1
HESI Specialty Exam Prep:
Gastrointestinal & Liver Disease
Nursing Care
Table of Contents
Subtopic 1: Peptic Ulcer Disease (PUD)...........................................................2
Subtopic 2: Gastroesophageal Reflux Disease (GERD)..................................11
Subtopic 3: Inflammatory Bowel Disease (IBD) — Crohn’s Disease &
Ulcerative Colitis............................................................................................19
Subtopic 4: Hepatitis (Types A–E, Management & Complications).................28
Subtopic 5: Hepatitis – Types, Transmission, and Nursing Management........36
Subtopic 6: Gastrointestinal Bleeding – Causes, Management, and
Emergency Interventions...............................................................................47
Subtopic 7: Gastrointestinal Diagnostic Tests (Imaging, Labs, Endoscopy). . .55
Subtopic 8: Gastrointestinal Diagnostic Tests & Interpretation (Q141–160). .64
Subtopic 9: Hepatic Encephalopathy and Hepatorenal Syndrome (Questions
161–180)........................................................................................................73
Subtopic 10: Nursing Management of Hepatic and GI Emergencies..............82
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Subtopic 1: Peptic Ulcer Disease (PUD)
Question 1:
A 58-year-old male presents with burning epigastric pain relieved by food but
worsens at night. He has a history of NSAID use. Which of the following
would most likely be included in the patient’s treatment plan?
A. Discontinue NSAIDs and start proton pump inhibitors (PPIs)
B. Increase dietary fiber intake and avoid red meat
C. Begin antacid therapy and increase fluid intake
D. Administer acetaminophen for pain and advise a high-protein diet
Correct Answer: A. Discontinue NSAIDs and start proton pump inhibitors
(PPIs)
Rationale: NSAIDs are a common cause of peptic ulcers by inhibiting
prostaglandin synthesis. Discontinuing NSAIDs and initiating PPIs such as
omeprazole helps reduce gastric acid secretion, promoting ulcer healing.
Question 2:
A nurse is teaching a patient with duodenal ulcers about signs of
gastrointestinal bleeding. Which symptom should the nurse instruct the
patient to report immediately?
A. Decreased appetite
B. Dark, tarry stools
C. Nausea after eating
D. Occasional heartburn
Correct Answer: B. Dark, tarry stools
, 3
Rationale: Melena (black, tarry stools) indicates upper gastrointestinal
bleeding, a serious complication of duodenal ulcers and requires immediate
medical attention.
Question 3:
Which diagnostic test is most definitive for identifying Helicobacter pylori
infection in a patient with suspected peptic ulcer disease?
A. Fecal occult blood test
B. Urea breath test
C. Barium swallow
D. Upper abdominal ultrasound
Correct Answer: B. Urea breath test
Rationale: The urea breath test is a non-invasive and highly accurate test for
detecting active H. pylori infection, the most common cause of PUD.
Question 4:
A patient is prescribed triple therapy for H. pylori-positive peptic ulcer
disease. What does this regimen typically include?
A. Antacids, corticosteroids, PPI
B. H2 blocker, PPI, acetaminophen
C. PPI, amoxicillin, clarithromycin
D. Sucralfate, metronidazole, magnesium hydroxide
Correct Answer: C. PPI, amoxicillin, clarithromycin
Rationale: Triple therapy includes a proton pump inhibitor (e.g., omeprazole)
and two antibiotics (commonly amoxicillin and clarithromycin) to eradicate H.
pylori infection.
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Question 5:
A nurse is assessing a patient with a suspected gastric ulcer. Which symptom
would most likely differentiate it from a duodenal ulcer?
A. Pain worsens with food intake
B. Pain is relieved by food
C. Pain is worse at night
D. Weight gain over several weeks
Correct Answer: A. Pain worsens with food intake
Rationale: Gastric ulcers typically cause epigastric pain that worsens with
eating due to acid secretion; in contrast, duodenal ulcer pain improves with
food.
Question 6:
A patient with PUD reports sudden sharp epigastric pain, a rigid abdomen,
and shoulder pain. What is the nurse’s priority action?
A. Encourage oral fluids
B. Administer antacids
C. Notify the healthcare provider immediately
D. Reassure the patient it’s likely gas pain
Correct Answer: C. Notify the healthcare provider immediately
Rationale: These signs suggest a perforated ulcer, a life-threatening
emergency requiring immediate surgical intervention.
Question 7:
Which dietary instruction is appropriate for a patient recovering from a
bleeding gastric ulcer?
