NUR 265 EXAM 1 /NUR265 ADVANCED CONCEPTS
OF MEDICAL NURSING EXAM 2025 WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED DETAILED
ANSWERS |FREQUENTLY TESTED QUESTIONS
AND SOLUTIONS |ALREADY GRADED A+|BRAND
NEW VERSION !!!|GUARANTEED PASS |LATEST
UPDATE
A patient who underwent a gastroduodenostomy (Billroth I) 12 hours ago reports increasing abdominal
pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the past
hour. Which nursing action is the highest priority?
a. Monitor drainage.
b. Contact the surgeon.
c. Irrigate the NG tube.
d. Give prescribed morphine.
ANS: B
Increased pain and 200 mL of bright red NG drainage 12 hours after surgery indicate possible
postoperative hemorrhage, and immediate actions such as blood transfusion or return to surgery are
needed (or both). Because the NG is draining, there is no indication that irrigation is needed.
Continuing to monitor the NG drainage is needed but not an adequate response to the findings. The
patient may need morphine, but this is not the highest priority action.
Which patient statement indicates that the nurse's postoperative teaching after a gastroduodenostomy
has been effective?
a. "I will drink more liquids with my meals."
b. "I should choose high carbohydrate foods."
c. "Vitamin supplements may prevent anemia."
d. "Persistent heartburn is expected after surgery."
ANS: C
Cobalamin deficiency may occur after partial gastrectomy, and the patient may need to receive
cobalamin via injections or nasal spray. Although peptic ulcer disease may recur, persistent heartburn
is not expected after surgery, and the patient should call the health care provider if this occurs.
1|Page
,Ingestion of liquids with meals is avoided to prevent dumping syndrome. Foods that have moderate
fat and low carbohydrate should be chosen to prevent dumping syndrome.
At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports
that dizziness, weakness, and palpitations occur about 20 minutes after each meal. Which action would
the nurse teach the patient to take?
a. Increase the amount of fluid with meals.
b. Eat foods that are higher in carbohydrates.
c. Lie down for about 30 minutes after eating.
d. Drink sugared fluids or eat candy after meals.
ANS: C
The patient is experiencing symptoms of dumping syndrome, which may be reduced by lying down for
a short rest after eating. Increasing fluid intake and choosing high carbohydrate foods will increase
the risk for dumping syndrome. Having a sweet drink or hard candy will correct the hypoglycemia that
is associated with dumping syndrome but will not prevent dumping syndrome.
A patient who takes a nonsteroidal antiinflammatory drug (NSAID) daily for the management of severe
rheumatoid arthritis has recently developed melena. What would the nurse anticipate teaching the
patient?
a. Substitution of acetaminophen (Tylenol) for the NSAID
b. Use of enteric-coated NSAIDs to reduce gastric irritation
c. Reasons for using corticosteroids to treat the rheumatoid arthritis
d. Misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa
ANS: D
Misoprostol, a prostaglandin analog, reduces acid secretion and the incidence of upper GI bleeding
associated with NSAID use. Enteric coating of NSAIDs does not reduce the risk for GI bleeding.
Corticosteroids increase the risk for ulcer development and will not be substituted for NSAIDs for this
patient. Acetaminophen will not be effective in treating rheumatoid arthritis.
The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic
ulcer. Which medication schedule would the nurse teach the patient?
a. Sucralfate at bedtime and antacids before each meal
b. Sucralfate and antacids together 0 minutes before meals
c. Antacids 30 minutes before each dose of sucralfate is taken
d. Antacids after meals and sucralfate 30 minutes before meals
ANS: D
Sucralfate is most effective when the pH is low and should not be given with or soon after antacids.
Antacids are most effective when taken after eating. Administration of sucralfate 30 minutes before
eating and antacids just after eating will ensure that both drugs can be most effective. The other
regimens will decrease the effectiveness of the medications.
Which information about dietary management would the nurse include when teaching a patient with
peptic ulcer disease (PUD)?
a. "You will need to remain on a bland diet."
