GI EXAM QUESTIONS AND ANSWERS
The nurse caring for a client with small-bowel obstruction would plan to implement
which nursing intervention first?
a. Administering pain medication
b. Obtaining a blood sample for laboratory studies
c. Preparing to insert a nasogastric (NG) tube
d. Administering I.V. fluids - Answer -Answer D. I.V. infusions containing normal saline
solution and potassium should be given first to maintain fluid and electrolyte balance.
For the client's comfort and to assist in bowel decompression, the nurse should prepare
to insert an NG tube next. A blood sample is then obtained for laboratory studies to aid
in the diagnosis of bowel obstruction and guide treatment. Blood studies usually include
a complete blood count, serum electrolyte levels, and blood urea nitrogen level. Pain
medication often is withheld until obstruction is diagnosed because analgesics can
decrease intestinal motility
1. An adult who has cholecystitis reports clay colored stools and moderate jaundice.
Which is the best explanation for the presence of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct. - Answer -(4) Clay colored stools
means bile is not getting through to the duodenum. The bile duct is obstructed so bile
backs up into the bloodstream causing jaundice
Atropine 0.5 mg is ordered for a client having an acute attack of cholecystitis. What is
the primary purpose of this drug for this client?
1. decrease skeletal muscle spasms.
2. increase gastrointestinal peristalsis
3. decrease smooth muscle contractions
4. decrease anxiety - Answer -(3) Atropine is an anticholinergic drug , which will
decrease contractions of the gallbladder.
An adult male is admitted to the hospital complaining of burning epigastric pain. He
reports to the nurse that he has gained 14 pounds over the last two months. Which
nursing response is best?
1. "Why were you eating more?"
2. "Has the weight gain been intentional?"
3. "Does your weight usually fluctuate this much?"
,4. "How did your eating habits change?" - Answer -(4) Weight gain may occur due to
increased consumption of food as the client tries to feed a duodenal ulcer. "Why"
questions are threatening to clients. #3 asks for a yes or no answer. This will not give as
much information as asking about the eating habits.
A barium enema is ordered for an adult male client. The nurse is teaching him what to
expect regarding the procedure. Which statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure. - Answer -1) The bowel must
be free of fecal material for good visualization of the bowel. He will be on a clear liquid
or low residue diet for the day preceding the exam. The client is put in several positions
during the test. Barium is given by enema. It is given by mouth in an upper GI series.
An adult is admitted with a duodenal ulcer. On the second day after admission, the
client develops severe, persistent pain radiating to the shoulder. What action should the
nurse take first?
1. Notify the physician.
2. Place client in a high-Fowler's position to decrease pressure on the gastric area and
shoulder.
3. Examine the client for board-like rigidity of the abdomen.
4. Administer ordered prn pain medication. - Answer -(3) The nurse should first do a
quick assessment to determine if the cause of the pain is more apt to be perforation of
the ulcer or something else such as cardiac pain. If the ulcer has perforated the client's
abdomen will be tender and rigid - board like.
. During preparation for bowel surgery, a male client receives an antibiotic to reduce
intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and
may lead to hypoprothrombinemia?
a. vitamin A
b. vitamin D
c. vitamin E
d. vitamin K - Answer -Answer D. Intestinal bacteria synthesize such nutritional
substances as vitamin K, thiamine, riboflavin, vitamin B12, folic acid, biotin, and nicotinic
acid. Therefore, antibiotic therapy may interfere with synthesis of these substances,
including vitamin K. Intestinal bacteria don't synthesize vitamins A, D, or E.
A male client with a recent history of rectal bleeding is being prepared for a
colonoscopy. How should the nurse position the client for this test initially?
a. Lying on the right side with legs straight
b. Lying on the left side with knees bent
, c. Prone with the torso elevated
d. Bent over with hands touching the floor - Answer -Answer B. For a colonoscopy, the
nurse initially should position the client on the left side with knees bent. Placing the
client on the right side with legs straight, prone with the torso elevated, or bent over with
hands touching the floor wouldn't allow proper visualization of the large intestine.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate
that the client has deficient vitamin K absorption caused by this hepatic disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura and petechiae
d. Gynecomastia and testicular atrophy - Answer -Answer C. A hepatic disorder, such
as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a
clotting factor). Consequently, the nurse should monitor the client for signs of bleeding,
including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and
orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy
result from decreased estrogen metabolism by the diseased liver.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
a. Appendicitis
b. Pancreatitis
c. Cholecystitis
d. Gastric ulcer - Answer -Answer B. Hypovolemic shock from fluid shifts is a major
factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume
deficit.
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube
becomes clogged. To remedy this problem and teach the client's family how to deal with
it at home, what should the nurse do?
a. Irrigate the tube with cola.
b. Advance the tube into the intestine.
c. Apply intermittent suction to the tube.
d. Withdraw the obstruction with a 30-ml syringe. - Answer -Answer A. The nurse
should irrigate the tube with cola because its effervescence and acidity are suited to the
purpose, it's inexpensive, and it's readily available in most homes. Advancing the NG
tube is inappropriate because the tube is designed to stay in the stomach and isn't long
enough to reach the intestines. Applying intermittent suction or using a syringe for
aspiration is unlikely to dislodge the material clogging the tube but may create excess
pressure. Intermittent suction may even collapse the tube.
