MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain, and appendici�s is suspected. Laboratory tests are performed, and the nurse notes that
the client's white blood cell (WBC) count is elevated. On the basis of these findings, the nurse should
ques�on which health care provider (HCP) prescrip�on documented in the client's medical record?
A. Apply a cold pack to the abdomen.
B. Administer 30 mL of milk of magnesia (MOM).
C. Maintain nothing by mouth (nil per os [NPO]) status.
D. Ini�ate an intravenous (IV) line for the administra�on of IV fluids. - ansB. Administer 30 mL of milk of
magnesia (MOM).
Ra�onale:
Appendici�s should be suspected in a client with an elevated WBC count complaining of acute right
lower abdominal quadrant pain. Laxa�ves are never prescribed because if appendici�s is present, the
effect of the laxa�ve may cause a rupture with resultant peritoni�s. Cold packs may be prescribed for
comfort. The client would be NPO and given IV fluids in prepara�on for possible surgery.
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain. Appendici�s is suspected, and appropriate laboratory tests are performed. The
emergency department nurse reviews the test results and notes that the client's white blood cell (WBC)
count is elevated. The nurse also reviews the prescrip�ons from the health care provider (HCP). The
nurse should contact the HCP to ques�on which prescrip�on if noted in the client's record?
A. Maintain a semi Fowler's posi�on.
B. Maintain on NPO (nothing by mouth) status.
C.Apply a hea�ng pad to the lower abdomen for comfort.
D. Ini�ate an intravenous (IV) line with the administra�on of IV fluids. - ansC.Apply a hea�ng pad to the
lower abdomen for comfort.
Ra�onale:
Appendici�s should be suspected in a client with an elevated WBC count who is complaining of acute
right lower quadrant abdominal pain. A semi Fowler's posi�on is maintained for comfort. The client
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
would be on NPO status and given IV fluids in prepara�on for possible surgery. Heat should never be
applied to the abdomen because this may increase circula�on to the appendix, poten�ally leading to
increased inflamma�on and perfora�on.
A client experiencing chronic dumping syndrome makes the following comments to the nurse. Which
one indicates the need for further teaching?
A. "I eat at least 3 large meals each day."
B. "I eat while lying in a semirecumbent posi�on."
C. "I have eliminated taking liquids with my meals."
D. "I eat a high-protein, low- to moderate-carbohydrate diet." - ansA. "I eat at least 3 large meals each
day."
Ra�onale:
Dumping syndrome describes a group of symptoms that occur a�er ea�ng. It is believed to result from
rapid dumping of gastric contents into the small intes�ne, which causes fluid to shi� into the intes�ne.
Signs and symptoms of dumping syndrome include diarrhea, abdominal disten�on, swea�ng, pallor,
palpita�ons, and syncope. To manage this syndrome, clients are encouraged to decrease the amount of
food taken at each si�ng, eat in a semirecumbent posi�on, eliminate inges�ng fluids with meals, and
avoid consump�on of high-carbohydrate meals.
A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the
stoma. What is the correct interpreta�on 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 preopera�ve bowel prepara�on. - ansA. This is a normal, expected event.
Ra�onale:
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
As peristalsis returns following crea�on of a colostomy, the client begins to pass malodorous flatus. This
indicates returning bowel func�on and is an expected event. Within 72 hours of surgery, the client
should begin passing stool via the colostomy. Op�ons 2, 3, and 4 are incorrect interpreta�ons.
A client has a large, deep duodenal ulcer diagnosed by endoscopy. Which sign or symptom indica�ve of a
complica�on should the nurse look for during the client's postprocedure assessment?
A. Bradycardia
B. Nausea and vomi�ng
C. Numbness in the legs
D. A rigid, boardlike abdomen - ansD. A rigid, boardlike abdomen
Ra�onale:
The client with a large, deep duodenal ulcer is at risk for perfora�on of the ulcer. If this occurs, the client
will experience sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading
over the abdomen, which then becomes rigid and boardlike. Tachycardia, not bradycardia, may occur as
hypovolemic shock develops. Nausea and vomi�ng may not occur if the pyloric sphincter is intact.
Numbness in the legs is not an associated finding.
A client has just had a hemorrhoidectomy. Which nursing interven�ons are appropriate for this client?
Select all that apply.
A. Administer stool so�eners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary reten�on.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing un�l the packing is removed.
E. Help the client to a Fowler's posi�on to place pressure on the rectal area and decrease bleeding. -
ansA. Administer stool so�eners as prescribed.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing un�l the packing is removed.
, MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
Ra�onale:
Nursing interven�ons a�er a hemorrhoidectomy are aimed at management of pain and avoidance of
bleeding and incision rupture. Stool so�eners and a high-fiber diet will help the client to avoid straining,
thereby reducing the chances of rupturing the incision. An ice pack will increase comfort and decrease
bleeding. Op�ons 2 and 5 are incorrect interven�ons.
A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate
postopera�ve period for which most frequent complica�on of this type of surgery?
A. Folate deficiency
B. Malabsorp�on of fat
C. Intes�nal obstruc�on
D. Fluid and electrolyte imbalance - ansD. Fluid and electrolyte imbalance
Ra�onale:
A frequent complica�on 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 un�l the client can tolerate a diet orally. Intes�nal obstruc�on is a
less frequent complica�on. Fat malabsorp�on and folate deficiency are complica�ons that could occur
later in the postopera�ve period.
A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which
item as part of the client's care plan?
