1|Page
NUR 242 EXAM 3 – 2026/2027 MEDICAL-
SURGICAL NURSING II: COMPLEX CARE 300
QUESTIONS | ANSWERS & RATIONALES | A+
GRADE
## Table of Contents
| Section | Topic | Questions |
|---------|------------------------------|-----------|
| 1 | Gastrointestinal Disorders (Bleeding, Obstruction, Pancreatitis) | 1–
45 |
| 2 | Hepatic & Biliary Disorders (Cirrhosis, Hepatitis, Cholecystitis) |
46–90 |
| 3 | Renal Disorders (AKI, CKD, Dialysis) | 91–135 |
| 4 | Endocrine Disorders (Diabetes, Thyroid, Adrenal) | 136–180 |
| 5 | Hematologic Disorders (Anemia, DIC, Sickle Cell) | 181–215 |
| 6 | Oncologic Emergencies (TLS, SIADH, Hypercalcemia) | 216–250 |
| 7 | Immunologic Disorders (Lupus, HIV, Organ Transplant) | 251–280 |
| 8 | Burns & Wound Care | 281–300 |
---
,2|Page
## Section 1: Gastrointestinal Disorders (Bleeding, Obstruction,
Pancreatitis)
**Questions 1–45**
**1.** A patient presents with hematemesis, melena, and hypotension.
Which intervention is priority?
A) NG tube placement
B) IV access and fluid resuscitation
C) Proton pump inhibitor
D) Endoscopy
**Answer: B** – ABCs first: restore intravascular volume.
**2.** Which finding is most concerning for esophageal variceal
hemorrhage?
A) Hematemesis
B) Melena
C) Hypotension with tachycardia
D) All of the above
**Answer: D** – Variceal bleed is life-threatening.
**3.** A patient with cirrhosis and hematemesis receives octreotide.
What is the mechanism?
A) Vasoconstriction of splanchnic vessels
,3|Page
B) Platelet aggregation
C) Gastric acid reduction
D) Clot stabilization
**Answer: A** – Octreotide reduces portal pressure.
**4.** Which medication is used for acute variceal hemorrhage after
resuscitation?
A) Propranolol
B) Octreotide
C) Spironolactone
D) Lactulose
**Answer: B** – Octreotide is first-line pharmacotherapy.
**5.** A patient with acute pancreatitis has lipase 1200 U/L, glucose
180, and calcium 7.5 mg/dL. Which finding indicates severe
pancreatitis?
A) Lipase level
B) Hypocalcemia
C) Hyperglycemia
D) All of the above
**Answer: B** – Hypocalcemia indicates fat saponification (poor
prognosis).
, 4|Page
**6.** Which scoring system predicts mortality in acute pancreatitis?
A) Ranson criteria
B) Child-Pugh score
C) MELD score
D) Glasgow coma scale
**Answer: A** – Ranson criteria at 48 hours.
**7.** A patient with acute pancreatitis develops abdominal distension,
fever, and hypotension. Most likely complication?
A) Pseudocyst
B) Infected necrosis
C) Splenic vein thrombosis
D) Pleural effusion
**Answer: B** – Infected necrosis requires antibiotics and possible
debridement.
**8.** Which intervention is most important in acute pancreatitis?
A) IV fluids
B) Pain control
C) NPO status
D) Antibiotics
**Answer: A** – Aggressive fluid resuscitation prevents pancreatic
necrosis.
NUR 242 EXAM 3 – 2026/2027 MEDICAL-
SURGICAL NURSING II: COMPLEX CARE 300
QUESTIONS | ANSWERS & RATIONALES | A+
GRADE
## Table of Contents
| Section | Topic | Questions |
|---------|------------------------------|-----------|
| 1 | Gastrointestinal Disorders (Bleeding, Obstruction, Pancreatitis) | 1–
45 |
| 2 | Hepatic & Biliary Disorders (Cirrhosis, Hepatitis, Cholecystitis) |
46–90 |
| 3 | Renal Disorders (AKI, CKD, Dialysis) | 91–135 |
| 4 | Endocrine Disorders (Diabetes, Thyroid, Adrenal) | 136–180 |
| 5 | Hematologic Disorders (Anemia, DIC, Sickle Cell) | 181–215 |
| 6 | Oncologic Emergencies (TLS, SIADH, Hypercalcemia) | 216–250 |
| 7 | Immunologic Disorders (Lupus, HIV, Organ Transplant) | 251–280 |
| 8 | Burns & Wound Care | 281–300 |
---
,2|Page
## Section 1: Gastrointestinal Disorders (Bleeding, Obstruction,
Pancreatitis)
**Questions 1–45**
**1.** A patient presents with hematemesis, melena, and hypotension.
Which intervention is priority?
A) NG tube placement
B) IV access and fluid resuscitation
C) Proton pump inhibitor
D) Endoscopy
**Answer: B** – ABCs first: restore intravascular volume.
**2.** Which finding is most concerning for esophageal variceal
hemorrhage?
A) Hematemesis
B) Melena
C) Hypotension with tachycardia
D) All of the above
**Answer: D** – Variceal bleed is life-threatening.
**3.** A patient with cirrhosis and hematemesis receives octreotide.
What is the mechanism?
A) Vasoconstriction of splanchnic vessels
,3|Page
B) Platelet aggregation
C) Gastric acid reduction
D) Clot stabilization
**Answer: A** – Octreotide reduces portal pressure.
**4.** Which medication is used for acute variceal hemorrhage after
resuscitation?
A) Propranolol
B) Octreotide
C) Spironolactone
D) Lactulose
**Answer: B** – Octreotide is first-line pharmacotherapy.
**5.** A patient with acute pancreatitis has lipase 1200 U/L, glucose
180, and calcium 7.5 mg/dL. Which finding indicates severe
pancreatitis?
A) Lipase level
B) Hypocalcemia
C) Hyperglycemia
D) All of the above
**Answer: B** – Hypocalcemia indicates fat saponification (poor
prognosis).
, 4|Page
**6.** Which scoring system predicts mortality in acute pancreatitis?
A) Ranson criteria
B) Child-Pugh score
C) MELD score
D) Glasgow coma scale
**Answer: A** – Ranson criteria at 48 hours.
**7.** A patient with acute pancreatitis develops abdominal distension,
fever, and hypotension. Most likely complication?
A) Pseudocyst
B) Infected necrosis
C) Splenic vein thrombosis
D) Pleural effusion
**Answer: B** – Infected necrosis requires antibiotics and possible
debridement.
**8.** Which intervention is most important in acute pancreatitis?
A) IV fluids
B) Pain control
C) NPO status
D) Antibiotics
**Answer: A** – Aggressive fluid resuscitation prevents pancreatic
necrosis.