2|Page
,b. "Avoid foods that cause pain after you eat them."
c. "High-protein foods are least likely to cause pain."
d. "You should avoid eating raw fruits and vegetables."
ANS: B
The best information is that each person should choose foods that are not associated with
postprandial discomfort. Raw fruits and vegetables may irritate the gastric mucosa but chewing well
seems to decrease this problem and some patients tolerate these healthy foods well. High-protein
foods help neutralize acid, but they also stimulate hydrochloric (HCl) acid secretion and may increase
discomfort for some patients. Bland diets may be recommended during an acute exacerbation of PUD,
but there is little evidence to support their ongoing use.
A patient is diagnosed with stomach cancer after an unintended 20-lb weight loss. Which action would
the nurse include in the plan of care?
a. Refer the patient for hospice services.
b. Infuse IV fluids through a central line.
c. Teach the patient about antiemetic therapy.
d. Offer supplemental feedings between meals.
ANS: D
The patient data indicate a poor nutritional state and improvement in nutrition will be helpful in
improving the response to therapies such as surgery, chemotherapy, or radiation. Nausea and
vomiting are not common clinical manifestations of stomach cancer. There is no indication that the
patient requires hospice or IV fluid infusions.
A patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for
developing stomach cancer. What would the nurse teach the patient to avoid?
a. Emotionally stressful situations
b. Smoked foods such as ham and bacon
c. Foods that cause distention or bloating
d. Chronic use of H2 blocking medications
ANS: B
Smoked foods such as bacon, ham, and smoked sausage increase the risk for stomach cancer. Stressful
situations, abdominal distention, and use of H2 blockers are not associated with an increased
incidence of stomach cancer.
The nurse is assessing a patient who had a total gastrectomy 8 hours ago. Which information is most
important to report to the health care provider?
a. Hemoglobin (Hgb) 10.8 g/dL
b. Temperature 102.1F (38.9C)
3|Page
, c. Absent bowel sounds in all quadrants
d. Scant nasogastric (NG) tube drainage
ANS: B
An elevation in temperature may indicate leakage at the anastomosis, which may require return to
surgery or keeping the patient NPO. The other findings are expected in the immediate postoperative
period for patients who have this surgery and do not require any urgent action.
A patient has just been admitted to the emergency department with nausea and vomiting. Which
information requires the most rapid intervention by the nurse?
a. The patient has been vomiting for 4 days.
b. The patient takes antacids 8 to 10 times a day.
c. The patient is lethargic and difficult to arouse.
d. The patient had a small intestinal resection 2 years ago.
ANS: C
A lethargic patient is at risk for aspiration, and the nurse will need to position the patient to decrease
aspiration risk. The other information is also important to collect, but it does not require as quick
action as the risk for aspiration.
A young adult has been admitted to the emergency department with nausea and vomiting. Which action
could the RN delegate to assistive personnel (AP)?
a. Auscultate the bowel sounds.
b. Assess for signs of dehydration.
c. Assist the patient with oral care.
d. Ask more questions about the nausea.
ANS: C
Oral care is included in AP education and scope of practice. The other actions are all assessments that
require more education and a higher scope of nursing practice
A patient has been admitted with hypotension and dehydration after 3 days of nausea and vomiting.
Which prescribed action will the nurse implement first?
a. Insert a nasogastric (NG) tube.
b. Infuse normal saline at 250 mL/hr.
c. Administer IV ondansetron (Zofran).
d. Provide oral care with moistened swabs.
ANS: B
Because the patient has severe dehydration, rehydration with IV fluids is the priority. The other
orders would be accomplished after the IV fluids are initiated.
