---
# NCLEX-RN Gastrointestinal Questions for
2024-2025 Exams – 70 Questions to Pass
on First Attempt
---
**01.** A nurse is assessing a client with suspected appendicitis. Which finding is most characteristic?
A) Rebound tenderness in the right upper quadrant
B) Pain that starts in the epigastric area and moves to the right lower quadrant
C) Left lower quadrant pain relieved by passing flatus
D) Diffuse abdominal pain with vomiting
🔍 RATIONALE💡-- Classic appendicitis presents with periumbilical or epigastric pain that migrates to the
right lower quadrant (McBurney’s point) over 4-6 hours. Rebound tenderness may be present but is not
the earliest sign.
ANSWER💫✔️-- B) Pain that starts in the epigastric area and moves to the right lower quadrant
---
**02.** A nurse is caring for a client with a new ileostomy. Which finding should the nurse report to the
provider immediately?
A) Liquid stool output of 800 mL in 24 hours
B) A stoma that is dusky purple in color
C) Irritated skin around the stoma
D) The client reports a sensation of needing to defecate
,🔍 RATIONALE💡-- A dusky or purple stoma indicates ischemia or necrosis, a surgical emergency. Normal
stoma is pink/red and moist. Liquid output is expected; skin irritation is common; rectal sensation is
normal after ileostomy.
ANSWER💫✔️-- B) A stoma that is dusky purple in color
---
**03.** A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates understanding?
A) “I will change the pouch every day to prevent infection.”
B) “I will cut the skin barrier opening exactly the size of my stoma.”
C) “I will empty the pouch when it is one‑third to one‑half full.”
D) “I can use aspirin to clean around the stoma.”
🔍 RATIONALE💡-- Emptying the pouch when 1/3‑1/2 full prevents leakage and weight on the adhesive.
The opening should be 1-2 mm larger than the stoma. Pouches can stay on 3-7 days. Use mild soap and
water, not aspirin.
ANSWER💫✔️-- C) “I will empty the pouch when it is one‑third to one‑half full.”
---
**04.** A nurse is assessing a client with acute pancreatitis. Which laboratory finding is most specific?
A) Elevated serum amylase
B) Elevated serum lipase
C) Elevated liver function tests
D) Hypocalcemia
,🔍 RATIONALE💡-- Lipase is more specific and sensitive for pancreatitis than amylase; it remains
elevated longer. Both can be elevated, but lipase is the preferred marker.
ANSWER💫✔️-- B) Elevated serum lipase
---
**05.** A nurse is caring for a client with cirrhosis who has ascites. Which intervention is most
important?
A) Measure abdominal girth daily
B) Restrict protein intake
C) Administer enteral feedings
D) Encourage a high‑sodium diet
🔍 RATIONALE💡-- Daily abdominal girth monitoring assesses progression of ascites. Sodium restriction
(not high) is key; protein restriction is only for hepatic encephalopathy.
ANSWER💫✔️-- A) Measure abdominal girth daily
---
**06.** A nurse is assessing a client with diverticulitis. Which finding requires immediate intervention?
A) Left lower quadrant pain
B) Nausea and vomiting
C) Fever of 38.5°C (101.3°F)
D) Rigid, board‑like abdomen
🔍 RATIONALE💡-- Rigid, board‑like abdomen suggests peritonitis or perforation, a surgical emergency.
The other findings are common in diverticulitis but not immediately life‑threatening.
, ANSWER💫✔️-- D) Rigid, board‑like abdomen
---
**07.** A nurse is teaching a client with gastroesophageal reflux disease (GERD) about lifestyle
modifications. Which instruction should the nurse include?
A) “Lie down immediately after eating to help digestion.”
B) “Avoid eating within 2-3 hours of bedtime.”
C) “Increase intake of peppermint and chocolate.”
D) “Wear tight‑fitting clothing to support the abdomen.”
🔍 RATIONALE💡-- Avoiding food 2-3 hours before bedtime reduces acid reflux. Lying down after eating
worsens reflux. Peppermint, chocolate, and tight clothing should be avoided as they relax the lower
esophageal sphincter.
ANSWER💫✔️-- B) “Avoid eating within 2-3 hours of bedtime.”
---
**08.** A nurse is caring for a client with a nasogastric (NG) tube for gastric decompression. Which
finding indicates proper tube placement?
A) Aspirated fluid pH of 3
B) The client reports feeling hungry
C) The nurse hears air bubbles over the epigastrium
D) The external tube length is 50 cm
🔍 RATIONALE💡-- Gastric aspirate pH ≤4.0 confirms gastric placement. Auscultation is less reliable.
External length varies; x‑ray is gold standard.