A. "You should eat spicy food to stimulate healing."
HESI Specialty Exam Prep:
Gastrointestinal & Liver Disease
Nursing Care
Table of Contents
Subtopic 1: Peptic Ulcer Disease (PUD)...........................................................2
Subtopic 2: Gastroesophageal Reflux Disease (GERD)..................................11
Subtopic 3: Inflammatory Bowel Disease (IBD) — Crohn’s Disease &
Ulcerative Colitis............................................................................................19
Subtopic 4: Hepatitis (Types A–E, Management & Complications).................28
Subtopic 5: Hepatitis – Types, Transmission, and Nursing Management........36
Subtopic 6: Gastrointestinal Bleeding – Causes, Management, and
Emergency Interventions...............................................................................47
Subtopic 7: Gastrointestinal Diagnostic Tests (Imaging, Labs, Endoscopy). . .55
Subtopic 8: Gastrointestinal Diagnostic Tests & Interpretation (Q141–160). .64
Subtopic 9: Hepatic Encephalopathy and Hepatorenal Syndrome (Questions
161–180)........................................................................................................73
Subtopic 10: Nursing Management of Hepatic and GI Emergencies..............82
, 2
Subtopic 1: Peptic Ulcer Disease (PUD)
Question 1:
A 58-year-old male presents with burning epigastric pain relieved by food but
worsens at night. He has a history of NSAID use. Which of the following
would most likely be included in the patient’s treatment plan?
A. Discontinue NSAIDs and start proton pump inhibitors (PPIs)
B. Increase dietary fiber intake and avoid red meat
C. Begin antacid therapy and increase fluid intake
D. Administer acetaminophen for pain and advise a high-protein diet
Correct Answer: A. Discontinue NSAIDs and start proton pump inhibitors
(PPIs)
Rationale: NSAIDs are a common cause of peptic ulcers by inhibiting
prostaglandin synthesis. Discontinuing NSAIDs and initiating PPIs such as
omeprazole helps reduce gastric acid secretion, promoting ulcer healing.
Question 2:
A nurse is teaching a patient with duodenal ulcers about signs of
gastrointestinal bleeding. Which symptom should the nurse instruct the
patient to report immediately?
A. Decreased appetite
B. Dark, tarry stools
C. Nausea after eating
D. Occasional heartburn
Correct Answer: B. Dark, tarry stools
, 3
Rationale: Melena (black, tarry stools) indicates upper gastrointestinal
bleeding, a serious complication of duodenal ulcers and requires immediate
medical attention.
Question 3:
Which diagnostic test is most definitive for identifying Helicobacter pylori
infection in a patient with suspected peptic ulcer disease?
A. Fecal occult blood test
B. Urea breath test
C. Barium swallow
D. Upper abdominal ultrasound
Correct Answer: B. Urea breath test
Rationale: The urea breath test is a non-invasive and highly accurate test for
detecting active H. pylori infection, the most common cause of PUD.
Question 4:
A patient is prescribed triple therapy for H. pylori-positive peptic ulcer
disease. What does this regimen typically include?
A. Antacids, corticosteroids, PPI
B. H2 blocker, PPI, acetaminophen
C. PPI, amoxicillin, clarithromycin
D. Sucralfate, metronidazole, magnesium hydroxide
Correct Answer: C. PPI, amoxicillin, clarithromycin
Rationale: Triple therapy includes a proton pump inhibitor (e.g., omeprazole)
and two antibiotics (commonly amoxicillin and clarithromycin) to eradicate H.
pylori infection.
, 4
Question 5:
A nurse is assessing a patient with a suspected gastric ulcer. Which symptom
would most likely differentiate it from a duodenal ulcer?
A. Pain worsens with food intake
B. Pain is relieved by food
C. Pain is worse at night
D. Weight gain over several weeks
Correct Answer: A. Pain worsens with food intake
Rationale: Gastric ulcers typically cause epigastric pain that worsens with
eating due to acid secretion; in contrast, duodenal ulcer pain improves with
food.
Question 6:
A patient with PUD reports sudden sharp epigastric pain, a rigid abdomen,
and shoulder pain. What is the nurse’s priority action?
A. Encourage oral fluids
B. Administer antacids
C. Notify the healthcare provider immediately
D. Reassure the patient it’s likely gas pain
Correct Answer: C. Notify the healthcare provider immediately
Rationale: These signs suggest a perforated ulcer, a life-threatening
emergency requiring immediate surgical intervention.
Question 7:
Which dietary instruction is appropriate for a patient recovering from a
bleeding gastric ulcer?
A. "You should eat spicy food to stimulate healing."
