Upper GI NCLEX Questions (2025) | High-Yield Practice with Verified Answers & Rationales
The nurse explains to the patient with gastroesophageal reflux disease that this disorder: A. results in
acid erosion and ulceration of the esophagus caused by frequent vomiting, B. will require surgical
wrapping or repair of the pyloric sphincter to control the symptoms, C. is the protrusion of a portion of
the stomach into to esophagus through an opening in the diaphragm, D. often involves relaxation of the
lower esophageal sphincter, allowing stomach contents to back up into the espophagus -
(ANSWER)Answer: D. The acidic contents of the stomach touching the inside of the esophagus are
responsible for the physical sensation known as "heart-burn" that is a cardinal symptom of GERD
The nurse is teaching the patient and family about possible causative factors for peptic ulcers. The nurse
explains that ulcer formation is: (Source: Medical-Surgical Nursing, LDH p. 1004) a) caused by stressful
lifestyle and other acid producing factors such as H. pylori. b) inherited within families and reinforced by
bacterial spread of Staphylococcus aureus in childhood. c) promoted by factors that tend to cause
oversecretion of acid, such as excess dietary fats, smoking, and H. pylor. d) promoted by a combination
of possible factors that may result in erosion of the gastric mucosa, including certain drugs and alcohol -
(ANSWER)Peptic ulcers develop only in the presence of an acidic environment. However, an excess of
hydrochloric acid (HCl) may not be necessary for ulcer development. The back-diffusion of HCl into the
gastric mucosa results in cellular destruction and inflammation. Histamine is released from the damaged
mucosa, resulting in vasodilation and increased capillary permeability and further secretion of acid and
pepsin. A variety of agents (i.e., certain infections, medications, and lifestyle factors) can damage the
mucosal barrier
"Which of the following types of gastritis is
associated with Helicobacter pylori and duodenal ulcers?
1. Erosive (hemorrhagic) gastritis
2. Fundic gland gastritis (type A)
3. Antral gland gastritis (type B)
4.Aspiring-induced gastric ulcer - (ANSWER)Answer: 3 - Erosive (hemorrhagic) gastritis can be
caused by ingestion of substances that irritate the gastric mucosa. Fundic gland gastritis (type A) is
associated with diffuse severe mucosal atrophy and the presence of pernicious anemia. Antral gland
gastritis (type B) is the most common form of gastritis, and is associated with Helicobacter pylori and
duodenal ulcers
Caffeinated beverages and smoking are risk factors to assess for in the development of what condition?
A. Duodenal ulcers B. Peptic ulcers C. Helicobacter pylori D. Esophageal reflux - (ANSWER)Answer: B PUD
risk factors include family history, blood group O, smoking tobacco, and beverages containing caffeine
,Upper GI NCLEX Questions (2025) | High-Yield Practice with Verified Answers & Rationales
Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older
persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse
should assign the highest priority to which of the following interventions? 1. Decrease daily intake of
vegetables and water, and ambulate frequently 2. Drink coffee diluted with milk at each meal, and
remain in an upright position for 30 minutes. 3. Eat small, frequent meals, and remain in an upright
position for at least 30 minutes after eating 4. Avoid over-the-counter drugs that have antacids in them -
(ANSWER)Answer 3, Eating small and frequent meals requires less release of hydrochloric acid.
Remaining in an upright position for 30 minutes after meals prevents reflux into the esophagus which is
often exacerbated when lying down, expecially after a large meal which makes the patient tired
The nurse is performing an admission assessment on a client diagnosed with gastroesophageal reflux
disease (GERD). Which signs and symptoms would indicate GERD? 1. Pyrosis, water brash, and flatulence
