1
HESI GI Bleeds Exam Bank: Upper & Lower
Bleeding, Nutrition & Medication Q&A
Table of Contents
Subtopic 1: Upper Gastrointestinal Bleeds—Etiology, Assessment & Initial Interventions ... 2
Subtopic 2: Lower Gastrointestinal Bleeds—Etiologies, Diagnostics & Interventions .......... 9
Subtopic 3: Nutritional Support in GI Bleeding—Dietary Needs, NPO Protocols & Refeeding
Strategies ................................................................................................................... 17
Subtopic 4: Pharmacologic Management of GI Bleeding—Medications, Mechanisms, and
Nursing Implications ................................................................................................... 25
Subtopic 5: Risk Factors, Prevention, and Patient Education in GI Bleeds ........................ 33
, 2
Subtopic 1: Upper Gastrointestinal Bleeds—Etiology,
Assessment & Initial Interventions
(Questions 1–20)
1. A patient presents with hematemesis and hypotension. What is the nurse’s priority
action?
A. Administer antiemetic medication
B. Initiate large-bore IV access for fluid resuscitation
C. Insert a nasogastric tube for lavage
D. Prepare the patient for an upper endoscopy
Correct Answer: B
Rationale: The immediate priority in a patient with suspected upper GI bleeding and
hypotension is to restore circulating volume to prevent shock. Large-bore IV access
ensures rapid fluid or blood administration.
2. Which of the following is the most common cause of upper GI bleeding?
A. Gastric carcinoma
B. Peptic ulcer disease (PUD)
C. Mallory-Weiss tear
D. Esophageal varices
Correct Answer: B
Rationale: PUD accounts for the majority of upper GI bleeds due to erosion of the
gastrointestinal mucosa by acid and pepsin.
3. Which laboratory result is most indicative of acute upper GI bleeding?
, 3
A. Elevated ALT and AST
B. Low potassium
C. Elevated BUN with normal creatinine
D. Decreased lipase
Correct Answer: C
Rationale: Elevated BUN with normal creatinine may suggest a high protein load in the gut
from blood digestion in upper GI bleeding.
4. A nurse suspects a bleeding duodenal ulcer. Which symptom is most consistent with
this diagnosis?
A. Vomiting bright red blood
B. Tarry, black stools (melena)
C. Epigastric pain after eating
D. Hematochezia
Correct Answer: B
Rationale: Melena results from digested blood, typically from upper GI bleeding sources
like duodenal ulcers.
5. Which medication is first-line in the management of bleeding esophageal varices?
A. Pantoprazole
B. Sucralfate
C. Octreotide
D. Metoclopramide
Correct Answer: C
, 4
Rationale: Octreotide reduces portal hypertension and is essential in managing bleeding
varices.
6. What is the purpose of administering pantoprazole in a patient with an upper GI bleed?
A. To increase GI motility
B. To reduce gastric acid secretion
C. To treat infection
D. To promote clot formation
Correct Answer: B
Rationale: Proton pump inhibitors like pantoprazole decrease gastric acid, helping to
stabilize clots and prevent rebleeding.
7. During nasogastric lavage, bright red blood is aspirated. What does this indicate?
A. Blood from a hemorrhoidal source
B. Active upper GI bleeding
C. Resolved bleeding
D. Bleeding in the colon
Correct Answer: B
Rationale: Bright red blood indicates recent or ongoing upper GI bleeding.
8. Which vital sign change would most concern a nurse in a patient with suspected GI
bleeding?
A. Increased respiratory rate from 18 to 20
B. Blood pressure drop from 128/80 to 92/60 mmHg
C. Pulse increase from 76 to 82 bpm
HESI GI Bleeds Exam Bank: Upper & Lower
Bleeding, Nutrition & Medication Q&A
Table of Contents
Subtopic 1: Upper Gastrointestinal Bleeds—Etiology, Assessment & Initial Interventions ... 2
Subtopic 2: Lower Gastrointestinal Bleeds—Etiologies, Diagnostics & Interventions .......... 9
Subtopic 3: Nutritional Support in GI Bleeding—Dietary Needs, NPO Protocols & Refeeding
Strategies ................................................................................................................... 17
Subtopic 4: Pharmacologic Management of GI Bleeding—Medications, Mechanisms, and
Nursing Implications ................................................................................................... 25
Subtopic 5: Risk Factors, Prevention, and Patient Education in GI Bleeds ........................ 33
, 2
Subtopic 1: Upper Gastrointestinal Bleeds—Etiology,
Assessment & Initial Interventions
(Questions 1–20)
1. A patient presents with hematemesis and hypotension. What is the nurse’s priority
action?
A. Administer antiemetic medication
B. Initiate large-bore IV access for fluid resuscitation
C. Insert a nasogastric tube for lavage
D. Prepare the patient for an upper endoscopy
Correct Answer: B
Rationale: The immediate priority in a patient with suspected upper GI bleeding and
hypotension is to restore circulating volume to prevent shock. Large-bore IV access
ensures rapid fluid or blood administration.
2. Which of the following is the most common cause of upper GI bleeding?
A. Gastric carcinoma
B. Peptic ulcer disease (PUD)
C. Mallory-Weiss tear
D. Esophageal varices
Correct Answer: B
Rationale: PUD accounts for the majority of upper GI bleeds due to erosion of the
gastrointestinal mucosa by acid and pepsin.
3. Which laboratory result is most indicative of acute upper GI bleeding?
, 3
A. Elevated ALT and AST
B. Low potassium
C. Elevated BUN with normal creatinine
D. Decreased lipase
Correct Answer: C
Rationale: Elevated BUN with normal creatinine may suggest a high protein load in the gut
from blood digestion in upper GI bleeding.
4. A nurse suspects a bleeding duodenal ulcer. Which symptom is most consistent with
this diagnosis?
A. Vomiting bright red blood
B. Tarry, black stools (melena)
C. Epigastric pain after eating
D. Hematochezia
Correct Answer: B
Rationale: Melena results from digested blood, typically from upper GI bleeding sources
like duodenal ulcers.
5. Which medication is first-line in the management of bleeding esophageal varices?
A. Pantoprazole
B. Sucralfate
C. Octreotide
D. Metoclopramide
Correct Answer: C
, 4
Rationale: Octreotide reduces portal hypertension and is essential in managing bleeding
varices.
6. What is the purpose of administering pantoprazole in a patient with an upper GI bleed?
A. To increase GI motility
B. To reduce gastric acid secretion
C. To treat infection
D. To promote clot formation
Correct Answer: B
Rationale: Proton pump inhibitors like pantoprazole decrease gastric acid, helping to
stabilize clots and prevent rebleeding.
7. During nasogastric lavage, bright red blood is aspirated. What does this indicate?
A. Blood from a hemorrhoidal source
B. Active upper GI bleeding
C. Resolved bleeding
D. Bleeding in the colon
Correct Answer: B
Rationale: Bright red blood indicates recent or ongoing upper GI bleeding.
8. Which vital sign change would most concern a nurse in a patient with suspected GI
bleeding?
A. Increased respiratory rate from 18 to 20
B. Blood pressure drop from 128/80 to 92/60 mmHg
C. Pulse increase from 76 to 82 bpm
