EXAM
Exam Solution ga
Med Surg Gastrointestinal NCLEX Questions 2026 A+ GR
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ADE ASSURED COMPLETE SOLUTIONS AND VERIFIED A
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NSWERS (DBB39) ga
QUESTION 1 ga
The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) abo
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ut substances to avoid. Which items should the nurse include on this list? Select all that
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apply.
A. Coffee
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B. Chocolate
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C. Peppermint
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D. Nonfat milk
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E. Fried chicken F. Scrambled eggs
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ANSWER
A. Coffee
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B. Chocolate
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C. Peppermint
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E. Fried chicken Rationale: Foods that decrease lower esophageal sphincter (LES) pressure and irritate
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the esophagus will increase reflux and exacerbate the symptoms of GERD and therefore should be avoi
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ded. Aggravating substances include coffee, chocolate, peppermint, fried or fatty foods, carbonated beve
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rages, and alcohol. Options 4 and 6 do not promote this effect.
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QUESTION 2 ga
A client has undergone esophagogastroduodenoscopy. The nurse should place highest pr
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iority on which item as part of the client's care plan? 1. Monitoring the temperature 2. M
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onitoring complaints of heartburn 3. Giving warm gargles for a sore throat 4. Assessing f
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or the return of the gag reflex
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ANSWER
4. Assessing for the return of the gag reflex Rationale: The nurse places highest priority on assessing fo
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r return of the gag reflex. This assessment addresses the client's airway. The nurse also monitors the cli
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ent's vital signs and for a sudden increase in temperature, which could indicate perforation of the gastr
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,ointestinal tract. This complication would be accompanied by other signs as well, such as pain. Monitori
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ng for sore throat and heartburn are also important; however, the client's airway is the priority.
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QUESTION 3 ga
The nurse is providing dietary teaching for a client with a diagnosis of chronic gastritis.
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The nurse instructs the client to include which foods rich in vitamin B12 in the diet? Sel
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ect all that apply.
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A. Nuts
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B. Corn
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C. Liver
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D. Applesga
E. Lentils F. Bananas
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ANSWER
A. Nuts
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C. Liver
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E. Lentils Rationale: Chronic gastritis causes deterioration and atrophy of the lining of the stomach, lea
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ding to the loss of function of the parietal cells. The source of intrinsic factor is lost, which results in an
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ainability to absorb vitamin B12, leading to development of pernicious anemia. Clients must increase the
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ir intake of vitamin B12 by increasing consumption of foods rich in this vitamin, such as nuts, organ me
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ats, dried beans, citrus fruits, green leafy vegetables, and yeast.
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QUESTION 4 ga
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment findi
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ng would most likely indicate perforation of the ulcer?
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A. Bradycardia
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B. Numbness in the legs
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C. Nausea and vomiting
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D. A rigid, boardlike abdomen
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ANSWER
D. A rigid, boardlike abdomen Rationale: Perforation of an ulcer is a surgical emergency and is characte
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rized by sudden, sharp, intolerable severe pain beginning in the mid-
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epigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomit
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ing may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an a
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ssociated finding. ga
QUESTION 5 ga
The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). W
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hich postoperative prescription should the nurse question and verify?
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A. Leg exercises
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B. Early ambulation
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, C. Irrigating the nasogastric tube
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D. Coughing and deep-breathing exercises
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ANSWER
C. Irrigating the nasogastric tube Rationale: In a gastrojejunostomy (Billroth II procedure), the proximal
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remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is cri
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tical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the
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gastric tube after gastric surgery, unless specifically prescribed by the health care provider. In this situ
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ation, the nurse should clarify the prescription. Options 1, 2, and 4 are appropriate postoperative interv
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entions.
QUESTION 6 ga
The nurse is providing discharge instructions to a client following gastrectomy and shou
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ld instruct the client to take which measure to assist in preventing dumping syndrome?
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A. Ambulate following a meal.
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B. Eat high-carbohydrate foods.
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C. Limit the fluids taken with meals.
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D. Sit in a high Fowler's position during meals.
