NURS 120 | Medical-Surgical Nursing | Gastrointestinal Disorders |
2026 Update |WCU
1. A patient with suspected peptic ulcer disease (PUD) suddenly develops a
rigid, board-like abdomen and reports severe, radiating shoulder pain. Which
complication should the nurse prioritize?
A. Perforation with peritonitis
B. Gastric outlet obstruction
C. Gastrointestinal hemorrhage
D. Dumping syndrome
Answer: A
Rationale: A rigid, board-like abdomen and referred shoulder pain (Kehr’s sign) are classic
indicators of perforation, leading to peritonitis, which is a surgical emergency.
2. The nurse is caring for a patient with hepatic encephalopathy. Which
laboratory result is the primary rationale for the administration of lactulose?
A. Elevated Serum Ammonia
B. Elevated Serum Bilirubin
C. Decreased Serum Albumin
D. Elevated Alanine Aminotransferase (ALT)
Answer: A
Rationale: Lactulose is an osmotic laxative used to reduce serum ammonia levels by
trapping it in the gut and promoting its excretion through stool to improve neurologic
function.
,3. Which teaching point is most critical for a patient diagnosed with
Gastroesophageal Reflux Disease (GERD) regarding nighttime symptom
management?
A. Eat a high-protein snack before bed to neutralize acid.
B. Lie flat on the left side to promote gastric emptying.
C. Drink a glass of milk to coat the esophagus.
D. Avoid eating within 3 hours of bedtime.
Answer: D
Rationale: Avoiding food for at least 3 hours before sleep reduces the volume of stomach
contents and acid production, decreasing the risk of nocturnal reflux.
4. A patient who underwent a Billroth II procedure for gastric cancer reports
dizziness, palpitations, and abdominal cramping shortly after eating. What is the
nurse’s priority intervention?
A. Encourage the patient to lie down for 30 minutes after meals.
B. Administer a PRN dose of an antacid.
C. Increase the patient’s intake of concentrated carbohydrates.
D. Prepare the patient for a return to surgery.
Answer: A
Rationale: These are symptoms of dumping syndrome. Lying down after meals slows the
transit of food from the stomach to the small intestine, alleviating symptoms.
5. The nurse observes a patient’s stoma 24 hours after a permanent colostomy.
Which finding requires immediate notification of the healthcare provider?
A. The stoma is dark purple and appears dusky.
B. Small amounts of blood are oozing from the stoma.
C. The stoma is swollen and protruding slightly.
D. There is no flatus or stool being produced.
Answer: A
, Rationale: A dark purple or dusky stoma indicates compromised blood flow (ischemia)
and requires immediate surgical assessment to prevent tissue necrosis.
6. Which dietary instruction should the nurse provide to a patient during the
acute phase of Diverticulitis?
A. High-fiber diet with seeds and nuts.
B. Full liquid diet with protein shakes.
C. Strict vegan diet to reduce inflammation.
D. Low-fiber or NPO status to rest the bowel.
Answer: D
Rationale: During an acute flare of diverticulitis, the bowel requires rest (NPO or low
fiber) to allow inflammation to subside before transitioning to a high-fiber diet for
prevention.
7. A patient with Ulcerative Colitis is prescribed Sulfasalazine. The nurse should
assess for which allergy before administering the first dose?
A. Penicillin
B. Iodine
C. Sulfa drugs or Salicylates
D. Latex
Answer: C
Rationale: Sulfasalazine contains both a sulfa antibiotic component and a salicylate
(aspirin-like) component; therefore, allergies to either must be ruled out.
8. Which assessment finding is a classic indicator of acute pancreatitis?
A. Pain that is relieved by eating a fatty meal.
B. Severe epigastric pain that radiates to the back.
C. Epigastric pain that radiates to the left shoulder.
D. Tenderness at McBurney’s point.
Answer: B
2026 Update |WCU
1. A patient with suspected peptic ulcer disease (PUD) suddenly develops a
rigid, board-like abdomen and reports severe, radiating shoulder pain. Which
complication should the nurse prioritize?
A. Perforation with peritonitis
B. Gastric outlet obstruction
C. Gastrointestinal hemorrhage
D. Dumping syndrome
Answer: A
Rationale: A rigid, board-like abdomen and referred shoulder pain (Kehr’s sign) are classic
indicators of perforation, leading to peritonitis, which is a surgical emergency.
2. The nurse is caring for a patient with hepatic encephalopathy. Which
laboratory result is the primary rationale for the administration of lactulose?
A. Elevated Serum Ammonia
B. Elevated Serum Bilirubin
C. Decreased Serum Albumin
D. Elevated Alanine Aminotransferase (ALT)
Answer: A
Rationale: Lactulose is an osmotic laxative used to reduce serum ammonia levels by
trapping it in the gut and promoting its excretion through stool to improve neurologic
function.
,3. Which teaching point is most critical for a patient diagnosed with
Gastroesophageal Reflux Disease (GERD) regarding nighttime symptom
management?
A. Eat a high-protein snack before bed to neutralize acid.
B. Lie flat on the left side to promote gastric emptying.
C. Drink a glass of milk to coat the esophagus.
D. Avoid eating within 3 hours of bedtime.
Answer: D
Rationale: Avoiding food for at least 3 hours before sleep reduces the volume of stomach
contents and acid production, decreasing the risk of nocturnal reflux.
4. A patient who underwent a Billroth II procedure for gastric cancer reports
dizziness, palpitations, and abdominal cramping shortly after eating. What is the
nurse’s priority intervention?
A. Encourage the patient to lie down for 30 minutes after meals.
B. Administer a PRN dose of an antacid.
C. Increase the patient’s intake of concentrated carbohydrates.
D. Prepare the patient for a return to surgery.
Answer: A
Rationale: These are symptoms of dumping syndrome. Lying down after meals slows the
transit of food from the stomach to the small intestine, alleviating symptoms.
5. The nurse observes a patient’s stoma 24 hours after a permanent colostomy.
Which finding requires immediate notification of the healthcare provider?
A. The stoma is dark purple and appears dusky.
B. Small amounts of blood are oozing from the stoma.
C. The stoma is swollen and protruding slightly.
D. There is no flatus or stool being produced.
Answer: A
, Rationale: A dark purple or dusky stoma indicates compromised blood flow (ischemia)
and requires immediate surgical assessment to prevent tissue necrosis.
6. Which dietary instruction should the nurse provide to a patient during the
acute phase of Diverticulitis?
A. High-fiber diet with seeds and nuts.
B. Full liquid diet with protein shakes.
C. Strict vegan diet to reduce inflammation.
D. Low-fiber or NPO status to rest the bowel.
Answer: D
Rationale: During an acute flare of diverticulitis, the bowel requires rest (NPO or low
fiber) to allow inflammation to subside before transitioning to a high-fiber diet for
prevention.
7. A patient with Ulcerative Colitis is prescribed Sulfasalazine. The nurse should
assess for which allergy before administering the first dose?
A. Penicillin
B. Iodine
C. Sulfa drugs or Salicylates
D. Latex
Answer: C
Rationale: Sulfasalazine contains both a sulfa antibiotic component and a salicylate
(aspirin-like) component; therefore, allergies to either must be ruled out.
8. Which assessment finding is a classic indicator of acute pancreatitis?
A. Pain that is relieved by eating a fatty meal.
B. Severe epigastric pain that radiates to the back.
C. Epigastric pain that radiates to the left shoulder.
D. Tenderness at McBurney’s point.
Answer: B