1. Monitoring the temperature
2. Monitoring complaints of heartburn
3. Giving warm gargles for a sore throat
4. Assessing for the return of the gag reflex - ans4. Assessing for the return of the gag reflex
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain, and appendici�s is suspected. Laboratory tests are performed, and the nurse notes that
the client's white blood cell (WBC) count is elevated. On the basis of these findings, the nurse should
ques�on which health care provider (HCP) prescrip�on documented in the client's medical record?
A. Apply a cold pack to the abdomen.
B. Administer 30 mL of milk of magnesia (MOM).
C. Maintain nothing by mouth (nil per os [NPO]) status.
D. Ini�ate an intravenous (IV) line for the administra�on of IV fluids. - ansB. Administer 30 mL of milk of
magnesia (MOM).
Ra�onale:
Appendici�s should be suspected in a client with an elevated WBC count complaining of acute right
lower abdominal quadrant pain. Laxa�ves are never prescribed because if appendici�s is present, the
effect of the laxa�ve may cause a rupture with resultant peritoni�s. Cold packs may be prescribed for
comfort. The client would be NPO and given IV fluids in prepara�on for possible surgery.
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain. Appendici�s is suspected, and appropriate laboratory tests are performed. The
emergency department nurse reviews the test results and notes that the client's white blood cell (WBC)
count is elevated. The nurse also reviews the prescrip�ons from the health care provider (HCP). The
nurse should contact the HCP to ques�on which prescrip�on if noted in the client's record?
A. Maintain a semi Fowler's posi�on.
B. Maintain on NPO (nothing by mouth) status.
C.Apply a hea�ng pad to the lower abdomen for comfort.
D. Ini�ate an intravenous (IV) line with the administra�on of IV fluids. - ansC.Apply a hea�ng pad to the
lower abdomen for comfort.
Ra�onale:
Appendici�s should be suspected in a client with an elevated WBC count who is complaining of acute
right lower quadrant abdominal pain. A semi Fowler's posi�on is maintained for comfort. The client
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
would be on NPO status and given IV fluids in prepara�on for possible surgery. Heat should never be
applied to the abdomen because this may increase circula�on to the appendix, poten�ally leading to
increased inflamma�on and perfora�on.
A client experiencing chronic dumping syndrome makes the following comments to the nurse. Which
one indicates the need for further teaching?
A. "I eat at least 3 large meals each day."
B. "I eat while lying in a semirecumbent posi�on."
C. "I have eliminated taking liquids with my meals."
D. "I eat a high-protein, low- to moderate-carbohydrate diet." - ansA. "I eat at least 3 large meals each
day."
Ra�onale:
Dumping syndrome describes a group of symptoms that occur a�er ea�ng. It is believed to result from
rapid dumping of gastric contents into the small intes�ne, which causes fluid to shi� into the intes�ne.
Signs and symptoms of dumping syndrome include diarrhea, abdominal disten�on, swea�ng, pallor,
palpita�ons, and syncope. To manage this syndrome, clients are encouraged to decrease the amount of
food taken at each si�ng, eat in a semirecumbent posi�on, eliminate inges�ng fluids with meals, and
avoid consump�on of high-carbohydrate meals.
A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the
stoma. What is the correct interpreta�on 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 preopera�ve bowel prepara�on. - ansA. This is a normal, expected event.
Ra�onale:
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
As peristalsis returns following crea�on of a colostomy, the client begins to pass malodorous flatus. This
indicates returning bowel func�on and is an expected event. Within 72 hours of surgery, the client
should begin passing stool via the colostomy. Op�ons 2, 3, and 4 are incorrect interpreta�ons.
A client has a large, deep duodenal ulcer diagnosed by endoscopy. Which sign or symptom indica�ve of a
complica�on should the nurse look for during the client's postprocedure assessment?
A. Bradycardia
B. Nausea and vomi�ng
C. Numbness in the legs
D. A rigid, boardlike abdomen - ansD. A rigid, boardlike abdomen
Ra�onale:
The client with a large, deep duodenal ulcer is at risk for perfora�on of the ulcer. If this occurs, the client
will experience sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading
over the abdomen, which then becomes rigid and boardlike. Tachycardia, not bradycardia, may occur as
hypovolemic shock develops. Nausea and vomi�ng may not occur if the pyloric sphincter is intact.
Numbness in the legs is not an associated finding.
A client has just had a hemorrhoidectomy. Which nursing interven�ons are appropriate for this client?
Select all that apply.
A. Administer stool so�eners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary reten�on.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing un�l the packing is removed.
E. Help the client to a Fowler's posi�on to place pressure on the rectal area and decrease bleeding. -
ansA. Administer stool so�eners as prescribed.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing un�l the packing is removed.
, MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
Ra�onale:
Nursing interven�ons a�er a hemorrhoidectomy are aimed at management of pain and avoidance of
bleeding and incision rupture. Stool so�eners and a high-fiber diet will help the client to avoid straining,
thereby reducing the chances of rupturing the incision. An ice pack will increase comfort and decrease
bleeding. Op�ons 2 and 5 are incorrect interven�ons.
A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate
postopera�ve period for which most frequent complica�on of this type of surgery?
A. Folate deficiency
B. Malabsorp�on of fat
C. Intes�nal obstruc�on
D. Fluid and electrolyte imbalance - ansD. Fluid and electrolyte imbalance
Ra�onale:
A frequent complica�on 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 un�l the client can tolerate a diet orally. Intes�nal obstruc�on is a
less frequent complica�on. Fat malabsorp�on and folate deficiency are complica�ons that could occur
later in the postopera�ve period.
A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which
item as part of the client's care plan?
1. Monitoring the temperature
2. Monitoring complaints of heartburn
3. Giving warm gargles for a sore throat
4. Assessing for the return of the gag reflex - ans4. Assessing for the return of the gag reflex
