Your nursing exam, revealed. EXACT Nur Medical Surg 203 questions with verified answers. Join our community of successful nursing students who passed easily.
Nursing Exams
Detailed Answer Explanations Well-structured questions covering all topics, accompanied by organized images.
Purchase For $30/monthYour nursing exam, revealed. EXACT Nur Medical Surg 203 questions with verified answers. Join our community of successful nursing students who passed easily.
A client presented to the Emergency Department with complaints of nausea, vomiting, LUQ pain, and is sweating. During the physical assessment, the client is found to be sitting leaning forward because he feels less pain in this position. The nurse correctly suspects that the client has:
Acute pancreatitis
Hepatitis B
Gallstones
Appendicitis
The Correct Answer is:
A. Acute pancreatitis
Detailed Explanation:
Acute pancreatitis typically presents with severe epigastric or left upper quadrant (LUQ) pain that radiates to the back. Patients often assume a forward-leaning or fetal position because it reduces pressure on the inflamed pancreas and alleviates pain. Other classic symptoms include nausea, vomiting, diaphoresis, and abdominal tenderness. Common causes include gallstones, alcohol use, and certain medications. This condition requires immediate medical management to prevent complications such as shock, necrosis, or respiratory distress.
The nurse is providing education to the patient about a low-fat diet. The nurse suspects the patient needs additional education when he states:
"I can eat baked fish."
"I can eat chicken that has been broiled."
"I'll start to eat more roasted turkey for dinner."
"I can still eat a hamburger and fries when I go out with friends."
The Correct Answer is:
D. "I can still eat a hamburger and fries when I go out with friends."
Detailed Explanation:
A hamburger and fries are high in saturated fats and trans fats, which contradict the principles of a low-fat diet. Consuming such foods can elevate cholesterol levels and increase the risk of cardiovascular disease. Patients should instead choose lean meats (like chicken, turkey, or fish) prepared by baking, broiling, or roasting, and pair them with vegetables or whole grains. Education should emphasize limiting fried and processed foods to maintain heart and liver health.
Insulin is most rapidly absorbed into the:
Abdomen
Legs
Arms
Buttocks
The Correct Answer is:
A. Abdomen
Detailed Explanation:
The abdomen provides the fastest and most consistent absorption site for insulin due to its rich blood supply and thinner subcutaneous tissue compared to other areas. This makes it the preferred injection site, especially for rapid-acting or short-acting insulin. Rotation of injection sites within the same region is recommended to prevent lipodystrophy and maintain consistent absorption rates. In contrast, insulin injected into the thighs, arms, or buttocks absorbs more slowly.
A patient with type 2 diabetes mellitus asks the nurse how metformin decreases blood sugar. What is the best response by the nurse?
The medication decreases glucose production in the liver
The medication blocks carbohydrate absorption in the intestine
The medication increases insulin release from the pancreas
The medication increases insulin resistance of the cells in the body
The Correct Answer is:
A. The medication decreases glucose production in the liver
Detailed Explanation:
Metformin (a biguanide) lowers blood glucose primarily by reducing hepatic glucose production and improving insulin sensitivity in peripheral tissues. It does not stimulate insulin secretion, making it less likely to cause hypoglycemia. Additionally, it enhances glucose uptake by muscles and reduces intestinal glucose absorption slightly. By suppressing the liver’s excessive glucose output, metformin effectively maintains fasting glucose control and is considered the first-line therapy for type 2 diabetes mellitus.
The nurse is caring for a patient being treated for new onset of gallstones. The patient asks the nurse if he will have to have surgery. How will the nurse respond?
"You need to ask the doctor about your concerns."
"Treatment for gallstones may include diet modification, weight loss, medication or surgery."
"You will have to have surgery if you continue to have gallstones."
"Tell me more about your concerns."
The Correct Answer is:
B. "Treatment for gallstones may include diet modification, weight loss, medication or surgery."
Detailed Explanation:
The most accurate and therapeutic response is to inform the patient that treatment options for gallstones vary depending on the severity of symptoms and complications. Mild cases may be managed with dietary changes, weight management, or medications that dissolve gallstones. Surgery (cholecystectomy) is recommended if gallstones cause repeated pain, obstruction, or infection. Providing this balanced explanation addresses the patient’s concern while supporting informed decision-making about future care.
Which statement by a newly diagnosed diabetic patient most strongly indicates a need for further teaching about exercise?
"Before going to the gym, I do not need to check my blood sugar."
"If my blood sugar is below 100 before exercising, I should eat a snack."
"I must carry hard candy."
"I can go swimming as part of my exercise routine."
The Correct Answer is:
A. "Before going to the gym, I do not need to check my blood sugar."
Detailed Explanation:
Patients with diabetes should always check their blood glucose level before exercising to prevent hypoglycemia or identify dangerously high readings. Exercise lowers blood sugar by increasing glucose uptake by the muscles. If glucose is too low (<100 mg/dL), a pre-exercise snack is needed; if too high (>250 mg/dL with ketones), exercise should be postponed. Not checking blood glucose shows a lack of understanding of safe diabetes self-management practices.
It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?
Hepatitis C
Hepatitis A
Hepatitis D
Hepatitis B
The Correct Answer is:
B. Hepatitis A
Detailed Explanation:
Hepatitis A is most commonly transmitted through the fecal–oral route, often from ingesting food or water contaminated with the virus. Outbreaks are typically linked to poor sanitation or improper hand hygiene during food preparation. Unlike hepatitis B and C, which are spread through blood and body fluids, hepatitis A does not cause chronic liver disease and usually resolves on its own. Preventive measures include proper handwashing, safe food handling, and vaccination against the hepatitis A virus.
The nurse knows a Whipple procedure may be performed if a patient has which disorder?
Cholecystitis
Liver cancer
Bowel obstruction
Pancreatic cancer
The Correct Answer is:
D. Pancreatic cancer
Detailed Explanation:
A Whipple procedure (pancreaticoduodenectomy) is a complex surgical operation primarily performed to treat pancreatic cancer, especially when the tumor is located in the head of the pancreas. The procedure involves removing the head of the pancreas, part of the duodenum, gallbladder, and sometimes a portion of the stomach, followed by reconnection of the digestive tract. This surgery aims to eliminate the cancerous tissue, relieve symptoms like jaundice and pain, and improve survival outcomes when the cancer is resectable.
A nurse is collecting data from a client who has pancreatitis. Which of the following findings should the nurse identify as a manifestation of pancreatitis?
Gray-blue discoloration of the skin around the umbilicus
Generalized cyanosis
Hyperactive bowel sounds
Wheezing in the lower lung fields
The Correct Answer is:
A. Gray-blue discoloration of the skin around the umbilicus
Detailed Explanation:
A gray-blue discoloration around the umbilicus, known as Cullen’s sign, is a classic indicator of acute pancreatitis. It results from internal bleeding caused by pancreatic enzyme leakage that leads to subcutaneous tissue discoloration. This finding signals severe disease and possible hemorrhagic pancreatitis, requiring urgent medical attention. Other signs may include epigastric pain radiating to the back, nausea, vomiting, and elevated serum amylase and lipase levels. Immediate supportive care and close monitoring are critical for recovery.
When insulin is not present in adequate amounts to meet metabolic needs, the body breaks down __________ and __________ for energy.
Insulin and glucagon
Proteins and fats
Macrophages and phagocytes
Leukocytes and erythrocytes
The Correct Answer is:
B. Proteins and fats
Detailed Explanation:
When insulin levels are insufficient, as in uncontrolled diabetes mellitus, the body cannot use glucose for energy. To compensate, it begins breaking down proteins and fats to produce energy. Fat breakdown leads to the accumulation of ketone bodies, resulting in metabolic acidosis (ketoacidosis) if severe. Protein catabolism contributes to muscle wasting and weakness. This metabolic shift reflects the body’s attempt to supply energy in the absence of adequate glucose utilization.
Trusted by thousands of nursing students worldwide for exam success.
