ATI Medical-Surgical | Gastrointestinal Disorders | Exam 6 Practice
Questions |Answers |Rationales
1. A nurse is providing discharge teaching to a client who has gastroesophageal
reflux disease (GERD). Which of the following statements by the client indicates
an understanding of the teaching?
A. I will eat a large snack just before going to bed.
B. I will drink orange juice with every breakfast.
C. I will sleep with the head of my bed elevated on 6-inch blocks.
D. I will wear a tight-fitting girdle to support my abdomen.
Answer: C
Rationale: Elevating the head of the bed helps prevent the reflux of gastric contents while
sleeping. Large snacks, acidic juices, and tight clothing can all exacerbate GERD symptoms.
2. A nurse is assessing a client who has acute pancreatitis. Which of the
following findings is the priority to report to the provider?
A. Hand spasms when taking a blood pressure
B. Absent bowel sounds
C. Epigastric pain radiating to the back
D. Serum amylase level three times the normal range
Answer: A
Rationale: Hand spasms (Trousseau’s sign) indicate hypocalcemia, a frequent
complication of pancreatitis that can lead to seizures and laryngospasms. This is a priority
over expected symptoms like pain or elevated enzymes.
,3. A client is being treated for a duodenal ulcer. The nurse should expect the
client to report that the pain occurs at which of the following times?
A. Immediately after eating a meal
B. Only when the stomach is full
C. During the night, often between 1 AM and 3 AM
D. While lying on the left side
Answer: C
Rationale: Duodenal ulcer pain typically occurs 1.5 to 3 hours after a meal and often wakes
the client during the night when the stomach is empty. Pain is often relieved by food
ingestion.
4. A nurse is caring for a client who is 2 days postoperative following a gastric
bypass. Which of the following findings should the nurse report to the provider
immediately?
A. Reports of incisional pain with coughing
B. Increased heart rate and epigastric pain
C. Urine output of 40 mL over the last hour
D. Bowel sounds are present in all four quadrants
Answer: B
Rationale: Tachycardia and epigastric pain are early signs of an anastomotic leak, a life-
threatening complication following gastric bypass surgery.
5. A nurse is caring for a client with cirrhosis and a high serum ammonia level.
Which of the following medications should the nurse expect to administer?
A. Lactulose
B. Spironolactone
C. Propranolol
D. Vitamin K
Answer: A
, Rationale: Lactulose is used to promote the excretion of ammonia through the stool in
clients with hepatic encephalopathy caused by cirrhosis.
6. A nurse is teaching a client with Crohn’s disease about dietary management.
Which of the following foods should the nurse recommend?
A. Fresh broccoli with cheese sauce
B. Grilled chicken breast and white rice
C. Popcorn with butter
D. Whole-grain wheat bread
Answer: B
Rationale: Clients with Crohn’s disease should follow a low-fiber, high-protein diet to
minimize bowel stimulation. Grilled chicken and white rice are appropriate, while high-
fiber foods like broccoli and popcorn should be avoided.
7. A nurse is assessing a client who has a suspected small bowel obstruction.
Which of the following findings should the nurse expect?
A. Profuse projectile vomiting
B. Visible peristaltic waves in the upper abdomen
C. Intermittent, lower abdominal cramping
D. Metabolic acidosis
Answer: A
Rationale: Profuse vomiting is a classic sign of small bowel obstruction. Visible peristaltic
waves and metabolic alkalosis (due to loss of gastric acid) are also common. Lower
abdominal cramping is more characteristic of large bowel obstruction.
Questions |Answers |Rationales
1. A nurse is providing discharge teaching to a client who has gastroesophageal
reflux disease (GERD). Which of the following statements by the client indicates
an understanding of the teaching?
A. I will eat a large snack just before going to bed.
B. I will drink orange juice with every breakfast.
C. I will sleep with the head of my bed elevated on 6-inch blocks.
D. I will wear a tight-fitting girdle to support my abdomen.
Answer: C
Rationale: Elevating the head of the bed helps prevent the reflux of gastric contents while
sleeping. Large snacks, acidic juices, and tight clothing can all exacerbate GERD symptoms.
2. A nurse is assessing a client who has acute pancreatitis. Which of the
following findings is the priority to report to the provider?
A. Hand spasms when taking a blood pressure
B. Absent bowel sounds
C. Epigastric pain radiating to the back
D. Serum amylase level three times the normal range
Answer: A
Rationale: Hand spasms (Trousseau’s sign) indicate hypocalcemia, a frequent
complication of pancreatitis that can lead to seizures and laryngospasms. This is a priority
over expected symptoms like pain or elevated enzymes.
,3. A client is being treated for a duodenal ulcer. The nurse should expect the
client to report that the pain occurs at which of the following times?
A. Immediately after eating a meal
B. Only when the stomach is full
C. During the night, often between 1 AM and 3 AM
D. While lying on the left side
Answer: C
Rationale: Duodenal ulcer pain typically occurs 1.5 to 3 hours after a meal and often wakes
the client during the night when the stomach is empty. Pain is often relieved by food
ingestion.
4. A nurse is caring for a client who is 2 days postoperative following a gastric
bypass. Which of the following findings should the nurse report to the provider
immediately?
A. Reports of incisional pain with coughing
B. Increased heart rate and epigastric pain
C. Urine output of 40 mL over the last hour
D. Bowel sounds are present in all four quadrants
Answer: B
Rationale: Tachycardia and epigastric pain are early signs of an anastomotic leak, a life-
threatening complication following gastric bypass surgery.
5. A nurse is caring for a client with cirrhosis and a high serum ammonia level.
Which of the following medications should the nurse expect to administer?
A. Lactulose
B. Spironolactone
C. Propranolol
D. Vitamin K
Answer: A
, Rationale: Lactulose is used to promote the excretion of ammonia through the stool in
clients with hepatic encephalopathy caused by cirrhosis.
6. A nurse is teaching a client with Crohn’s disease about dietary management.
Which of the following foods should the nurse recommend?
A. Fresh broccoli with cheese sauce
B. Grilled chicken breast and white rice
C. Popcorn with butter
D. Whole-grain wheat bread
Answer: B
Rationale: Clients with Crohn’s disease should follow a low-fiber, high-protein diet to
minimize bowel stimulation. Grilled chicken and white rice are appropriate, while high-
fiber foods like broccoli and popcorn should be avoided.
7. A nurse is assessing a client who has a suspected small bowel obstruction.
Which of the following findings should the nurse expect?
A. Profuse projectile vomiting
B. Visible peristaltic waves in the upper abdomen
C. Intermittent, lower abdominal cramping
D. Metabolic acidosis
Answer: A
Rationale: Profuse vomiting is a classic sign of small bowel obstruction. Visible peristaltic
waves and metabolic alkalosis (due to loss of gastric acid) are also common. Lower
abdominal cramping is more characteristic of large bowel obstruction.
