ATI MED SURG 1: GASTROINTESTINAL —
COMPLETE PRACTICE EXAM350 EXAM-
STYLE QUESTIONS WITH DETAILED
RATIONALES2026 LATEST UPDATED |
NURSING & HEALTHCARE SPECIALIST
LEVEL
Section 1: Gastrointestinal Bleeding (Questions 1–15)
1. A patient vomits bright red blood with a blood pressure of
88/56 mmHg and heart rate of 122 bpm. Which nursing
intervention takes PRIORITY?
A. Prepare the patient for emergent endoscopy
B. Administer IV proton pump inhibitor as ordered
C. Insert a nasogastric tube for gastric lavage
D. Establish two large-bore IV lines and initiate fluid resuscitation
Answer: D
Rationale: Hemodynamic instability requires immediate vascular
access and aggressive fluid resuscitation to restore perfusion
before any diagnostic or therapeutic procedure.
,2. A patient with upper GI bleeding has orthostatic hypotension
with dizziness upon sitting. What does this finding indicate?
A. Volume depletion of at least 15–20% blood volume loss
requiring immediate intervention
B. Normal compensatory response to bleeding
C. Adequate fluid resuscitation
D. Need for oral iron supplementation only
Answer: A
Rationale: Orthostatic hypotension indicates significant volume
depletion of at least 15–20% blood volume loss, requiring
immediate nursing intervention.
3. A patient is admitted with melena and coffee-ground emesis.
The nurse correctly identifies these findings as consistent with:
A. Lower gastrointestinal bleeding
B. Colonic diverticular bleeding
C. Upper gastrointestinal bleeding
D. Hemorrhoidal bleeding
Answer: C
Rationale: Melena and coffee-ground emesis both indicate upper
GI bleeding proximal to the ligament of Treitz where blood is
digested by gastric acid and intestinal bacteria.
,4. Which of the following BEST describes hematochezia?
A. Black tarry foul-smelling stool
B. Bright red or maroon blood passed per rectum
C. Coffee-ground appearance of vomitus
D. Blood-tinged mucus in stool only
Answer: B
Rationale: Hematochezia refers to bright red or maroon rectal
bleeding typically indicating a lower GI source; massive upper GI
hemorrhage with rapid transit can also cause it.
5. A nurse is preparing a patient for an upper endoscopy (EGD) for
GI bleeding evaluation. Which instruction is essential?
A. "You may eat a light breakfast."
B. "You must be NPO for 6–8 hours before the procedure."
C. "You should drink plenty of water before the procedure."
D. "You can take your oral medications with a small sip of water."
Answer: B
Rationale: NPO status prevents aspiration during the procedure.
Oral medications may be withheld or given with a small sip per
provider order.
, 6. A nurse is caring for a patient who is 1 hour postoperative
following an EGD. Which assessment finding requires immediate
notification of the provider?
A. Sore throat and mild hoarseness when speaking
B. Absence of the gag reflex upon stimulation
C. Sudden onset of sharp, radiating substernal pain
D. Diffuse abdominal bloating and mild belching
Answer: C
Rationale: Sharp, sudden, or radiating substernal, epigastric, or
back pain can indicate systemic perforation of the esophagus or
stomach, which is a life-threatening emergency. Sore throat and
bloating are expected side effects.
7. Which finding in a patient with upper GI bleeding requires
IMMEDIATE intervention?
A. Orthostatic hypotension with dizziness upon sitting
B. Blood pressure 110/70 mmHg
C. Heart rate 88 bpm
D. Hemoglobin 10.2 g/dL
Answer: A
Rationale: Orthostatic hypotension indicates significant volume
depletion requiring immediate nursing intervention.
COMPLETE PRACTICE EXAM350 EXAM-
STYLE QUESTIONS WITH DETAILED
RATIONALES2026 LATEST UPDATED |
NURSING & HEALTHCARE SPECIALIST
LEVEL
Section 1: Gastrointestinal Bleeding (Questions 1–15)
1. A patient vomits bright red blood with a blood pressure of
88/56 mmHg and heart rate of 122 bpm. Which nursing
intervention takes PRIORITY?
A. Prepare the patient for emergent endoscopy
B. Administer IV proton pump inhibitor as ordered
C. Insert a nasogastric tube for gastric lavage
D. Establish two large-bore IV lines and initiate fluid resuscitation
Answer: D
Rationale: Hemodynamic instability requires immediate vascular
access and aggressive fluid resuscitation to restore perfusion
before any diagnostic or therapeutic procedure.
,2. A patient with upper GI bleeding has orthostatic hypotension
with dizziness upon sitting. What does this finding indicate?
A. Volume depletion of at least 15–20% blood volume loss
requiring immediate intervention
B. Normal compensatory response to bleeding
C. Adequate fluid resuscitation
D. Need for oral iron supplementation only
Answer: A
Rationale: Orthostatic hypotension indicates significant volume
depletion of at least 15–20% blood volume loss, requiring
immediate nursing intervention.
3. A patient is admitted with melena and coffee-ground emesis.
The nurse correctly identifies these findings as consistent with:
A. Lower gastrointestinal bleeding
B. Colonic diverticular bleeding
C. Upper gastrointestinal bleeding
D. Hemorrhoidal bleeding
Answer: C
Rationale: Melena and coffee-ground emesis both indicate upper
GI bleeding proximal to the ligament of Treitz where blood is
digested by gastric acid and intestinal bacteria.
,4. Which of the following BEST describes hematochezia?
A. Black tarry foul-smelling stool
B. Bright red or maroon blood passed per rectum
C. Coffee-ground appearance of vomitus
D. Blood-tinged mucus in stool only
Answer: B
Rationale: Hematochezia refers to bright red or maroon rectal
bleeding typically indicating a lower GI source; massive upper GI
hemorrhage with rapid transit can also cause it.
5. A nurse is preparing a patient for an upper endoscopy (EGD) for
GI bleeding evaluation. Which instruction is essential?
A. "You may eat a light breakfast."
B. "You must be NPO for 6–8 hours before the procedure."
C. "You should drink plenty of water before the procedure."
D. "You can take your oral medications with a small sip of water."
Answer: B
Rationale: NPO status prevents aspiration during the procedure.
Oral medications may be withheld or given with a small sip per
provider order.
, 6. A nurse is caring for a patient who is 1 hour postoperative
following an EGD. Which assessment finding requires immediate
notification of the provider?
A. Sore throat and mild hoarseness when speaking
B. Absence of the gag reflex upon stimulation
C. Sudden onset of sharp, radiating substernal pain
D. Diffuse abdominal bloating and mild belching
Answer: C
Rationale: Sharp, sudden, or radiating substernal, epigastric, or
back pain can indicate systemic perforation of the esophagus or
stomach, which is a life-threatening emergency. Sore throat and
bloating are expected side effects.
7. Which finding in a patient with upper GI bleeding requires
IMMEDIATE intervention?
A. Orthostatic hypotension with dizziness upon sitting
B. Blood pressure 110/70 mmHg
C. Heart rate 88 bpm
D. Hemoglobin 10.2 g/dL
Answer: A
Rationale: Orthostatic hypotension indicates significant volume
depletion requiring immediate nursing intervention.
