NUR 242 Med-Surg Exam 3 Study Guide (100
NCLEX-Style Questions + Answers)
1. A client with GERD is teaching back lifestyle changes. Which statement indicates the need for
further teaching?
A. “I will avoid eating 3 hours before bedtime.”
B. “I will elevate the head of my bed.”
C. “I can have peppermint tea after meals.”
D. “I will avoid tight clothing at the waist.”
Answer: C – Peppermint worsens reflux.
2. A client with gastritis reports abdominal discomfort and vomiting blood. What is the priority?
A. Administer antacids
B. Assess blood pressure
C. Obtain stool sample
D. Start clear-liquid diet
Answer: B – Assess for hypovolemic shock.
3. The nurse recognizes which finding as classic for a hiatal hernia?
A. Mid-abdominal cramping
B. Heartburn relieved by lying down
C. Chest discomfort after meals
D. Pain radiating to the back
Answer: C
4. A client with peptic ulcer disease is positive for H. pylori. Which medication regimen is
expected?
A. PPI + 2 antibiotics
B. Antacid only
C. Steroids + antacids
D. H2 blocker only
Answer: A
5. Which assessment finding suggests peritonitis?
,A. Hyperactive bowel sounds
B. Boardlike abdomen
C. Watery diarrhea
D. Severe reflux
Answer: B
6. A client with right-lower-quadrant pain and rebound tenderness likely has:
A. Peritonitis
B. Appendicitis
C. Diverticulitis
D. Crohn’s disease
Answer: B
7. What is the priority intervention for suspected appendicitis?
A. Apply heat
B. Give laxatives
C. Risk for rupture.
D. Perform deep palpation
Answer: C – Risk for rupture.
8. Which symptom most indicates gastroenteritis dehydration?
A. Warm skin
B. Bounding pulses
C. Poor skin turgor
D. Bradycardia
Answer: C
9. A client with ulcerative colitis is at highest risk for:
A. Fistulas
B. Toxic megacolon
C. Small bowel obstruction
D. Steatorrhea
Answer: B
10. Which assessment finding is typical of Crohn’s disease?
A. Bloody stools only
B. Continuous lesions
, C. Cobblestone bowel pattern
D. Pain relieved after eating
Answer: C
11. A client with diverticulitis should avoid which food?
A. White rice
B. Applesauce
C. Popcorn
D. Eggs
Answer: C
12. A patient with Hepatitis A expresses concern about family transmission. The nurse teaches
transmission occurs via:
A. Blood exposure
B. Semen
C. Fecal–oral route
D. Tattoos
Answer: C
13. Which finding in Hepatitis B requires immediate attention?
A. Fatigue
B. Loss of appetite
C. Clay-colored stools
D. Mild abdominal pain
Answer: C – Indicates bile obstruction.
14. Hepatitis C is most commonly transmitted through:
A. Sharing utensils
B. Unprotected sex
C. Drinking contaminated water
D. Blood-to-blood exposure
Answer: D
15. A client with Hepatitis D must also have a history of:
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
NCLEX-Style Questions + Answers)
1. A client with GERD is teaching back lifestyle changes. Which statement indicates the need for
further teaching?
A. “I will avoid eating 3 hours before bedtime.”
B. “I will elevate the head of my bed.”
C. “I can have peppermint tea after meals.”
D. “I will avoid tight clothing at the waist.”
Answer: C – Peppermint worsens reflux.
2. A client with gastritis reports abdominal discomfort and vomiting blood. What is the priority?
A. Administer antacids
B. Assess blood pressure
C. Obtain stool sample
D. Start clear-liquid diet
Answer: B – Assess for hypovolemic shock.
3. The nurse recognizes which finding as classic for a hiatal hernia?
A. Mid-abdominal cramping
B. Heartburn relieved by lying down
C. Chest discomfort after meals
D. Pain radiating to the back
Answer: C
4. A client with peptic ulcer disease is positive for H. pylori. Which medication regimen is
expected?
A. PPI + 2 antibiotics
B. Antacid only
C. Steroids + antacids
D. H2 blocker only
Answer: A
5. Which assessment finding suggests peritonitis?
,A. Hyperactive bowel sounds
B. Boardlike abdomen
C. Watery diarrhea
D. Severe reflux
Answer: B
6. A client with right-lower-quadrant pain and rebound tenderness likely has:
A. Peritonitis
B. Appendicitis
C. Diverticulitis
D. Crohn’s disease
Answer: B
7. What is the priority intervention for suspected appendicitis?
A. Apply heat
B. Give laxatives
C. Risk for rupture.
D. Perform deep palpation
Answer: C – Risk for rupture.
8. Which symptom most indicates gastroenteritis dehydration?
A. Warm skin
B. Bounding pulses
C. Poor skin turgor
D. Bradycardia
Answer: C
9. A client with ulcerative colitis is at highest risk for:
A. Fistulas
B. Toxic megacolon
C. Small bowel obstruction
D. Steatorrhea
Answer: B
10. Which assessment finding is typical of Crohn’s disease?
A. Bloody stools only
B. Continuous lesions
, C. Cobblestone bowel pattern
D. Pain relieved after eating
Answer: C
11. A client with diverticulitis should avoid which food?
A. White rice
B. Applesauce
C. Popcorn
D. Eggs
Answer: C
12. A patient with Hepatitis A expresses concern about family transmission. The nurse teaches
transmission occurs via:
A. Blood exposure
B. Semen
C. Fecal–oral route
D. Tattoos
Answer: C
13. Which finding in Hepatitis B requires immediate attention?
A. Fatigue
B. Loss of appetite
C. Clay-colored stools
D. Mild abdominal pain
Answer: C – Indicates bile obstruction.
14. Hepatitis C is most commonly transmitted through:
A. Sharing utensils
B. Unprotected sex
C. Drinking contaminated water
D. Blood-to-blood exposure
Answer: D
15. A client with Hepatitis D must also have a history of:
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
