ATI MED-SURG GASTROINTESTINAL TEST
BANK (2026/2027) UPDATED VERSION
EXAM WITH ACCURATE QUESTIONS &
ANSWERS (VERIFIED ANSWERS) AND
DEEP EXPERT RATIONALES | 100%
GUARANTEED PASS
{JUST RELEASED}
Question 1
A nurse is caring for a client who is 24 hours postoperative following a subtotal
gastrectomy. The client’s nasogastric (NG) tube is draining small amounts of dark brown
fluid. Which of the following actions should the nurse take first?
A. Irrigate the NG tube with 30 mL of sterile normal saline.
B. Reposition the NG tube by advancing it 5 cm.
C. Document the finding and continue to monitor.
D. Notify the surgeon immediately.
E. Increase the suction from low intermittent to high continuous.
Answer: C
,Expert Rationale: For the first 24 hours following a subtotal gastrectomy, small
amounts of dark brown or dark red drainage from the NG tube are normal and
expected as old blood is cleared from the surgical site. The nurse should document
this finding and monitor for changes. Irrigating or repositioning the NG tube post-
gastrectomy is contraindicated without explicit surgeon orders because
manipulation can disrupt the delicate gastric sutures or anastomosis line, leading to
hemorrhage or perforation.
Question 2
A nurse is assessing a client admitted with acute pancreatitis. Which of the following
clinical findings should the nurse identify as a manifestation of hypocalcemia?
A. Positive Trousseau's sign
B. Hyperreflexia and absent deep tendon reflexes
C. Prominent U waves on the electrocardiogram
D. Flaccid paralysis
E. Negative Chvostek's sign
Answer: A
,Expert Rationale: Acute pancreatitis can cause hypocalcemia due to fat necrosis,
where liberated fatty acids bind with calcium ions (saponification). A positive
Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff above
systolic pressure for 3 minutes) is a classic indicator of neuromuscular irritability
due to hypocalcemia. Prominent U waves indicate hypokalemia, not hypocalcemia.
Question 3
A nurse is providing discharge teaching to a client who has a new diagnosis of Celiac
Disease. Which of the following food choices indicated by the client demonstrates an
understanding of the gluten-free diet?
A. Whole wheat crackers with peanut butter
B. Grilled chicken breast with wild rice and broccoli
C. Cream of mushroom soup made with barley rye roux
D. Baked cod rolled in panko breadcrumbs
E. Oatmeal cookies made with standard commercial oats
Answer: B
Expert Rationale: Celiac disease requires a strict lifelong gluten-free diet to prevent
damage to the small intestinal mucosa. Gluten is found in wheat, rye, and barley.
Wild rice, poultry, and fresh vegetables like broccoli are naturally gluten-free and
completely safe. Panko, barley, wheat crackers, and standard commercial oats (due
to cross-contamination) all contain gluten.
, Question 4
A nurse is assessing a client with a history of liver cirrhosis who presents with worsening
hepatic encephalopathy. Which of the following lab values should the nurse expect to be
elevated?
A. Alanine aminotransferase (ALT)
B. Total bilirubin
C. Serum ammonia
D. Serum albumin
E. Partial thromboplastin time (PTT)
Answer: C
Expert Rationale: Hepatic encephalopathy is a neuropsychiatric complication of
advanced liver disease primarily caused by the accumulation of neurotoxic
substances, most notably serum ammonia. When the liver fails, it can no longer
convert ammonia (a byproduct of protein breakdown by intestinal bacteria) into
urea for excretion, leading to elevated blood levels that cross the blood-brain
barrier.
Question 5
A nurse is caring for a client who has an active upper gastrointestinal bleed and is
receiving a transfusion of packed red blood cells. Which of the following findings is the
most reliable indicator of effective volume resuscitation?
BANK (2026/2027) UPDATED VERSION
EXAM WITH ACCURATE QUESTIONS &
ANSWERS (VERIFIED ANSWERS) AND
DEEP EXPERT RATIONALES | 100%
GUARANTEED PASS
{JUST RELEASED}
Question 1
A nurse is caring for a client who is 24 hours postoperative following a subtotal
gastrectomy. The client’s nasogastric (NG) tube is draining small amounts of dark brown
fluid. Which of the following actions should the nurse take first?
A. Irrigate the NG tube with 30 mL of sterile normal saline.
B. Reposition the NG tube by advancing it 5 cm.
C. Document the finding and continue to monitor.
D. Notify the surgeon immediately.
E. Increase the suction from low intermittent to high continuous.
Answer: C
,Expert Rationale: For the first 24 hours following a subtotal gastrectomy, small
amounts of dark brown or dark red drainage from the NG tube are normal and
expected as old blood is cleared from the surgical site. The nurse should document
this finding and monitor for changes. Irrigating or repositioning the NG tube post-
gastrectomy is contraindicated without explicit surgeon orders because
manipulation can disrupt the delicate gastric sutures or anastomosis line, leading to
hemorrhage or perforation.
Question 2
A nurse is assessing a client admitted with acute pancreatitis. Which of the following
clinical findings should the nurse identify as a manifestation of hypocalcemia?
A. Positive Trousseau's sign
B. Hyperreflexia and absent deep tendon reflexes
C. Prominent U waves on the electrocardiogram
D. Flaccid paralysis
E. Negative Chvostek's sign
Answer: A
,Expert Rationale: Acute pancreatitis can cause hypocalcemia due to fat necrosis,
where liberated fatty acids bind with calcium ions (saponification). A positive
Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff above
systolic pressure for 3 minutes) is a classic indicator of neuromuscular irritability
due to hypocalcemia. Prominent U waves indicate hypokalemia, not hypocalcemia.
Question 3
A nurse is providing discharge teaching to a client who has a new diagnosis of Celiac
Disease. Which of the following food choices indicated by the client demonstrates an
understanding of the gluten-free diet?
A. Whole wheat crackers with peanut butter
B. Grilled chicken breast with wild rice and broccoli
C. Cream of mushroom soup made with barley rye roux
D. Baked cod rolled in panko breadcrumbs
E. Oatmeal cookies made with standard commercial oats
Answer: B
Expert Rationale: Celiac disease requires a strict lifelong gluten-free diet to prevent
damage to the small intestinal mucosa. Gluten is found in wheat, rye, and barley.
Wild rice, poultry, and fresh vegetables like broccoli are naturally gluten-free and
completely safe. Panko, barley, wheat crackers, and standard commercial oats (due
to cross-contamination) all contain gluten.
, Question 4
A nurse is assessing a client with a history of liver cirrhosis who presents with worsening
hepatic encephalopathy. Which of the following lab values should the nurse expect to be
elevated?
A. Alanine aminotransferase (ALT)
B. Total bilirubin
C. Serum ammonia
D. Serum albumin
E. Partial thromboplastin time (PTT)
Answer: C
Expert Rationale: Hepatic encephalopathy is a neuropsychiatric complication of
advanced liver disease primarily caused by the accumulation of neurotoxic
substances, most notably serum ammonia. When the liver fails, it can no longer
convert ammonia (a byproduct of protein breakdown by intestinal bacteria) into
urea for excretion, leading to elevated blood levels that cross the blood-brain
barrier.
Question 5
A nurse is caring for a client who has an active upper gastrointestinal bleed and is
receiving a transfusion of packed red blood cells. Which of the following findings is the
most reliable indicator of effective volume resuscitation?