ANSWER💫✔️-- A) Aspirated fluid pH of 3
# NCLEX-RN Gastrointestinal Questions for
2024-2025 Exams – 70 Questions to Pass
on First Attempt
---
**01.** A nurse is assessing a client with suspected appendicitis. Which finding is most characteristic?
A) Rebound tenderness in the right upper quadrant
B) Pain that starts in the epigastric area and moves to the right lower quadrant
C) Left lower quadrant pain relieved by passing flatus
D) Diffuse abdominal pain with vomiting
🔍 RATIONALE💡-- Classic appendicitis presents with periumbilical or epigastric pain that migrates to the
right lower quadrant (McBurney’s point) over 4-6 hours. Rebound tenderness may be present but is not
the earliest sign.
ANSWER💫✔️-- B) Pain that starts in the epigastric area and moves to the right lower quadrant
---
**02.** A nurse is caring for a client with a new ileostomy. Which finding should the nurse report to the
provider immediately?
A) Liquid stool output of 800 mL in 24 hours
B) A stoma that is dusky purple in color
C) Irritated skin around the stoma
D) The client reports a sensation of needing to defecate
,🔍 RATIONALE💡-- A dusky or purple stoma indicates ischemia or necrosis, a surgical emergency. Normal
stoma is pink/red and moist. Liquid output is expected; skin irritation is common; rectal sensation is
normal after ileostomy.
ANSWER💫✔️-- B) A stoma that is dusky purple in color
---
**03.** A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates understanding?
A) “I will change the pouch every day to prevent infection.”
B) “I will cut the skin barrier opening exactly the size of my stoma.”
C) “I will empty the pouch when it is one‑third to one‑half full.”
D) “I can use aspirin to clean around the stoma.”
🔍 RATIONALE💡-- Emptying the pouch when 1/3‑1/2 full prevents leakage and weight on the adhesive.
The opening should be 1-2 mm larger than the stoma. Pouches can stay on 3-7 days. Use mild soap and
water, not aspirin.
ANSWER💫✔️-- C) “I will empty the pouch when it is one‑third to one‑half full.”
---
**04.** A nurse is assessing a client with acute pancreatitis. Which laboratory finding is most specific?
A) Elevated serum amylase
B) Elevated serum lipase
C) Elevated liver function tests
D) Hypocalcemia
,🔍 RATIONALE💡-- Lipase is more specific and sensitive for pancreatitis than amylase; it remains
elevated longer. Both can be elevated, but lipase is the preferred marker.
ANSWER💫✔️-- B) Elevated serum lipase
---
**05.** A nurse is caring for a client with cirrhosis who has ascites. Which intervention is most
important?
A) Measure abdominal girth daily
B) Restrict protein intake
C) Administer enteral feedings
D) Encourage a high‑sodium diet
🔍 RATIONALE💡-- Daily abdominal girth monitoring assesses progression of ascites. Sodium restriction
(not high) is key; protein restriction is only for hepatic encephalopathy.
ANSWER💫✔️-- A) Measure abdominal girth daily
---
**06.** A nurse is assessing a client with diverticulitis. Which finding requires immediate intervention?
A) Left lower quadrant pain
B) Nausea and vomiting
C) Fever of 38.5°C (101.3°F)
D) Rigid, board‑like abdomen
🔍 RATIONALE💡-- Rigid, board‑like abdomen suggests peritonitis or perforation, a surgical emergency.
The other findings are common in diverticulitis but not immediately life‑threatening.
, ANSWER💫✔️-- D) Rigid, board‑like abdomen
---
**07.** A nurse is teaching a client with gastroesophageal reflux disease (GERD) about lifestyle
modifications. Which instruction should the nurse include?
A) “Lie down immediately after eating to help digestion.”
B) “Avoid eating within 2-3 hours of bedtime.”
C) “Increase intake of peppermint and chocolate.”
D) “Wear tight‑fitting clothing to support the abdomen.”
🔍 RATIONALE💡-- Avoiding food 2-3 hours before bedtime reduces acid reflux. Lying down after eating
worsens reflux. Peppermint, chocolate, and tight clothing should be avoided as they relax the lower
esophageal sphincter.
ANSWER💫✔️-- B) “Avoid eating within 2-3 hours of bedtime.”
---
**08.** A nurse is caring for a client with a nasogastric (NG) tube for gastric decompression. Which
finding indicates proper tube placement?
A) Aspirated fluid pH of 3
B) The client reports feeling hungry
C) The nurse hears air bubbles over the epigastrium
D) The external tube length is 50 cm
🔍 RATIONALE💡-- Gastric aspirate pH ≤4.0 confirms gastric placement. Auscultation is less reliable.
External length varies; x‑ray is gold standard.
ANSWER💫✔️-- A) Aspirated fluid pH of 3