Which patient would the nurse assess first after receiving change-of-shift report?
a. A patient with esophageal varices who has a rapid heart rate
b. A patient with a history of gastrointestinal bleeding who has melena
c. A patient with nausea who has a dose of metoclopramide (Reglan) due
d. A patient who is crying after receiving a diagnosis of esophageal cancer
4|Page
OF MEDICAL NURSING EXAM 2025 WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED DETAILED
ANSWERS |FREQUENTLY TESTED QUESTIONS
AND SOLUTIONS |ALREADY GRADED A+|BRAND
NEW VERSION !!!|GUARANTEED PASS |LATEST
UPDATE
A patient who underwent a gastroduodenostomy (Billroth I) 12 hours ago reports increasing abdominal
pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the past
hour. Which nursing action is the highest priority?
a. Monitor drainage.
b. Contact the surgeon.
c. Irrigate the NG tube.
d. Give prescribed morphine.
ANS: B
Increased pain and 200 mL of bright red NG drainage 12 hours after surgery indicate possible
postoperative hemorrhage, and immediate actions such as blood transfusion or return to surgery are
needed (or both). Because the NG is draining, there is no indication that irrigation is needed.
Continuing to monitor the NG drainage is needed but not an adequate response to the findings. The
patient may need morphine, but this is not the highest priority action.
Which patient statement indicates that the nurse's postoperative teaching after a gastroduodenostomy
has been effective?
a. "I will drink more liquids with my meals."
b. "I should choose high carbohydrate foods."
c. "Vitamin supplements may prevent anemia."
d. "Persistent heartburn is expected after surgery."
ANS: C
Cobalamin deficiency may occur after partial gastrectomy, and the patient may need to receive
cobalamin via injections or nasal spray. Although peptic ulcer disease may recur, persistent heartburn
is not expected after surgery, and the patient should call the health care provider if this occurs.
1|Page
,Ingestion of liquids with meals is avoided to prevent dumping syndrome. Foods that have moderate
fat and low carbohydrate should be chosen to prevent dumping syndrome.
At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports
that dizziness, weakness, and palpitations occur about 20 minutes after each meal. Which action would
the nurse teach the patient to take?
a. Increase the amount of fluid with meals.
b. Eat foods that are higher in carbohydrates.
c. Lie down for about 30 minutes after eating.
d. Drink sugared fluids or eat candy after meals.
ANS: C
The patient is experiencing symptoms of dumping syndrome, which may be reduced by lying down for
a short rest after eating. Increasing fluid intake and choosing high carbohydrate foods will increase
the risk for dumping syndrome. Having a sweet drink or hard candy will correct the hypoglycemia that
is associated with dumping syndrome but will not prevent dumping syndrome.
A patient who takes a nonsteroidal antiinflammatory drug (NSAID) daily for the management of severe
rheumatoid arthritis has recently developed melena. What would the nurse anticipate teaching the
patient?
a. Substitution of acetaminophen (Tylenol) for the NSAID
b. Use of enteric-coated NSAIDs to reduce gastric irritation
c. Reasons for using corticosteroids to treat the rheumatoid arthritis
d. Misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa
ANS: D
Misoprostol, a prostaglandin analog, reduces acid secretion and the incidence of upper GI bleeding
associated with NSAID use. Enteric coating of NSAIDs does not reduce the risk for GI bleeding.
Corticosteroids increase the risk for ulcer development and will not be substituted for NSAIDs for this
patient. Acetaminophen will not be effective in treating rheumatoid arthritis.
The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic
ulcer. Which medication schedule would the nurse teach the patient?
a. Sucralfate at bedtime and antacids before each meal
b. Sucralfate and antacids together 0 minutes before meals
c. Antacids 30 minutes before each dose of sucralfate is taken
d. Antacids after meals and sucralfate 30 minutes before meals
ANS: D
Sucralfate is most effective when the pH is low and should not be given with or soon after antacids.
Antacids are most effective when taken after eating. Administration of sucralfate 30 minutes before
eating and antacids just after eating will ensure that both drugs can be most effective. The other
regimens will decrease the effectiveness of the medications.
Which information about dietary management would the nurse include when teaching a patient with
peptic ulcer disease (PUD)?
a. "You will need to remain on a bland diet."
