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NUR1025 Med Surg Gastrointestinal
NCLEX 2026 STUDY GUIDE 1000
QUESTIONS AND EXPERT VERIFIED
ANSWERS WITH RATIONALES
ALREADY GRADED A+,exams of
nursing
The nurse is providing care for a client with a recent transverse colostomy. Which observation
requires immediate notification of the health care provider?
A. Stoma is beefy red and shiny
B. Purple discoloration of the stoma
C. Skin excoriation around the stoma
D. Semi-formed stool noted in the ostomy pouch --//ANS//--B. Purple discoloration of the stoma
Rationale:
Ischemia of the stoma would be associated with a dusky or bluish or purple color. A beefy red
and shiny stoma is normal and expected. Skin excoriation needs to be addressed and treated but
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does not require as immediate attention as purple discoloration of the stoma. Semi-formed stool
is a normal finding.
A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus
from the stoma. What is the correct interpretation by the nurse?
A. This is a normal, expected event.
B. The client is experiencing early signs of ischemic bowel.
C. The client should not have the nasogastric tube removed.
D. This indicates inadequate preoperative bowel preparation. --//ANS//--A. This is a normal,
expected event.
Rationale:
As peristalsis returns following creation of a colostomy, the client begins to pass malodorous
flatus. This indicates returning bowel function and is an expected event. Within 72 hours of
surgery, the client should begin passing stool via the colostomy. Options 2, 3, and 4 are incorrect
interpretations.
A client has just had surgery to create an ileostomy. The nurse assesses the client in the
immediate postoperative period for which most frequent complication of this type of surgery?
A. Folate deficiency
B. Malabsorption of fat
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C. Intestinal obstruction
D. Fluid and electrolyte imbalance --//ANS//--D. Fluid and electrolyte imbalance
Rationale:
A frequent complication that occurs following ileostomy is fluid and electrolyte imbalance. The
client requires constant monitoring of intake and output to prevent this from occurring. Losses
require replacement by intravenous infusion until the client can tolerate a diet orally. Intestinal
obstruction is a less frequent complication. Fat malabsorption and folate deficiency are
complications that could occur later in the postoperative period.
The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome
(IBS). Which statement by the client indicates a need for further teaching?
A. "I need to limit my intake of dietary fiber."
B. "I need to drink plenty, at least 8 to 10 cups daily."
C. "I need to eat regular meals and chew my food well."
D. "I will take the prescribed medications because they will regulate my bowel patterns." --
//ANS//--A. "I need to limit my intake of dietary fiber."
Rationale:
IBS is a functional gastrointestinal disorder that causes chronic or recurrent diarrhea,
constipation, and/or abdominal pain and bloating. Dietary fiber and bulk help to produce bulky,
soft stools and establish regular bowel elimination habits. Therefore, the client should consume a
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high-fiber diet. Eating regular meals, drinking 8 to 10 cups of liquid a day, and chewing food
slowly help to promote normal bowel function. Medication therapy depends on the main
symptoms of IBS. Bulk-forming laxatives or antidiarrheal agents or other agents may be
prescribed.
The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which
findings indicate this occurrence?
A. Sweating and pallor
B. Bradycardia and indigestion
C. Double vision and chest pain
D. Abdominal cramping and pain --//ANS//--A. Sweating and pallor
Rationale:
Early manifestations of dumping syndrome occur 5 to 30 minutes after eating. Symptoms include
vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down.
The nurse inspects the color of the drainage from a nasogastric tube on a postoperative client
approximately 24 hours after gastric surgery. Which finding indicates the need to notify the
health care provider (HCP)?
A. Dark red drainage
B. Dark brown drainage
NUR1025 Med Surg Gastrointestinal
NCLEX 2026 STUDY GUIDE 1000
QUESTIONS AND EXPERT VERIFIED
ANSWERS WITH RATIONALES
ALREADY GRADED A+,exams of
nursing
The nurse is providing care for a client with a recent transverse colostomy. Which observation
requires immediate notification of the health care provider?
A. Stoma is beefy red and shiny
B. Purple discoloration of the stoma
C. Skin excoriation around the stoma
D. Semi-formed stool noted in the ostomy pouch --//ANS//--B. Purple discoloration of the stoma
Rationale:
Ischemia of the stoma would be associated with a dusky or bluish or purple color. A beefy red
and shiny stoma is normal and expected. Skin excoriation needs to be addressed and treated but
,2|Page
does not require as immediate attention as purple discoloration of the stoma. Semi-formed stool
is a normal finding.
A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus
from the stoma. What is the correct interpretation by the nurse?
A. This is a normal, expected event.
B. The client is experiencing early signs of ischemic bowel.
C. The client should not have the nasogastric tube removed.
D. This indicates inadequate preoperative bowel preparation. --//ANS//--A. This is a normal,
expected event.
Rationale:
As peristalsis returns following creation of a colostomy, the client begins to pass malodorous
flatus. This indicates returning bowel function and is an expected event. Within 72 hours of
surgery, the client should begin passing stool via the colostomy. Options 2, 3, and 4 are incorrect
interpretations.
A client has just had surgery to create an ileostomy. The nurse assesses the client in the
immediate postoperative period for which most frequent complication of this type of surgery?
A. Folate deficiency
B. Malabsorption of fat
,3|Page
C. Intestinal obstruction
D. Fluid and electrolyte imbalance --//ANS//--D. Fluid and electrolyte imbalance
Rationale:
A frequent complication that occurs following ileostomy is fluid and electrolyte imbalance. The
client requires constant monitoring of intake and output to prevent this from occurring. Losses
require replacement by intravenous infusion until the client can tolerate a diet orally. Intestinal
obstruction is a less frequent complication. Fat malabsorption and folate deficiency are
complications that could occur later in the postoperative period.
The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome
(IBS). Which statement by the client indicates a need for further teaching?
A. "I need to limit my intake of dietary fiber."
B. "I need to drink plenty, at least 8 to 10 cups daily."
C. "I need to eat regular meals and chew my food well."
D. "I will take the prescribed medications because they will regulate my bowel patterns." --
//ANS//--A. "I need to limit my intake of dietary fiber."
Rationale:
IBS is a functional gastrointestinal disorder that causes chronic or recurrent diarrhea,
constipation, and/or abdominal pain and bloating. Dietary fiber and bulk help to produce bulky,
soft stools and establish regular bowel elimination habits. Therefore, the client should consume a
, 4|Page
high-fiber diet. Eating regular meals, drinking 8 to 10 cups of liquid a day, and chewing food
slowly help to promote normal bowel function. Medication therapy depends on the main
symptoms of IBS. Bulk-forming laxatives or antidiarrheal agents or other agents may be
prescribed.
The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which
findings indicate this occurrence?
A. Sweating and pallor
B. Bradycardia and indigestion
C. Double vision and chest pain
D. Abdominal cramping and pain --//ANS//--A. Sweating and pallor
Rationale:
Early manifestations of dumping syndrome occur 5 to 30 minutes after eating. Symptoms include
vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down.
The nurse inspects the color of the drainage from a nasogastric tube on a postoperative client
approximately 24 hours after gastric surgery. Which finding indicates the need to notify the
health care provider (HCP)?
A. Dark red drainage
B. Dark brown drainage
