoglobin of 10 g/dL
,C. Heart rate of 124 bpm
D. Epigastric pain
Correct Answer: C
Rationale: Tachycardia indicates possible hypovolemia and impending shock.
Melena and pain are expected findings but less immediately life-threatening.
Question 6
A nurse is caring for a patient with hepatitis B. Which action is most important to
prevent transmission?
A. Use contact precautions
B. Perform strict hand hygiene
C. Avoid shared personal items
D. Place patient in a private room
Correct Answer: C
Rationale: Hepatitis B is transmitted through blood and body fluids. Avoiding
shared items such as razors and toothbrushes prevents transmission.
Question 7
A patient with peptic ulcer disease asks why proton pump inhibitors are prescribed.
The nurse explains that these medications:
A. Neutralize stomach acid
B. Protect the gastric mucosa
C. Decrease gastric acid secretion
D. Kill Helicobacter pylori
Correct Answer: C
Rationale: Proton pump inhibitors reduce gastric acid secretion by inhibiting the
proton pump in parietal cells.
, Question 8
Which assessment finding suggests a complication of gallbladder disease?
A. Right upper quadrant pain after fatty meals
B. Clay-colored stools
C. Nausea and vomiting
D. Bloating after eating
Correct Answer: B
Rationale: Clay-colored stools indicate biliary obstruction, suggesting impaired
bile flow and a more serious complication.
Question 9
A nurse is caring for a patient with an NG tube connected to suction. Which
assessment finding requires immediate intervention?
A. Greenish drainage
B. Decreased bowel sounds
C. Dry oral mucosa
D. Tube dislodgement
Correct Answer: D
Rationale: A dislodged NG tube can lead to aspiration and ineffective gastric
decompression, requiring prompt action.
Question 10
A patient with ulcerative colitis is at increased risk for which complication?
A. Small bowel obstruction
B. Colon cancer
C. Gallstones
D. Pancreatitis