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When
assessing this client, the nurse expects to note:
The nurse caring for a client with small-bowel obstruction would plan to implement
which nursing intervention first?
a. Administering pain medication
b. Obtaining a blood sample for laboratory studies
c. Preparing to insert a nasogastric (NG) tube
d. Administering I.V. fluids - Answer -Answer D. I.V. infusions containing normal saline
solution and potassium should be given first to maintain fluid and electrolyte balance.
For the client's comfort and to assist in bowel decompression, the nurse should prepare
to insert an NG tube next. A blood sample is then obtained for laboratory studies to aid
in the diagnosis of bowel obstruction and guide treatment. Blood studies usually include
a complete blood count, serum electrolyte levels, and blood urea nitrogen level. Pain
medication often is withheld until obstruction is diagnosed because analgesics can
decrease intestinal motility
1. An adult who has cholecystitis reports clay colored stools and moderate jaundice.
Which is the best explanation for the presence of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct. - Answer -(4) Clay colored stools
means bile is not getting through to the duodenum. The bile duct is obstructed so bile
backs up into the bloodstream causing jaundice
Atropine 0.5 mg is ordered for a client having an acute attack of cholecystitis. What is
the primary purpose of this drug for this client?
1. decrease skeletal muscle spasms.
2. increase gastrointestinal peristalsis
3. decrease smooth muscle contractions
4. decrease anxiety - Answer -(3) Atropine is an anticholinergic drug , which will
decrease contractions of the gallbladder.
An adult male is admitted to the hospital complaining of burning epigastric pain. He
reports to the nurse that he has gained 14 pounds over the last two months. Which
nursing response is best?
1. "Why were you eating more?"
2. "Has the weight gain been intentional?"
3. "Does your weight usually fluctuate this much?"
,4. "How did your eating habits change?" - Answer -(4) Weight gain may occur due to
increased consumption of food as the client tries to feed a duodenal ulcer. "Why"
questions are threatening to clients. #3 asks for a yes or no answer. This will not give as
much information as asking about the eating habits.
A barium enema is ordered for an adult male client. The nurse is teaching him what to
expect regarding the procedure. Which statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure. - Answer -1) The bowel must
be free of fecal material for good visualization of the bowel. He will be on a clear liquid
or low residue diet for the day preceding the exam. The client is put in several positions
during the test. Barium is given by enema. It is given by mouth in an upper GI series.
An adult is admitted with a duodenal ulcer. On the second day after admission, the
client develops severe, persistent pain radiating to the shoulder. What action should the
nurse take first?
1. Notify the physician.
2. Place client in a high-Fowler's position to decrease pressure on the gastric area and
shoulder.
3. Examine the client for board-like rigidity of the abdomen.
4. Administer ordered prn pain medication. - Answer -(3) The nurse should first do a
quick assessment to determine if the cause of the pain is more apt to be perforation of
the ulcer or something else such as cardiac pain. If the ulcer has perforated the client's
abdomen will be tender and rigid - board like.
. During preparation for bowel surgery, a male client receives an antibiotic to reduce
intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and
may lead to hypoprothrombinemia?
a. vitamin A
b. vitamin D
c. vitamin E
d. vitamin K - Answer -Answer D. Intestinal bacteria synthesize such nutritional
substances as vitamin K, thiamine, riboflavin, vitamin B12, folic acid, biotin, and nicotinic
acid. Therefore, antibiotic therapy may interfere with synthesis of these substances,
including vitamin K. Intestinal bacteria don't synthesize vitamins A, D, or E.
A male client with a recent history of rectal bleeding is being prepared for a
colonoscopy. How should the nurse position the client for this test initially?
a. Lying on the right side with legs straight
b. Lying on the left side with knees bent
, c. Prone with the torso elevated
d. Bent over with hands touching the floor - Answer -Answer B. For a colonoscopy, the
nurse initially should position the client on the left side with knees bent. Placing the
client on the right side with legs straight, prone with the torso elevated, or bent over with
hands touching the floor wouldn't allow proper visualization of the large intestine.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate
that the client has deficient vitamin K absorption caused by this hepatic disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura and petechiae
d. Gynecomastia and testicular atrophy - Answer -Answer C. A hepatic disorder, such
as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a
clotting factor). Consequently, the nurse should monitor the client for signs of bleeding,
including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and
orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy
result from decreased estrogen metabolism by the diseased liver.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
a. Appendicitis
b. Pancreatitis
c. Cholecystitis
d. Gastric ulcer - Answer -Answer B. Hypovolemic shock from fluid shifts is a major
factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume
deficit.
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube
becomes clogged. To remedy this problem and teach the client's family how to deal with
it at home, what should the nurse do?
a. Irrigate the tube with cola.
b. Advance the tube into the intestine.
c. Apply intermittent suction to the tube.
d. Withdraw the obstruction with a 30-ml syringe. - Answer -Answer A. The nurse
should irrigate the tube with cola because its effervescence and acidity are suited to the
purpose, it's inexpensive, and it's readily available in most homes. Advancing the NG
tube is inappropriate because the tube is designed to stay in the stomach and isn't long
enough to reach the intestines. Applying intermittent suction or using a syringe for
aspiration is unlikely to dislodge the material clogging the tube but may create excess
pressure. Intermittent suction may even collapse the tube.
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When
assessing this client, the nurse expects to note:
