NU 185:Exam 3 NCLEX style questions
A nurse is teaching a client newly diagnosed with chronic gastritis. Which of the following
statements indicates a need for further teaching?
A. "I will avoid drinking alcohol."
B. "I should take NSAIDs regularly for my joint pain."
C. "I will quit smoking."
D. "I will follow up with my provider about my H. pylori test."
Answer:
Rationale:
NSAIDs (like ibuprofen) are a major irritant to the gastric lining and a common cause of both
acute and chronic gastritis. Clients with chronic gastritis should avoid regular NSAID use.
The other choices reflect appropriate understanding and management.
Which statement made by a client with GERD indicates correct understanding of discharge
teaching?
A. "I'll lie down right after eating to help with digestion."
B. "I will eat small meals throughout the day."
C. "I should avoid elevating the head of my bed."
D. "Spicy foods help reduce acid production."
Answer:
Rationale:
Small, frequent meals reduce gastric pressure and acid reflux. Lying down after meals and
spicy foods worsen GERD. The head of the bed should be elevated 6-8 inches to reduce
nighttime reflux.
A client with a history of peptic ulcer disease presents with a rigid abdomen and severe pain.
Which action should the nurse take first?
A. Administer prescribed pain medication
B. Notify the healthcare provider
,C. Check the client's last stool for occult blood
D. Place the client in a high Fowler's position
Answer:
Rationale:
A rigid abdomen indicates possible perforation — a life-threatening complication of PUD.
This is a medical emergency, and the provider should be notified immediately. Pain meds
may mask symptoms and delay intervention.
A client diagnosed with H. pylori infection is prescribed triple therapy. Which combination
of medications would the nurse expect to administer?
A. A PPI, a laxative, and an antacid
B. A PPI, amoxicillin, and clarithromycin
C. An H2 blocker, bismuth, and prednisone
D. A PPI, sucralfate, and ibuprofen
Answer:
Rationale:
Triple therapy for H. pylori typically includes:
• A proton pump inhibitor (PPI) like omeprazole
• Amoxicillin
• Clarithromycin
This combination eradicates the bacteria and reduces acid to promote healing. The other
options are incorrect or harmful (e.g., ibuprofen can worsen ulcers).
A 5-week-old infant presents with projectile vomiting after feeds and signs of dehydration.
Which finding would the nurse expect during assessment?
A. Decreased bowel sounds
B. Olive-shaped mass in the right upper quadrant
C. Hyperactive reflexes
D. Cyanosis around the lips
Answer:
Rationale:
Pyloric stenosis causes hypertrophy of the pylorus, leading to an olive-shaped mass and
,projectile vomiting. Dehydration, visible peristalsis, and metabolic alkalosis are also common.
Cyanosis and reflex changes are not typical findings.
A nurse is caring for a newborn with a cleft palate. Which intervention is most important to
prevent complications during feeding?
A. Use a standard bottle and nipple
B. Feed in the supine position
C. Burp the infant frequently during feeds
D. Encourage breastfeeding as the only option
Answer: C
Rationale:
Infants with cleft palate swallow excess air during feeds due to poor suction. Frequent
burping helps prevent aspiration and abdominal distention. Standard bottles and supine
positions increase risk; special feeders and upright positioning are preferred. Breastfeeding
may not always be effective due to suction difficulty.
A client is admitted with acute gastritis after ingesting an unknown household cleaner.
Which medical order should the nurse question?
A. Administer IV fluids and monitor electrolytes
B. Insert a nasogastric tube for gastric lavage
C. Keep the client NPO
D. Administer a neutralizing agent as ordered
Answer:
Rationale:
Gastric lavage is contraindicated in caustic ingestions (acid or alkali cleaners) because it can
lead to perforation or cause further esophageal injury. All other options are part of
appropriate supportive care.
A client with chronic gastritis becomes tearful and states, "I'm scared this will never get
better." What is the nurse's best response?
A. "You shouldn't worry; many people have this."
B. "Let's talk more about what's worrying you."
, C. "You'll feel better once you take your medication."
D. "You have to reduce your stress or you'll make it worse."
Answer:
Rationale:
This response uses therapeutic communication to acknowledge and explore the client's
anxiety. The other options are dismissive or judgmental and do not address the emotional
need directly.
A nurse is developing a care plan for a client with chronic gastritis. Which of the following
interventions should be included to address imbalanced nutrition?
A. Encourage three large meals daily
B. Recommend avoiding bland foods
C. Provide small, frequent meals
D. Suggest caffeinated beverages to stimulate appetite
Answer: C
Rationale:
Clients with chronic gastritis often experience early satiety, nausea, and anorexia. Small,
frequent meals improve tolerance and nutritional intake. Caffeine, large meals, and spicy
foods can exacerbate symptoms.
The nurse is reviewing medication orders for a client with chronic gastritis. Which of the
following medications would the nurse question?
A. Omeprazole
B. Sucralfate
C. Ibuprofen
D. Ranitidine
Answer: C
Rationale:
NSAIDs like ibuprofen irritate the gastric mucosa and are contraindicated in chronic gastritis.
Omeprazole (PPI), ranitidine (H2 blocker), and sucralfate (mucosal barrier) are appropriate.
A client with acute gastritis reports vomiting for 12 hours and shows signs of dry mucous
membranes and poor skin turgor. Which intervention takes priority?
