ATI Med-Surg Gastrointestinal 2026/2027 | ATI RN Adult Medical-Surgical
Gastrointestinal Study Guide & Practice Questions | ATI Targeted Medical Surgical
Gastrointestinal Exam Prep, GI Nursing Review, Gastrointestinal Disorders,
Esophageal Disorders, GERD, Peptic Ulcer Disease, Gastritis, Inflammatory &
Noninflammatory Bowel Disorders, Crohn’s Disease, Ulcerative Colitis,
Cholecystitis, Cholelithiasis, Pancreatitis, Hepatitis, Cirrhosis, GI Diagnostic &
Therapeutic Procedures, Ostomy Care, Enteral Nutrition, Obesity Management,
Clinical Judgment, Prioritization, Patient Safety & Detailed Rationales
Question 1: A nurse is admitting a client with a suspected bowel
obstruction. The client reports severe, intermittent abdominal pain
and vomiting. Which of the following findings should the nurse
recognize as an early sign of a potential bowel perforation?
A. Hyperactive bowel sounds with mild abdominal distention
B. Abdominal tenderness with rigidity and hypotension
C. Nausea and vomiting with stable vital signs
D. Intermittent cramping pain with passage of flatus
CORRECT ANSWER: B. Abdominal tenderness with rigidity and
hypotension
Rationale: A bowel perforation is a life-threatening emergency that results
in the release of intestinal contents into the peritoneal cavity. This causes
peritoneal irritation, manifested by a rigid, board-like abdomen and
tenderness. As fluid shifts into the peritoneal cavity, circulating blood
volume drops, leading to hypotension. Hyperactive bowel sounds and mild
distention are more consistent with an early, uncomplicated obstruction.
The other options describe findings that do not indicate perforation.
Question 2: A nurse is preparing a community education program
about Hepatitis B. Which of the following statements should the
nurse include in the teaching?
A. The hepatitis B vaccine is given only to adults at high risk.
B. The hepatitis B vaccine can be administered as early as birth.
C. The second dose of the hepatitis B vaccine is given at 12 months of age.
D. Hepatitis B immune globulin is not part of the standard childhood
immunization schedule.
CORRECT ANSWER: B. The hepatitis B vaccine can be administered
as early as birth.
Rationale: The hepatitis B vaccine is part of the standard childhood
immunization schedule and can be given at birth, especially to infants born
,to hepatitis B surface antigen (HBsAg)-negative mothers. The second dose
is typically administered between 1 and 4 months of age, and the third dose
is given between 6 and 18 months. Hepatitis B immune globulin (HBIG) is
also part of the standard immunization strategy for infants born to HBsAg-
positive mothers. All statements in the original question source are
accurate, but only option B is correct in this revised format.
Question 3: A nurse is caring for a client scheduled for an
esophagogastroduodenoscopy (EGD). The nurse should identify
that this procedure is used to do which of the following?
A. Assess gallbladder function and biliary duct patency
B. Visualize the esophagus, stomach, and duodenum
C. Evaluate colonic mucosa for polyps and malignancies
D. Measure gastric acid secretion and pH levels
CORRECT ANSWER: B. Visualize the esophagus, stomach, and
duodenum
Rationale: An EGD uses a lighted flexible endoscope to directly visualize
the esophagus, stomach, and duodenum. It is a diagnostic tool used to
detect tumors, ulcerations, strictures, and other abnormalities. It also allows
for tissue biopsy and therapeutic interventions such as banding of varices. It
does not evaluate the gallbladder, colon, or measure gastric acid secretion.
Question 4: A nurse is caring for a client receiving total parenteral
nutrition (TPN) who has just returned to the room following
physical therapy. The nurse notes that the infusion pump for the
client's TPN is turned off. After restarting the infusion pump, the
nurse should monitor the client for which of the following findings?
A. Hyperglycemia and polyuria
B. Hypoglycemia with diaphoresis, weakness, and anxiety
C. Fluid overload with crackles and edema
D. Electrolyte imbalance with muscle cramping
CORRECT ANSWER: B. Hypoglycemia with diaphoresis, weakness,
and anxiety
Rationale: TPN solutions are highly concentrated in dextrose. Sudden
withdrawal of TPN can cause rebound hypoglycemia because the pancreas
continues to produce insulin in response to the high glucose load.
Manifestations include diaphoresis, weakness, anxiety, confusion, and
,hunger. The nurse should monitor blood glucose closely and restart the
infusion gradually. Hyperglycemia occurs with rapid infusion, not sudden
withdrawal.
Question 5: A nurse is assessing a client who is in the early stages
of hepatitis A. Which of the following manifestations should the
nurse expect?
A. Jaundice and dark urine
B. Severe anorexia and malaise
C. Right upper quadrant pain and hepatomegaly
D. Clay-colored stools and pruritus
CORRECT ANSWER: B. Severe anorexia and malaise
Rationale: Anorexia is an early manifestation of hepatitis A and is often
severe. It is thought to result from the release of a toxin by the damaged
liver or failure of damaged liver cells to detoxify an abnormal product.