2|Page
,b. "Avoid foods that cause pain after you eat them."
c. "High-protein foods are least likely to cause pain."
d. "You should avoid eating raw fruits and vegetables."
ANS: B
The best information is that each person should choose foods that are not associated with
postprandial discomfort. Raw fruits and vegetables may irritate the gastric mucosa but chewing well
seems to decrease this problem and some patients tolerate these healthy foods well. High-protein
foods help neutralize acid, but they also stimulate hydrochloric (HCl) acid secretion and may increase
discomfort for some patients. Bland diets may be recommended during an acute exacerbation of PUD,
but there is little evidence to support their ongoing use.
A patient is diagnosed with stomach cancer after an unintended 20-lb weight loss. Which action would
the nurse include in the plan of care?
a. Refer the patient for hospice services.
b. Infuse IV fluids through a central line.
c. Teach the patient about antiemetic therapy.
d. Offer supplemental feedings between meals.
ANS: D
The patient data indicate a poor nutritional state and improvement in nutrition will be helpful in
improving the response to therapies such as surgery, chemotherapy, or radiation. Nausea and
vomiting are not common clinical manifestations of stomach cancer. There is no indication that the
patient requires hospice or IV fluid infusions.
A patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for
developing stomach cancer. What would the nurse teach the patient to avoid?
a. Emotionally stressful situations
b. Smoked foods such as ham and bacon
c. Foods that cause distention or bloating
d. Chronic use of H2 blocking medications
ANS: B
Smoked foods such as bacon, ham, and smoked sausage increase the risk for stomach cancer. Stressful
situations, abdominal distention, and use of H2 blockers are not associated with an increased
incidence of stomach cancer.
The nurse is assessing a patient who had a total gastrectomy 8 hours ago. Which information is most
important to report to the health care provider?
a. Hemoglobin (Hgb) 10.8 g/dL
b. Temperature 102.1F (38.9C)
3|Page
, c. Absent bowel sounds in all quadrants
d. Scant nasogastric (NG) tube drainage
ANS: B
An elevation in temperature may indicate leakage at the anastomosis, which may require return to
surgery or keeping the patient NPO. The other findings are expected in the immediate postoperative
period for patients who have this surgery and do not require any urgent action.
A patient has just been admitted to the emergency department with nausea and vomiting. Which
information requires the most rapid intervention by the nurse?
a. The patient has been vomiting for 4 days.
b. The patient takes antacids 8 to 10 times a day.
c. The patient is lethargic and difficult to arouse.
d. The patient had a small intestinal resection 2 years ago.
ANS: C
A lethargic patient is at risk for aspiration, and the nurse will need to position the patient to decrease
aspiration risk. The other information is also important to collect, but it does not require as quick
action as the risk for aspiration.
A young adult has been admitted to the emergency department with nausea and vomiting. Which action
could the RN delegate to assistive personnel (AP)?
a. Auscultate the bowel sounds.
b. Assess for signs of dehydration.
c. Assist the patient with oral care.
d. Ask more questions about the nausea.
ANS: C
Oral care is included in AP education and scope of practice. The other actions are all assessments that
require more education and a higher scope of nursing practice
A patient has been admitted with hypotension and dehydration after 3 days of nausea and vomiting.
Which prescribed action will the nurse implement first?
a. Insert a nasogastric (NG) tube.
b. Infuse normal saline at 250 mL/hr.
c. Administer IV ondansetron (Zofran).
d. Provide oral care with moistened swabs.
ANS: B
Because the patient has severe dehydration, rehydration with IV fluids is the priority. The other
orders would be accomplished after the IV fluids are initiated.
Which patient would the nurse assess first after receiving change-of-shift report?
a. A patient with esophageal varices who has a rapid heart rate
b. A patient with a history of gastrointestinal bleeding who has melena
c. A patient with nausea who has a dose of metoclopramide (Reglan) due
d. A patient who is crying after receiving a diagnosis of esophageal cancer
4|Page
