NUR176/NUR 176 Exam 4 V3 | Concepts of
Adult Health Nursing for the Practical
Nurse I Q&A with Rationale | Hondros
College of Nursing
1. A patient with Gastroesophageal Reflux Disease (GERD) asks the nurse why they should
avoid eating before bedtime. Which response by the nurse is most appropriate?
A. Eating at night increases the production of insulin, which slows down digestion.
B. Lying flat after eating allows stomach acid to reflux more easily into the esophagus.
C. Digestive enzymes are only active during daylight hours.
D. Late-night snacks cause the lower esophageal sphincter to tighten too much.
Correct Answer: B
Rationale: Lying down within three hours of eating increases intra-abdominal pressure
and allows gastric contents to flow back into the esophagus. The nurse should instruct the
patient to remain upright for at least two hours after a meal. This positioning uses gravity
to help keep the stomach acid where it belongs.
2. Which clinical manifestation should the nurse prioritize when assessing a patient suspected
of having an acute intestinal obstruction?
A. Increased appetite and thirst.
B. High-pitched, tinkling bowel sounds above the obstruction.
,C. Productive cough with green sputum.
D. Lower extremity edema and redness.
Correct Answer: B
Rationale: In the early stages of a mechanical bowel obstruction, bowel sounds are often
hyperactive and high-pitched as the intestine tries to push contents past the blockage. As
the obstruction progresses, bowel sounds may become absent. Identifying these specific
sounds is critical for early diagnosis and intervention.
3. A nurse is providing discharge instructions for a patient who underwent a laparoscopic
cholecystectomy. Which dietary advice is most essential for the immediate postoperative
period?
A. Increase intake of high-fat dairy products to promote healing.
B. Avoid all carbohydrates for at least one month.
C. Adhere to a low-fat diet for several weeks to prevent indigestion.
D. Drink at least one gallon of fruit juice daily.
Correct Answer: C
Rationale: After gallbladder removal, the body must adjust to a continuous flow of bile into
the small intestine rather than stored bile. A low-fat diet helps prevent symptoms like
bloating, gas, and diarrhea during this adjustment period. Patients can gradually
reintroduce fats as tolerated over several weeks.
, 4. When caring for a patient with a newly applied plaster cast on the lower leg, which action
should the nurse take to ensure proper drying?
A. Cover the cast with a heavy wool blanket to keep it warm.
B. Use the fingertips to handle the cast while it is still damp.
C. Handle the cast with the palms of the hands only.
D. Apply a heating pad directly to the cast to speed up the process.
Correct Answer: C
Rationale: Handling a wet plaster cast with fingertips can create pressure points that lead
to skin breakdown or neurovascular compromise. Using the palms of the hands prevents
indentations while the material is setting. The cast should also remain uncovered to allow
air circulation for evaporation.
5. A patient with cirrhosis of the liver has developed hepatic encephalopathy. The nurse
expects the healthcare provider to order which medication to reduce ammonia levels?
A. Furosemide
B. Lactulose
C. Warfarin
D. Spironolactone
Correct Answer: B
Adult Health Nursing for the Practical
Nurse I Q&A with Rationale | Hondros
College of Nursing
1. A patient with Gastroesophageal Reflux Disease (GERD) asks the nurse why they should
avoid eating before bedtime. Which response by the nurse is most appropriate?
A. Eating at night increases the production of insulin, which slows down digestion.
B. Lying flat after eating allows stomach acid to reflux more easily into the esophagus.
C. Digestive enzymes are only active during daylight hours.
D. Late-night snacks cause the lower esophageal sphincter to tighten too much.
Correct Answer: B
Rationale: Lying down within three hours of eating increases intra-abdominal pressure
and allows gastric contents to flow back into the esophagus. The nurse should instruct the
patient to remain upright for at least two hours after a meal. This positioning uses gravity
to help keep the stomach acid where it belongs.
2. Which clinical manifestation should the nurse prioritize when assessing a patient suspected
of having an acute intestinal obstruction?
A. Increased appetite and thirst.
B. High-pitched, tinkling bowel sounds above the obstruction.
,C. Productive cough with green sputum.
D. Lower extremity edema and redness.
Correct Answer: B
Rationale: In the early stages of a mechanical bowel obstruction, bowel sounds are often
hyperactive and high-pitched as the intestine tries to push contents past the blockage. As
the obstruction progresses, bowel sounds may become absent. Identifying these specific
sounds is critical for early diagnosis and intervention.
3. A nurse is providing discharge instructions for a patient who underwent a laparoscopic
cholecystectomy. Which dietary advice is most essential for the immediate postoperative
period?
A. Increase intake of high-fat dairy products to promote healing.
B. Avoid all carbohydrates for at least one month.
C. Adhere to a low-fat diet for several weeks to prevent indigestion.
D. Drink at least one gallon of fruit juice daily.
Correct Answer: C
Rationale: After gallbladder removal, the body must adjust to a continuous flow of bile into
the small intestine rather than stored bile. A low-fat diet helps prevent symptoms like
bloating, gas, and diarrhea during this adjustment period. Patients can gradually
reintroduce fats as tolerated over several weeks.
, 4. When caring for a patient with a newly applied plaster cast on the lower leg, which action
should the nurse take to ensure proper drying?
A. Cover the cast with a heavy wool blanket to keep it warm.
B. Use the fingertips to handle the cast while it is still damp.
C. Handle the cast with the palms of the hands only.
D. Apply a heating pad directly to the cast to speed up the process.
Correct Answer: C
Rationale: Handling a wet plaster cast with fingertips can create pressure points that lead
to skin breakdown or neurovascular compromise. Using the palms of the hands prevents
indentations while the material is setting. The cast should also remain uncovered to allow
air circulation for evaporation.
5. A patient with cirrhosis of the liver has developed hepatic encephalopathy. The nurse
expects the healthcare provider to order which medication to reduce ammonia levels?
A. Furosemide
B. Lactulose
C. Warfarin
D. Spironolactone
Correct Answer: B
