MCA Exam 2: Upper and Lower GI Questions
and Correct Answers
Question 1
Which interventions are appropriate for a patient actively bleeding from a gastric
ulcer? (Select all that apply)
A. Keep patient NPO
B. Insert large-bore IV for fluids or blood products
C. Administer H2 blockers or PPIs
D. Encourage oral food intake to reduce acid
E. Administer IV corticosteroids
Correct Answer
Correct Answers: A, B, C
Rationale: The patient should be NPO to rest the gut, receive IV fluids/blood, and be
treated with PPIs or H2 blockers. Corticosteroids can worsen bleeding and are not
first-line.
Question 2
What is the most common cause of appendicitis?
A. Viral infection
B. Obstruction by a fecalith
C. Autoimmune inflammation
D. Gastric ulceration
Correct Answer
Correct Answer: B. Obstruction by a fecalith
Rationale: Appendicitis commonly results from obstruction of the appendix lumen
by a fecalith (hardened stool), leading to inflammation and possible rupture.
Page 1 of 74
,Question 3
A nurse is educating a patient with a new ostomy. Which statement by the patient
indicates a need for further teaching?
A. "I will chew my food thoroughly to avoid blockages."
B. "I should avoid foods that cause gas or odor."
C. "I will clean my stoma with alcohol to prevent infection."
D. "I will observe for signs of infection around the stoma site."
Correct Answer
Correct Answer: C. "I will clean my stoma with alcohol to prevent infection."
Rationale: Alcohol should not be used to clean the stoma as it can dry and irritate
the skin. Only warm water or prescribed cleansers are appropriate.
Question 4
Which interventions are appropriate for treating a patient with intestinal obstruction?
(Select all that apply)
A. NPO status
B. NG tube suction
C. Encourage ambulation
D. IV fluid replacement
E. Administer antiemetics
Correct Answer
Correct Answers: A, B, D, E
Rationale: Treatment includes bowel rest (NPO), NG decompression, IV fluids, and
symptom management with antiemetics. Ambulation may be encouraged later but
is not first-line in acute obstruction.
Page 2 of 74
,Question 5
A patient with a hiatal hernia is prescribed medication. Which class of medication
would be appropriate to manage symptoms?
A. Beta-blockers
B. Proton pump inhibitors (PPIs)
C. Opioids
D. Antihistamines
Correct Answer
Correct Answer: B. Proton pump inhibitors (PPIs)
Rationale: PPIs reduce gastric acid production, relieving symptoms like reflux and
preventing esophageal irritation, similar to GERD treatment.
Question 6
Which of the following patient statements indicates a need for immediate evaluation?
A. "The pain started around my belly button and moved to my lower right side."
B. "I had pain earlier, but now it suddenly stopped."
C. "I feel more pain when I lie on my right side."
D. "I've had this mild cramping for 24 hours."
Correct Answer
Correct Answer: B. "I had pain earlier, but now it suddenly stopped."
Rationale: Sudden relief of pain may indicate rupture of the appendix, which is a
surgical emergency due to the risk of peritonitis.
Question 7
The nurse is caring for a patient receiving promethazine IM for nausea. What is the
priority nursing consideration?
A. Monitor blood glucose
B. Administer via subcutaneous route
C. Monitor for sedation and respiratory depression
D. Encourage high-protein diet
Correct Answer
Correct Answer: C. Monitor for sedation and respiratory depression
Rationale: Promethazine has sedative effects and may depress respiration, especially
when given IM or IV.
Page 3 of 74
, Question 8
A client is diagnosed with a bleeding gastric ulcer. Which assessment finding requires
immediate intervention?
A. Epigastric burning relieved by food
B. Hematemesis (vomiting blood)
C. Mild nausea and bloating
D. Weight loss over 1 month
Correct Answer
Correct Answer: B. Hematemesis
Rationale: Vomiting blood indicates active GI bleeding, a potential emergency
requiring prompt treatment (e.g., NG tube, transfusion).
Question 9
Which of the following food items are common triggers for eosinophilic esophagitis?
(Select all that apply)
A. Milk
B. Egg
C. Chicken
D. Wheat
E. Beef
Correct Answer
Correct Answers: A, B, D, E
Rationale: Common food allergens associated with EoE include milk, egg, wheat,
rye, and beef. Chicken is not commonly listed as a primary trigger.
