ATI Medical-Surgical Nursing –
Gastrointestinal Disorders Exam | 190+
Practice Questions & Verified Answers | Study
Guide, Test Bank & Exam Prep | GI Disorders,
Liver, Gallbladder, Pancreas, Bowel &
Nutrition
Question 1: A nurse is assessing a client who has a history of chronic gastritis.
Which of the following dietary modifications should the nurse recommend to
minimize gastric irritation?
A. Increase intake of spicy foods to stimulate gastric acid production.
B. Consume large meals three times daily to dilute gastric acid.
C. Avoid foods that are highly seasoned or acidic.
D. Drink orange juice with each meal to enhance iron absorption.
CORRECT ANSWER: C. Avoid foods that are highly seasoned or acidic.
Rationale: Highly seasoned and acidic foods can irritate the gastric mucosa,
exacerbating chronic gastritis. Small, frequent meals and a bland diet are recommended
to reduce irritation and manage symptoms.
Question 2: A client with cirrhosis is exhibiting signs of hepatic
encephalopathy. Which of the following dietary modifications is most
appropriate for this client?
A. High-protein diet to promote liver regeneration.
B. Low-sodium diet to reduce ascites formation.
C. Restricted protein intake to reduce ammonia levels.
D. High-carbohydrate diet to prevent hypoglycemia.
CORRECT ANSWER: C. Restricted protein intake to reduce ammonia levels.
Rationale: In hepatic encephalopathy, the liver cannot effectively convert ammonia to
urea. Restricting dietary protein reduces the substrate for ammonia production, thereby
helping to decrease neurological symptoms.
Question 3: A nurse is providing discharge teaching to a client who had a
partial gastrectomy for stomach cancer. To prevent dumping syndrome, which
of the following instructions is most important?
A. Drink fluids with meals to slow gastric emptying.
B. Eat small, frequent meals that are low in carbohydrates.
C. Increase intake of milk and ice cream to add calories.
D. Lie down for 30 minutes immediately after eating.
,CORRECT ANSWER: B. Eat small, frequent meals that are low in
carbohydrates.
Rationale: Dumping syndrome occurs when hypertonic food rapidly enters the small
intestine. Small, frequent meals with low carbohydrate content help reduce osmotic
shifts and slow gastric emptying, minimizing symptoms.
Question 4: A client with ulcerative colitis is prescribed sulfasalazine. The
nurse should monitor the client for which of the following adverse effects?
A. Hypertension.
B. Hepatotoxicity.
C. Renal calculi.
D. Bone marrow suppression.
CORRECT ANSWER: D. Bone marrow suppression.
Rationale: Sulfasalazine can cause bone marrow suppression, leading to leukopenia,
thrombocytopenia, or anemia. Regular complete blood count (CBC) monitoring is
essential during therapy to detect early hematological changes.
Question 5: A nurse is caring for a client with acute pancreatitis. Which of the
following laboratory values would the nurse expect to be elevated?
A. Serum sodium.
B. Serum calcium.
C. Serum amylase.
D. Serum potassium.
CORRECT ANSWER: C. Serum amylase.
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to leakage of
pancreatic enzymes into the bloodstream. Amylase typically rises within 6-12 hours of
onset and remains elevated for 3-5 days.
Question 6: A client is scheduled for an esophagogastroduodenoscopy (EGD).
Which of the following is the priority nursing action before the procedure?
A. Administer a sedative.
B. Obtain a signed informed consent.
C. Place the client in the Trendelenburg position.
D. Start a peripheral IV line.
CORRECT ANSWER: B. Obtain a signed informed consent.
,Rationale: Obtaining a signed informed consent is the priority legal and ethical
requirement before an invasive procedure like an EGD. The nurse must ensure the client
understands the risks and benefits before the physician performs the procedure.
Question 7: A client with Crohn's disease is prescribed prednisone. The nurse
should instruct the client to monitor for which of the following adverse effects?
A. Hypotension.
B. Weight loss.
C. Hyperglycemia.
D. Bradycardia.
CORRECT ANSWER: C. Hyperglycemia.
Rationale: Prednisone, a corticosteroid, can cause hyperglycemia by promoting
gluconeogenesis and reducing peripheral glucose uptake. Clients should monitor blood
glucose levels and report signs of hyperglycemia such as polyuria and polydipsia.
Question 8: A nurse is providing dietary teaching to a client with celiac
disease. Which of the following foods is safe for the client to consume?
A. Rye bread.
B. Barley soup.
C. Rice cakes.
D. Wheat pasta.
CORRECT ANSWER: C. Rice cakes.
Rationale: Celiac disease requires a strict gluten-free diet. Rice cakes are made from
rice, which is a gluten-free grain. Rye, barley, and wheat all contain gluten and must be
avoided.