A nurse is teaching a client newly diagnosed with chronic gastritis. Which of the following
statements indicates a need for further teaching?
A. "I will avoid drinking alcohol."
B. "I should take NSAIDs regularly for my joint pain."
C. "I will quit smoking."
D. "I will follow up with my provider about my H. pylori test."
Answer:
Rationale:
NSAIDs (like ibuprofen) are a major irritant to the gastric lining and a common cause of both
acute and chronic gastritis. Clients with chronic gastritis should avoid regular NSAID use.
The other choices reflect appropriate understanding and management.
Which statement made by a client with GERD indicates correct understanding of discharge
teaching?
A. "I'll lie down right after eating to help with digestion."
B. "I will eat small meals throughout the day."
C. "I should avoid elevating the head of my bed."
D. "Spicy foods help reduce acid production."
Answer:
Rationale:
Small, frequent meals reduce gastric pressure and acid reflux. Lying down after meals and
spicy foods worsen GERD. The head of the bed should be elevated 6-8 inches to reduce
nighttime reflux.
A client with a history of peptic ulcer disease presents with a rigid abdomen and severe pain.
Which action should the nurse take first?
A. Administer prescribed pain medication
B. Notify the healthcare provider
,C. Check the client's last stool for occult blood
D. Place the client in a high Fowler's position
Answer:
Rationale:
A rigid abdomen indicates possible perforation — a life-threatening complication of PUD.
This is a medical emergency, and the provider should be notified immediately. Pain meds
may mask symptoms and delay intervention.
A client diagnosed with H. pylori infection is prescribed triple therapy. Which combination
of medications would the nurse expect to administer?
A. A PPI, a laxative, and an antacid
B. A PPI, amoxicillin, and clarithromycin
C. An H2 blocker, bismuth, and prednisone
D. A PPI, sucralfate, and ibuprofen
Answer:
Rationale:
Triple therapy for H. pylori typically includes:
• A proton pump inhibitor (PPI) like omeprazole
• Amoxicillin
• Clarithromycin
This combination eradicates the bacteria and reduces acid to promote healing. The other
options are incorrect or harmful (e.g., ibuprofen can worsen ulcers).
A 5-week-old infant presents with projectile vomiting after feeds and signs of dehydration.
Which finding would the nurse expect during assessment?
A. Decreased bowel sounds
B. Olive-shaped mass in the right upper quadrant
C. Hyperactive reflexes
D. Cyanosis around the lips
Answer:
Rationale:
Pyloric stenosis causes hypertrophy of the pylorus, leading to an olive-shaped mass and
,projectile vomiting. Dehydration, visible peristalsis, and metabolic alkalosis are also common.
Cyanosis and reflex changes are not typical findings.
A nurse is caring for a newborn with a cleft palate. Which intervention is most important to
prevent complications during feeding?
A. Use a standard bottle and nipple
B. Feed in the supine position
C. Burp the infant frequently during feeds
D. Encourage breastfeeding as the only option
Answer: C
Rationale:
Infants with cleft palate swallow excess air during feeds due to poor suction. Frequent
burping helps prevent aspiration and abdominal distention. Standard bottles and supine
positions increase risk; special feeders and upright positioning are preferred. Breastfeeding
may not always be effective due to suction difficulty.
A client is admitted with acute gastritis after ingesting an unknown household cleaner.
Which medical order should the nurse question?
A. Administer IV fluids and monitor electrolytes
B. Insert a nasogastric tube for gastric lavage
C. Keep the client NPO
D. Administer a neutralizing agent as ordered
Answer:
Rationale:
Gastric lavage is contraindicated in caustic ingestions (acid or alkali cleaners) because it can
lead to perforation or cause further esophageal injury. All other options are part of
appropriate supportive care.
A client with chronic gastritis becomes tearful and states, "I'm scared this will never get
better." What is the nurse's best response?
A. "You shouldn't worry; many people have this."
B. "Let's talk more about what's worrying you."
, C. "You'll feel better once you take your medication."
D. "You have to reduce your stress or you'll make it worse."
Answer:
Rationale:
This response uses therapeutic communication to acknowledge and explore the client's
anxiety. The other options are dismissive or judgmental and do not address the emotional
need directly.
A nurse is developing a care plan for a client with chronic gastritis. Which of the following
interventions should be included to address imbalanced nutrition?
A. Encourage three large meals daily
B. Recommend avoiding bland foods
C. Provide small, frequent meals
D. Suggest caffeinated beverages to stimulate appetite
Answer: C
Rationale:
Clients with chronic gastritis often experience early satiety, nausea, and anorexia. Small,
frequent meals improve tolerance and nutritional intake. Caffeine, large meals, and spicy
foods can exacerbate symptoms.
The nurse is reviewing medication orders for a client with chronic gastritis. Which of the
following medications would the nurse question?
A. Omeprazole
B. Sucralfate
C. Ibuprofen
D. Ranitidine
Answer: C
Rationale:
NSAIDs like ibuprofen irritate the gastric mucosa and are contraindicated in chronic gastritis.
Omeprazole (PPI), ranitidine (H2 blocker), and sucralfate (mucosal barrier) are appropriate.
A client with acute gastritis reports vomiting for 12 hours and shows signs of dry mucous
membranes and poor skin turgor. Which intervention takes priority?