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ANSWER
C. Limit the fluids taken with meals. Rationale: Dumping syndrome is a term that refers to a constellati
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on of vasomotor symptoms that occurs after eating, especially following a gastrojejunostomy (Billroth II
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procedure). Early manifestations usually occur within 30 minutes of eating and include vertigo, tachyc
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ardia, syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should instruct the
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client to decrease the amount of fluid taken at meals and to avoid high-
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carbohydrate foods, including fluids such as fruit nectars; to assume a low Fowler's position during me
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als; to lie down for 30 minutes after eating to delay gastric emptying; and to take antispasmodics as pr
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escribed.
QUESTION 7 ga
The nurse is doing an admission assessment on a client with a history of duodenal ulcer.
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To determine whether the problem is currently active, the nurse should assess the clien
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t for which sign(s)/symptom(s) of duodenal ulcer?
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A. Weight loss
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B. Nausea and vomiting
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C. Pain relieved by food intake
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D. Pain radiating down the right arm
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ANSWER
C. Pain relieved by food intake Rationale: A frequent symptom of duodenal ulcer is pain that is relieved
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by food intake. These clients generally describe the pain as a burning, heavy, sharp, or "hungry" pain th
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at often localizes in the mid-
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epigastric area. The client with duodenal ulcer usually does not experience weight loss or nausea and v
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omiting. These symptoms are more typical in the client with a gastric ulcer.
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Exam Solution ga
Med Surg Gastrointestinal NCLEX Questions 2026 A+ GR
ga ga ga ga ga ga ga
ADE ASSURED COMPLETE SOLUTIONS AND VERIFIED A
ga ga ga ga ga ga
NSWERS (DBB39) ga
QUESTION 1 ga
The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) abo
ga ga ga ga ga ga ga ga ga ga ga ga ga
ut substances to avoid. Which items should the nurse include on this list? Select all that
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
apply.
A. Coffee
ga
B. Chocolate
ga
C. Peppermint
ga
D. Nonfat milk
ga ga
E. Fried chicken F. Scrambled eggs
ga ga ga ga ga
ANSWER
A. Coffee
ga
B. Chocolate
ga
C. Peppermint
ga
E. Fried chicken Rationale: Foods that decrease lower esophageal sphincter (LES) pressure and irritate
ga ga ga ga ga ga ga ga ga ga ga ga ga ga
the esophagus will increase reflux and exacerbate the symptoms of GERD and therefore should be avoi
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ded. Aggravating substances include coffee, chocolate, peppermint, fried or fatty foods, carbonated beve
ga ga ga ga ga ga ga ga ga ga ga ga
rages, and alcohol. Options 4 and 6 do not promote this effect.
ga ga ga ga ga ga ga ga ga ga ga
QUESTION 2 ga
A client has undergone esophagogastroduodenoscopy. The nurse should place highest pr
ga ga ga ga ga ga ga ga ga ga
iority on which item as part of the client's care plan? 1. Monitoring the temperature 2. M
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
onitoring complaints of heartburn 3. Giving warm gargles for a sore throat 4. Assessing f
ga ga ga ga ga ga ga ga ga ga ga ga ga ga
or the return of the gag reflex
ga ga ga ga ga ga
ANSWER
4. Assessing for the return of the gag reflex Rationale: The nurse places highest priority on assessing fo
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
r return of the gag reflex. This assessment addresses the client's airway. The nurse also monitors the cli
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ent's vital signs and for a sudden increase in temperature, which could indicate perforation of the gastr
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
,ointestinal tract. This complication would be accompanied by other signs as well, such as pain. Monitori
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ng for sore throat and heartburn are also important; however, the client's airway is the priority.
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
QUESTION 3 ga
The nurse is providing dietary teaching for a client with a diagnosis of chronic gastritis.