Question 9: A client presents with severe right upper quadrant pain radiating
to the right shoulder. Which of the following conditions is most likely indicated
by this symptom?
A. Acute pancreatitis.
B. Cholecystitis.
C. Peptic ulcer disease.
D. Esophageal varices.
CORRECT ANSWER: B. Cholecystitis.
Rationale: Right upper quadrant pain radiating to the right shoulder (Kehr's sign or
referred pain) is a classic sign of biliary tract disease, such as cholecystitis. The phrenic
nerve irritation from gallbladder inflammation causes this referred pain.
, Question 10: A nurse is caring for a client who has an NG tube set to low
intermittent suction. Which of the following assessment findings indicates the
tube is in the correct position?
A. The client is able to talk without difficulty.
B. Aspiration of gastric contents with a pH of 4.
C. The tube is taped to the client's forehead.
D. Bowel sounds are hyperactive in all quadrants.
CORRECT ANSWER: B. Aspiration of gastric contents with a pH of 4.
Rationale: Aspiration of gastric contents with a pH of 4 or less confirms the tube's
placement in the stomach. This assessment provides objective evidence of correct
positioning, which is crucial before feeding or medication administration.
Question 11: Which of the following findings is most concerning in a client
with ulcerative colitis who is experiencing an acute exacerbation?
A. Bloody diarrhea of 10-20 stools per day.
B. Cramping abdominal pain.
C. Hemoglobin level of 10.5 g/dL.
D. Fever of 100.4°F (38°C).
CORRECT ANSWER: A. Bloody diarrhea of 10-20 stools per day.
Rationale: Frequent bloody diarrhea (10-20 stools/day) indicates severe disease activity
and places the client at high risk for dehydration, electrolyte imbalance, and
hypovolemic shock. This requires immediate medical intervention.
Question 12: A nurse is assessing a client with acute appendicitis. Which of the
following assessment findings is characteristic of this condition?
A. Rebound tenderness at McBurney's point.
B. Pain that is relieved by bending the knees.
C. Diffuse abdominal pain that radiates to the back.
D. Constipation for the past 3 days.
CORRECT ANSWER: A. Rebound tenderness at McBurney's point.
Rationale: Rebound tenderness (Blumberg's sign) at McBurney's point, located in the
right lower quadrant, is a classic peritoneal sign associated with acute appendicitis. This
indicates peritoneal irritation from an inflamed appendix.
Gastrointestinal Disorders Exam | 190+
Practice Questions & Verified Answers | Study
Guide, Test Bank & Exam Prep | GI Disorders,
Liver, Gallbladder, Pancreas, Bowel &
Nutrition
Question 1: A nurse is assessing a client who has a history of chronic gastritis.
Which of the following dietary modifications should the nurse recommend to
minimize gastric irritation?
A. Increase intake of spicy foods to stimulate gastric acid production.
B. Consume large meals three times daily to dilute gastric acid.
C. Avoid foods that are highly seasoned or acidic.
D. Drink orange juice with each meal to enhance iron absorption.
CORRECT ANSWER: C. Avoid foods that are highly seasoned or acidic.
Rationale: Highly seasoned and acidic foods can irritate the gastric mucosa,
exacerbating chronic gastritis. Small, frequent meals and a bland diet are recommended
to reduce irritation and manage symptoms.
Question 2: A client with cirrhosis is exhibiting signs of hepatic
encephalopathy. Which of the following dietary modifications is most
appropriate for this client?
A. High-protein diet to promote liver regeneration.
B. Low-sodium diet to reduce ascites formation.
C. Restricted protein intake to reduce ammonia levels.
D. High-carbohydrate diet to prevent hypoglycemia.
CORRECT ANSWER: C. Restricted protein intake to reduce ammonia levels.
Rationale: In hepatic encephalopathy, the liver cannot effectively convert ammonia to
urea. Restricting dietary protein reduces the substrate for ammonia production, thereby
helping to decrease neurological symptoms.
Question 3: A nurse is providing discharge teaching to a client who had a
partial gastrectomy for stomach cancer. To prevent dumping syndrome, which
of the following instructions is most important?
A. Drink fluids with meals to slow gastric emptying.
B. Eat small, frequent meals that are low in carbohydrates.
C. Increase intake of milk and ice cream to add calories.
D. Lie down for 30 minutes immediately after eating.
,CORRECT ANSWER: B. Eat small, frequent meals that are low in
carbohydrates.
Rationale: Dumping syndrome occurs when hypertonic food rapidly enters the small
intestine. Small, frequent meals with low carbohydrate content help reduce osmotic
shifts and slow gastric emptying, minimizing symptoms.
Question 4: A client with ulcerative colitis is prescribed sulfasalazine. The
nurse should monitor the client for which of the following adverse effects?
