Med-Surg NSG 123 Exam 2

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Sample questions from Med-Surg NSG 123 Exam 2

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In a gastroenterology clinic, a 19-year-old client reports recurrent abdominal pain and diarrhea. Which finding is more characteristic of Crohn's disease than ulcerative colitis?

   • A.Bloody diarrhea as the defining manifestation in nearly every flare
   • B.Skip lesions that may affect any part of the gastrointestinal tract
   • C.Continuous inflammation limited to the rectum and colon
   • D.Inflammation confined to the mucosal layer of the colon

   Rationale: Crohn's disease can affect any portion of the gastrointestinal tract and commonly has skip lesions with transmural inflammation. Continuous disease limited to the colon and rectum, with inflammation primarily involving the mucosa, is more consistent with ulcerative colitis. Bloody diarrhea can occur with ulcerative colitis but is not the defining pattern of Crohn's disease.

2. 2.In the emergency department, a 46-year-old client with a history of peptic ulcer disease develops sudden, severe abdominal pain and a rigid abdomen. Refer to the client's chart. Which actions are appropriate? Select all that apply.

   • A.Apply a heating pad to relax the abdominal muscles.
   • B.Keep the client NPO.
   • C.Prepare for urgent diagnostic evaluation and possible surgery.
   • D.Offer an antacid and reassess the pain in 1 hour.
   • E.Notify the health care provider immediately about suspected perforation.

   Rationale: The sudden severe pain and rigid abdomen documented at 1000, following a soft abdomen at 0800, suggest perforation and require immediate escalation. Keeping the client NPO is appropriate while urgent evaluation and possible surgery are considered. An antacid and delayed reassessment could dangerously postpone care, while heat is not an appropriate response to suspected perforation.

3. 3.During a home visit, a 34-year-old client with symptomatic gallstones asks what dietary change may reduce symptoms while awaiting follow-up. Which response is best?

   • A.Eat one large meal each day instead of smaller meals.
   • B.Increase high-fat foods to stimulate gallbladder emptying.
   • C.Choose lower-fat meals and limit fried foods.
   • D.Avoid all carbohydrates to prevent bile production.

   Rationale: Fat stimulates gallbladder contraction, which may trigger biliary pain when gallstones obstruct bile flow; choosing lower-fat foods can help reduce symptoms. Increasing fat intake may worsen pain rather than prevent it. Eliminating all carbohydrates is unnecessary, and one large meal is not a preferred strategy for symptom reduction.

4. 4.A parent of a 9-year-old recently diagnosed with celiac disease asks which food is appropriate. Which choice should the nurse recommend?

   • A.Rye toast
   • B.Wheat crackers
   • C.Barley soup
   • D.Plain rice with grilled chicken

   Answer and rationale are in the full material.

5. 5.At change of shift on a surgical unit, a 72-year-old client with a new colostomy has the findings shown. Refer to the client's chart. Which interpretations or actions are appropriate? Select all that apply.

   • A.The moist, red stoma is an expected finding.
   • B.The dusky stoma at 1000 requires prompt reporting.
   • C.The client should be taught to cut the pouch opening to fit closely around the stoma.
   • D.The pouch should be left off until the stoma becomes dry.
   • E.The decreasing output alone proves that the stoma is functioning normally.

   Answer and rationale are in the full material.