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
The nurse instructs the client to include which foods rich in vitamin B12 in the diet? Sel
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ect all that apply.
ga ga ga
A. Nuts
ga
B. Corn
ga
C. Liver
ga
D. Applesga
E. Lentils F. Bananas
ga ga ga
ANSWER
A. Nuts
ga
C. Liver
ga
E. Lentils Rationale: Chronic gastritis causes deterioration and atrophy of the lining of the stomach, lea
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ding to the loss of function of the parietal cells. The source of intrinsic factor is lost, which results in an
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga g
ainability to absorb vitamin B12, leading to development of pernicious anemia. Clients must increase the
ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ir intake of vitamin B12 by increasing consumption of foods rich in this vitamin, such as nuts, organ me
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ats, dried beans, citrus fruits, green leafy vegetables, and yeast.
ga ga ga ga ga ga ga ga ga
QUESTION 4 ga
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment findi
ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ng would most likely indicate perforation of the ulcer?
ga ga ga ga ga ga ga ga
A. Bradycardia
ga
B. Numbness in the legs
ga ga ga ga
C. Nausea and vomiting
ga ga ga
D. A rigid, boardlike abdomen
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ANSWER
D. A rigid, boardlike abdomen Rationale: Perforation of an ulcer is a surgical emergency and is characte
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
rized by sudden, sharp, intolerable severe pain beginning in the mid-
ga ga ga ga ga ga ga ga ga ga
epigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomit
ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ing may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an a
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ssociated finding. ga
QUESTION 5 ga
The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). W
ga ga ga ga ga ga ga ga ga ga ga ga ga
hich postoperative prescription should the nurse question and verify?
ga ga ga ga ga ga ga ga
A. Leg exercises
ga ga
B. Early ambulation
ga ga
, C. Irrigating the nasogastric tube
ga ga ga ga
D. Coughing and deep-breathing exercises
ga ga ga ga
ANSWER
C. Irrigating the nasogastric tube Rationale: In a gastrojejunostomy (Billroth II procedure), the proximal
ga ga ga ga ga ga ga ga ga ga ga ga ga
remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is cri
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
tical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
gastric tube after gastric surgery, unless specifically prescribed by the health care provider. In this situ
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ation, the nurse should clarify the prescription. Options 1, 2, and 4 are appropriate postoperative interv
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
entions.
QUESTION 6 ga
The nurse is providing discharge instructions to a client following gastrectomy and shou
ga ga ga ga ga ga ga ga ga ga ga ga
ld instruct the client to take which measure to assist in preventing dumping syndrome?
ga ga ga ga ga ga ga ga ga ga ga ga ga
A. Ambulate following a meal.
ga ga ga ga
B. Eat high-carbohydrate foods.
ga ga ga
C. Limit the fluids taken with meals.
ga ga ga ga ga ga
D. Sit in a high Fowler's position during meals.
ga ga ga ga ga ga ga ga
ANSWER
C. Limit the fluids taken with meals. Rationale: Dumping syndrome is a term that refers to a constellati
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
on of vasomotor symptoms that occurs after eating, especially following a gastrojejunostomy (Billroth II
ga ga ga ga ga ga ga ga ga ga ga ga ga
procedure). Early manifestations usually occur within 30 minutes of eating and include vertigo, tachyc
ga ga ga ga ga ga ga ga ga ga ga ga ga ga
ardia, syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should instruct the
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
client to decrease the amount of fluid taken at meals and to avoid high-
ga ga ga ga ga ga ga ga ga ga ga ga ga
carbohydrate foods, including fluids such as fruit nectars; to assume a low Fowler's position during me
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
als; to lie down for 30 minutes after eating to delay gastric emptying; and to take antispasmodics as pr
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
escribed.
QUESTION 7 ga
The nurse is doing an admission assessment on a client with a history of duodenal ulcer.
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
To determine whether the problem is currently active, the nurse should assess the clien
ga ga ga ga ga ga ga ga ga ga ga ga ga ga
t for which sign(s)/symptom(s) of duodenal ulcer?
ga ga ga ga ga ga
A. Weight loss
ga ga
B. Nausea and vomiting
ga ga ga
C. Pain relieved by food intake
ga ga ga ga ga
D. Pain radiating down the right arm
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ANSWER
C. Pain relieved by food intake Rationale: A frequent symptom of duodenal ulcer is pain that is relieved
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by food intake. These clients generally describe the pain as a burning, heavy, sharp, or "hungry" pain th
a ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
at often localizes in the mid-
ga ga ga ga ga
epigastric area. The client with duodenal ulcer usually does not experience weight loss or nausea and v
ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga ga
omiting. These symptoms are more typical in the client with a gastric ulcer.
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