A. Hypertension.
B. Hepatotoxicity.
C. Renal calculi.
D. Bone marrow suppression.
CORRECT ANSWER: D. Bone marrow suppression.
Rationale: Sulfasalazine can cause bone marrow suppression, leading to leukopenia,
thrombocytopenia, or anemia. Regular complete blood count (CBC) monitoring is
essential during therapy to detect early hematological changes.
Question 5: A nurse is caring for a client with acute pancreatitis. Which of the
following laboratory values would the nurse expect to be elevated?
A. Serum sodium.
B. Serum calcium.
C. Serum amylase.
D. Serum potassium.
CORRECT ANSWER: C. Serum amylase.
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to leakage of
pancreatic enzymes into the bloodstream. Amylase typically rises within 6-12 hours of
onset and remains elevated for 3-5 days.
Question 6: A client is scheduled for an esophagogastroduodenoscopy (EGD).
Which of the following is the priority nursing action before the procedure?
A. Administer a sedative.
B. Obtain a signed informed consent.
C. Place the client in the Trendelenburg position.
D. Start a peripheral IV line.
CORRECT ANSWER: B. Obtain a signed informed consent.
,Rationale: Obtaining a signed informed consent is the priority legal and ethical
requirement before an invasive procedure like an EGD. The nurse must ensure the client
understands the risks and benefits before the physician performs the procedure.
Question 7: A client with Crohn's disease is prescribed prednisone. The nurse
should instruct the client to monitor for which of the following adverse effects?
A. Hypotension.
B. Weight loss.
C. Hyperglycemia.
D. Bradycardia.
CORRECT ANSWER: C. Hyperglycemia.
Rationale: Prednisone, a corticosteroid, can cause hyperglycemia by promoting
gluconeogenesis and reducing peripheral glucose uptake. Clients should monitor blood
glucose levels and report signs of hyperglycemia such as polyuria and polydipsia.
Question 8: A nurse is providing dietary teaching to a client with celiac
disease. Which of the following foods is safe for the client to consume?
A. Rye bread.
B. Barley soup.
C. Rice cakes.
D. Wheat pasta.
CORRECT ANSWER: C. Rice cakes.
Rationale: Celiac disease requires a strict gluten-free diet. Rice cakes are made from
rice, which is a gluten-free grain. Rye, barley, and wheat all contain gluten and must be
avoided.
Question 9: A client presents with severe right upper quadrant pain radiating
to the right shoulder. Which of the following conditions is most likely indicated
by this symptom?
A. Acute pancreatitis.
B. Cholecystitis.
C. Peptic ulcer disease.
D. Esophageal varices.
CORRECT ANSWER: B. Cholecystitis.
Rationale: Right upper quadrant pain radiating to the right shoulder (Kehr's sign or
referred pain) is a classic sign of biliary tract disease, such as cholecystitis. The phrenic
nerve irritation from gallbladder inflammation causes this referred pain.
, Question 10: A nurse is caring for a client who has an NG tube set to low
intermittent suction. Which of the following assessment findings indicates the
tube is in the correct position?
A. The client is able to talk without difficulty.
B. Aspiration of gastric contents with a pH of 4.
C. The tube is taped to the client's forehead.
D. Bowel sounds are hyperactive in all quadrants.
CORRECT ANSWER: B. Aspiration of gastric contents with a pH of 4.
Rationale: Aspiration of gastric contents with a pH of 4 or less confirms the tube's
placement in the stomach. This assessment provides objective evidence of correct
positioning, which is crucial before feeding or medication administration.
Question 11: Which of the following findings is most concerning in a client
with ulcerative colitis who is experiencing an acute exacerbation?
A. Bloody diarrhea of 10-20 stools per day.
B. Cramping abdominal pain.
C. Hemoglobin level of 10.5 g/dL.
D. Fever of 100.4°F (38°C).
CORRECT ANSWER: A. Bloody diarrhea of 10-20 stools per day.
Rationale: Frequent bloody diarrhea (10-20 stools/day) indicates severe disease activity
and places the client at high risk for dehydration, electrolyte imbalance, and
hypovolemic shock. This requires immediate medical intervention.
Question 12: A nurse is assessing a client with acute appendicitis. Which of the
following assessment findings is characteristic of this condition?
A. Rebound tenderness at McBurney's point.
B. Pain that is relieved by bending the knees.
C. Diffuse abdominal pain that radiates to the back.
D. Constipation for the past 3 days.
CORRECT ANSWER: A. Rebound tenderness at McBurney's point.
Rationale: Rebound tenderness (Blumberg's sign) at McBurney's point, located in the
right lower quadrant, is a classic peritoneal sign associated with acute appendicitis. This
indicates peritoneal irritation from an inflamed appendix.