Jaundice, dark urine, clay-colored stools, and pruritus are typically later
manifestations associated with cholestasis. Early symptoms also include
malaise, nausea, and low-grade fever.
Question 6: A nurse is assessing a client who is experiencing
perforation of a peptic ulcer. Which of the following findings should
the nurse expect?
A. Board-like abdomen with severe pain radiating to the right shoulder
B. Epigastric pain relieved by food intake
C. Intermittent cramping and diarrhea
D. Hyperactive bowel sounds with mild distention
CORRECT ANSWER: A. Board-like abdomen with severe pain
radiating to the right shoulder
Rationale: Perforation of a peptic ulcer causes the release of gastric
contents into the peritoneal cavity, leading to chemical peritonitis. This
results in a rigid, board-like abdomen and severe pain that may radiate to
the right shoulder due to diaphragmatic irritation. Epigastric pain relieved
by food is characteristic of an uncomplicated duodenal ulcer. The other
options are not consistent with perforation.
, Question 7: A nurse is caring for a client with a nasogastric (NG)
tube who develops nausea. Which of the following actions should
the nurse take first?
A. Irrigate the tube with normal saline solution
B. Provide oral hygiene
C. Clamp the tube for 30 minutes
D. Increase the amount of suction
CORRECT ANSWER: A. Irrigate the tube with normal saline
solution
Rationale: If a client with an NG tube develops nausea, the nurse should
first irrigate the tube to determine if it is patent. If the tube is not patent,
gastric contents cannot be effectively evacuated, leading to a buildup of
pressure in the stomach that causes nausea and potentially vomiting.
Irrigating the tube helps identify the cause and allows the nurse to take
appropriate corrective measures.
Question 8: A nurse is teaching a client with diverticulitis about
preventing acute attacks. The nurse should advise the client to
consume foods that are which of the following?
A. Low in fiber
B. High in fiber
C. High in fat
D. Low in protein
CORRECT ANSWER: B. High in fiber
Rationale: Diverticulitis is inflammation of diverticula, which are pouches
that form on the walls of the intestines. A high-fiber diet is recommended to
prevent acute attacks because fiber adds bulk to the stool, reducing
pressure within the colon and decreasing the risk of inflammation. A low-
fiber diet is recommended during an acute attack to rest the bowel, but
long-term prevention requires a high-fiber diet.
Question 9: A nurse is assessing a client with a bowel obstruction.
Which of the following bowel sound findings should the nurse
expect?
A. Absent bowel sounds in all four quadrants
B. Hyperactive bowel sounds above the obstruction
Gastrointestinal Study Guide & Practice Questions | ATI Targeted Medical Surgical
Gastrointestinal Exam Prep, GI Nursing Review, Gastrointestinal Disorders,
Esophageal Disorders, GERD, Peptic Ulcer Disease, Gastritis, Inflammatory &
Noninflammatory Bowel Disorders, Crohn’s Disease, Ulcerative Colitis,
Cholecystitis, Cholelithiasis, Pancreatitis, Hepatitis, Cirrhosis, GI Diagnostic &
Therapeutic Procedures, Ostomy Care, Enteral Nutrition, Obesity Management,
Clinical Judgment, Prioritization, Patient Safety & Detailed Rationales
Question 1: A nurse is admitting a client with a suspected bowel
obstruction. The client reports severe, intermittent abdominal pain
and vomiting. Which of the following findings should the nurse
recognize as an early sign of a potential bowel perforation?
A. Hyperactive bowel sounds with mild abdominal distention
B. Abdominal tenderness with rigidity and hypotension
C. Nausea and vomiting with stable vital signs
D. Intermittent cramping pain with passage of flatus
CORRECT ANSWER: B. Abdominal tenderness with rigidity and
hypotension
Rationale: A bowel perforation is a life-threatening emergency that results
in the release of intestinal contents into the peritoneal cavity. This causes
peritoneal irritation, manifested by a rigid, board-like abdomen and
tenderness. As fluid shifts into the peritoneal cavity, circulating blood
volume drops, leading to hypotension. Hyperactive bowel sounds and mild
distention are more consistent with an early, uncomplicated obstruction.
The other options describe findings that do not indicate perforation.
Question 2: A nurse is preparing a community education program
about Hepatitis B. Which of the following statements should the
nurse include in the teaching?
A. The hepatitis B vaccine is given only to adults at high risk.
B. The hepatitis B vaccine can be administered as early as birth.
C. The second dose of the hepatitis B vaccine is given at 12 months of age.
D. Hepatitis B immune globulin is not part of the standard childhood
immunization schedule.
CORRECT ANSWER: B. The hepatitis B vaccine can be administered
as early as birth.
Rationale: The hepatitis B vaccine is part of the standard childhood
immunization schedule and can be given at birth, especially to infants born
,to hepatitis B surface antigen (HBsAg)-negative mothers. The second dose
is typically administered between 1 and 4 months of age, and the third dose
is given between 6 and 18 months. Hepatitis B immune globulin (HBIG) is
also part of the standard immunization strategy for infants born to HBsAg-
positive mothers. All statements in the original question source are
accurate, but only option B is correct in this revised format.
Question 3: A nurse is caring for a client scheduled for an
esophagogastroduodenoscopy (EGD). The nurse should identify
that this procedure is used to do which of the following?
A. Assess gallbladder function and biliary duct patency
B. Visualize the esophagus, stomach, and duodenum
C. Evaluate colonic mucosa for polyps and malignancies
D. Measure gastric acid secretion and pH levels
CORRECT ANSWER: B. Visualize the esophagus, stomach, and
duodenum
Rationale: An EGD uses a lighted flexible endoscope to directly visualize
the esophagus, stomach, and duodenum. It is a diagnostic tool used to
detect tumors, ulcerations, strictures, and other abnormalities. It also allows
for tissue biopsy and therapeutic interventions such as banding of varices. It
does not evaluate the gallbladder, colon, or measure gastric acid secretion.
Question 4: A nurse is caring for a client receiving total parenteral
nutrition (TPN) who has just returned to the room following
physical therapy. The nurse notes that the infusion pump for the
client's TPN is turned off. After restarting the infusion pump, the
nurse should monitor the client for which of the following findings?
A. Hyperglycemia and polyuria
B. Hypoglycemia with diaphoresis, weakness, and anxiety
C. Fluid overload with crackles and edema
D. Electrolyte imbalance with muscle cramping
CORRECT ANSWER: B. Hypoglycemia with diaphoresis, weakness,
and anxiety
Rationale: TPN solutions are highly concentrated in dextrose. Sudden
withdrawal of TPN can cause rebound hypoglycemia because the pancreas
continues to produce insulin in response to the high glucose load.
Manifestations include diaphoresis, weakness, anxiety, confusion, and
,hunger. The nurse should monitor blood glucose closely and restart the
infusion gradually. Hyperglycemia occurs with rapid infusion, not sudden
withdrawal.
Question 5: A nurse is assessing a client who is in the early stages
of hepatitis A. Which of the following manifestations should the
nurse expect?
A. Jaundice and dark urine
B. Severe anorexia and malaise
C. Right upper quadrant pain and hepatomegaly
D. Clay-colored stools and pruritus
CORRECT ANSWER: B. Severe anorexia and malaise
Rationale: Anorexia is an early manifestation of hepatitis A and is often
severe. It is thought to result from the release of a toxin by the damaged
liver or failure of damaged liver cells to detoxify an abnormal product.
Jaundice, dark urine, clay-colored stools, and pruritus are typically later
manifestations associated with cholestasis. Early symptoms also include
malaise, nausea, and low-grade fever.
Question 6: A nurse is assessing a client who is experiencing
perforation of a peptic ulcer. Which of the following findings should
the nurse expect?
A. Board-like abdomen with severe pain radiating to the right shoulder
B. Epigastric pain relieved by food intake
C. Intermittent cramping and diarrhea
D. Hyperactive bowel sounds with mild distention
CORRECT ANSWER: A. Board-like abdomen with severe pain
radiating to the right shoulder
Rationale: Perforation of a peptic ulcer causes the release of gastric
contents into the peritoneal cavity, leading to chemical peritonitis. This
results in a rigid, board-like abdomen and severe pain that may radiate to
the right shoulder due to diaphragmatic irritation. Epigastric pain relieved
by food is characteristic of an uncomplicated duodenal ulcer. The other
options are not consistent with perforation.
, Question 7: A nurse is caring for a client with a nasogastric (NG)
tube who develops nausea. Which of the following actions should
the nurse take first?
A. Irrigate the tube with normal saline solution
B. Provide oral hygiene
C. Clamp the tube for 30 minutes
D. Increase the amount of suction
CORRECT ANSWER: A. Irrigate the tube with normal saline
solution
Rationale: If a client with an NG tube develops nausea, the nurse should
first irrigate the tube to determine if it is patent. If the tube is not patent,
gastric contents cannot be effectively evacuated, leading to a buildup of
pressure in the stomach that causes nausea and potentially vomiting.
Irrigating the tube helps identify the cause and allows the nurse to take
appropriate corrective measures.
Question 8: A nurse is teaching a client with diverticulitis about
preventing acute attacks. The nurse should advise the client to
consume foods that are which of the following?
A. Low in fiber
B. High in fiber
C. High in fat
D. Low in protein
CORRECT ANSWER: B. High in fiber
Rationale: Diverticulitis is inflammation of diverticula, which are pouches
that form on the walls of the intestines. A high-fiber diet is recommended to
prevent acute attacks because fiber adds bulk to the stool, reducing
pressure within the colon and decreasing the risk of inflammation. A low-
fiber diet is recommended during an acute attack to rest the bowel, but
long-term prevention requires a high-fiber diet.
Question 9: A nurse is assessing a client with a bowel obstruction.
Which of the following bowel sound findings should the nurse
expect?
A. Absent bowel sounds in all four quadrants
B. Hyperactive bowel sounds above the obstruction