Page 4 of 74
and Correct Answers
Question 1
Which interventions are appropriate for a patient actively bleeding from a gastric
ulcer? (Select all that apply)
A. Keep patient NPO
B. Insert large-bore IV for fluids or blood products
C. Administer H2 blockers or PPIs
D. Encourage oral food intake to reduce acid
E. Administer IV corticosteroids
Correct Answer
Correct Answers: A, B, C
Rationale: The patient should be NPO to rest the gut, receive IV fluids/blood, and be
treated with PPIs or H2 blockers. Corticosteroids can worsen bleeding and are not
first-line.
Question 2
What is the most common cause of appendicitis?
A. Viral infection
B. Obstruction by a fecalith
C. Autoimmune inflammation
D. Gastric ulceration
Correct Answer
Correct Answer: B. Obstruction by a fecalith
Rationale: Appendicitis commonly results from obstruction of the appendix lumen
by a fecalith (hardened stool), leading to inflammation and possible rupture.
Page 1 of 74
,Question 3
A nurse is educating a patient with a new ostomy. Which statement by the patient
indicates a need for further teaching?
A. "I will chew my food thoroughly to avoid blockages."
B. "I should avoid foods that cause gas or odor."
C. "I will clean my stoma with alcohol to prevent infection."
D. "I will observe for signs of infection around the stoma site."
Correct Answer
Correct Answer: C. "I will clean my stoma with alcohol to prevent infection."
Rationale: Alcohol should not be used to clean the stoma as it can dry and irritate
the skin. Only warm water or prescribed cleansers are appropriate.
Question 4
Which interventions are appropriate for treating a patient with intestinal obstruction?
(Select all that apply)
A. NPO status
B. NG tube suction
C. Encourage ambulation
D. IV fluid replacement
E. Administer antiemetics
Correct Answer
Correct Answers: A, B, D, E
Rationale: Treatment includes bowel rest (NPO), NG decompression, IV fluids, and
symptom management with antiemetics. Ambulation may be encouraged later but
is not first-line in acute obstruction.
Page 2 of 74
,Question 5
A patient with a hiatal hernia is prescribed medication. Which class of medication
would be appropriate to manage symptoms?
A. Beta-blockers
B. Proton pump inhibitors (PPIs)
C. Opioids
D. Antihistamines
Correct Answer
Correct Answer: B. Proton pump inhibitors (PPIs)
Rationale: PPIs reduce gastric acid production, relieving symptoms like reflux and
preventing esophageal irritation, similar to GERD treatment.
Question 6
Which of the following patient statements indicates a need for immediate evaluation?
A. "The pain started around my belly button and moved to my lower right side."
B. "I had pain earlier, but now it suddenly stopped."
C. "I feel more pain when I lie on my right side."
D. "I've had this mild cramping for 24 hours."
Correct Answer
Correct Answer: B. "I had pain earlier, but now it suddenly stopped."
Rationale: Sudden relief of pain may indicate rupture of the appendix, which is a
surgical emergency due to the risk of peritonitis.
Question 7
The nurse is caring for a patient receiving promethazine IM for nausea. What is the
priority nursing consideration?
A. Monitor blood glucose
B. Administer via subcutaneous route
C. Monitor for sedation and respiratory depression
D. Encourage high-protein diet
Correct Answer
Correct Answer: C. Monitor for sedation and respiratory depression
Rationale: Promethazine has sedative effects and may depress respiration, especially
when given IM or IV.
Page 3 of 74
, Question 8
A client is diagnosed with a bleeding gastric ulcer. Which assessment finding requires
immediate intervention?
A. Epigastric burning relieved by food
B. Hematemesis (vomiting blood)
C. Mild nausea and bloating
D. Weight loss over 1 month
Correct Answer
Correct Answer: B. Hematemesis
Rationale: Vomiting blood indicates active GI bleeding, a potential emergency
requiring prompt treatment (e.g., NG tube, transfusion).
Question 9
Which of the following food items are common triggers for eosinophilic esophagitis?
(Select all that apply)
A. Milk
B. Egg
C. Chicken
D. Wheat
E. Beef
Correct Answer
Correct Answers: A, B, D, E
Rationale: Common food allergens associated with EoE include milk, egg, wheat,
rye, and beef. Chicken is not commonly listed as a primary trigger.
Page 4 of 74