2. Weight loss, dysarthria, and diarrhea 3. Decreased abdominal fat, proteinuria, and constipation 4.
Mid-epigastric pain, positive H. pylori test, and melena - (ANSWER)Correct answer: 1 (pyrosis, water
brash, and flatulence)1. Pyrosis is heartburn, water brash is the feeling of saliva secretion as a result of
reflux, and flatulence is gas—all symptoms of GERD 2. Gastroesophageal reflux disease does not cause
weight loss 3. There is no change in abdominal fat, no proteinuria (the result of a filtration problem
inthe kidney), and no alteration in bowel elimination for the client diagnosed with GERD 4. Mid-
epigastric pain, a positive H. pylori test, and melena are associated with gastric ulcer disease
The client with a hiatal hernia chronically experiences heartburn following meals. The nurse planc to
teach the client to avoid which action because it is contraindicated with hiatal hernia?1. Lying
recumbent following meals 2. Taking in small, frequent, bland meals 3. Raising the head of the bed on 6-
inch blocks 4. Taking H2-receptor antagonist medication - (ANSWER)Correct answer: 1Laying recumbant
following meals or at night will cause reflux and pain. Relief is usually achieved with the intake of small,
bland meals, use of H2 receptor antagonists and antacids, and elevation of the thorax after meals and
during sleep
What response should a nurse offer to a client who asks why he's having a vagotomy to treat his ulcer?
1. To repair a hole in the stomach 2. to reduce the ability of the stomach to produce acid 3. to prevent
the stomach from sliding into the chest 4. to remove a potentially malignant lesion in the stomach -
(ANSWER)Answer 2: A vagotomy is perfomred to elimniate the acid-secreting stimulus to gastric cells. a
perforation would be repaired with a gastric resection. Repair of hiatal hernia (fundoplication) prevents
the stomach from sliding through the diaphragm. Removal of a potentially malignant tumor wouldn't
reduce the entire acid-producing mechanism
, Upper GI NCLEX Questions (2025) | High-Yield Practice with Verified Answers & Rationales
The nurse is planning to teach a client with GERD about substances that will increase the LES
pressure.Which item shoud the nurse include on this list.1. Coffee 2. Chocolate 3. Fatty Foods 4. Nonfat
MIlk - (ANSWER)Correct Answer: Nonfat MIlkFoods that will increase LES pressure will decrease reflux
and lessen the symptoms of GERD. The food that will increase LES pressure is nonfat milk. The other
substances listed decrease LES pressure, thus increasing reflux symptoms. Aggravating substances
include the others listed and alcohol
Which assessment data support the client's diagnosis of gastric ulcer?"1. Presence of blood in the
client's stool for the past month.
2.Complaints of a burning sensation that moves like a wave.
3.Sharp pain in the upper abdomen after eating a heavy meal. 4.Comparison of complaints of pain with
ingestion of food and sleep - (ANSWER)"1. The presence of blood does not specifically indicate diagnosis
of an ulcer. The client could have hemorrhoids or cancer that would result in the presence of blood. 2. A
wavelike burning sensation is a symptom of gastroesophageal reflus. 3. Sharp pain in the upper
abdomen after eating a heavy meal is a symptom of gallbladder disease. 4. (CORRECT) In a client
diagosed with a gastric ulcer, pain usually occurs 30-60 minutes after eating, but not at night. In
contrast, a client with duodenal ulcer has pain durin ghte night that is often relieved by eating food. Pain
occurs 1-3 hours after meals
When assessing the client with the diagnosis of peptic ulcer disease, which physical examination should
the nurse implement first? Auscultate the client's bowel sounds in all four quadrants. 2.Palpate the
abdominal area for tenderness. 3.Percuss the abdominal borders to identify organs. 4.Assess the tender
area progressing to nontender - (ANSWER)Correct answer: #1. Auscultation should be used prior to
palpa-tion or percussion when assessing the abdomen. If the nurse manipulates the abdomen, the
bowel sounds can be altered and give false information
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most
likely indicate perforation of the ulcer? 1. Bradycardia 2. Numbness in the legs 3. Nausea and vomiting 4.
A rigid, board-like abdomen - (ANSWER)Answer 4, Perforation of an ulcer is a surgical emergency and is
characterized by sudden, sharp, intolerable severe pain beginning in the midepigastric area and
spreading over the abdomen, which become rigid and board-like. Nausea and vomiting may occur.
Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated
finding
Which of the following nursing interventions should the nurse perform for a female client receiving
enteral feedings through a gastrostomy tube? "a. Change the tube feeding solutions and tubing at least
The nurse explains to the patient with gastroesophageal reflux disease that this disorder: A. results in
acid erosion and ulceration of the esophagus caused by frequent vomiting, B. will require surgical
wrapping or repair of the pyloric sphincter to control the symptoms, C. is the protrusion of a portion of
the stomach into to esophagus through an opening in the diaphragm, D. often involves relaxation of the
lower esophageal sphincter, allowing stomach contents to back up into the espophagus -
(ANSWER)Answer: D. The acidic contents of the stomach touching the inside of the esophagus are
responsible for the physical sensation known as "heart-burn" that is a cardinal symptom of GERD
The nurse is teaching the patient and family about possible causative factors for peptic ulcers. The nurse
explains that ulcer formation is: (Source: Medical-Surgical Nursing, LDH p. 1004) a) caused by stressful
lifestyle and other acid producing factors such as H. pylori. b) inherited within families and reinforced by
bacterial spread of Staphylococcus aureus in childhood. c) promoted by factors that tend to cause
oversecretion of acid, such as excess dietary fats, smoking, and H. pylor. d) promoted by a combination
of possible factors that may result in erosion of the gastric mucosa, including certain drugs and alcohol -
(ANSWER)Peptic ulcers develop only in the presence of an acidic environment. However, an excess of
hydrochloric acid (HCl) may not be necessary for ulcer development. The back-diffusion of HCl into the
gastric mucosa results in cellular destruction and inflammation. Histamine is released from the damaged
mucosa, resulting in vasodilation and increased capillary permeability and further secretion of acid and
pepsin. A variety of agents (i.e., certain infections, medications, and lifestyle factors) can damage the
mucosal barrier
"Which of the following types of gastritis is
associated with Helicobacter pylori and duodenal ulcers?
1. Erosive (hemorrhagic) gastritis
2. Fundic gland gastritis (type A)
3. Antral gland gastritis (type B)
4.Aspiring-induced gastric ulcer - (ANSWER)Answer: 3 - Erosive (hemorrhagic) gastritis can be
caused by ingestion of substances that irritate the gastric mucosa. Fundic gland gastritis (type A) is
associated with diffuse severe mucosal atrophy and the presence of pernicious anemia. Antral gland
gastritis (type B) is the most common form of gastritis, and is associated with Helicobacter pylori and
duodenal ulcers
Caffeinated beverages and smoking are risk factors to assess for in the development of what condition?
A. Duodenal ulcers B. Peptic ulcers C. Helicobacter pylori D. Esophageal reflux - (ANSWER)Answer: B PUD
risk factors include family history, blood group O, smoking tobacco, and beverages containing caffeine
,Upper GI NCLEX Questions (2025) | High-Yield Practice with Verified Answers & Rationales
Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older
persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse
should assign the highest priority to which of the following interventions? 1. Decrease daily intake of
vegetables and water, and ambulate frequently 2. Drink coffee diluted with milk at each meal, and
remain in an upright position for 30 minutes. 3. Eat small, frequent meals, and remain in an upright
position for at least 30 minutes after eating 4. Avoid over-the-counter drugs that have antacids in them -
(ANSWER)Answer 3, Eating small and frequent meals requires less release of hydrochloric acid.
Remaining in an upright position for 30 minutes after meals prevents reflux into the esophagus which is
often exacerbated when lying down, expecially after a large meal which makes the patient tired
The nurse is performing an admission assessment on a client diagnosed with gastroesophageal reflux
disease (GERD). Which signs and symptoms would indicate GERD? 1. Pyrosis, water brash, and flatulence
2. Weight loss, dysarthria, and diarrhea 3. Decreased abdominal fat, proteinuria, and constipation 4.
Mid-epigastric pain, positive H. pylori test, and melena - (ANSWER)Correct answer: 1 (pyrosis, water
brash, and flatulence)1. Pyrosis is heartburn, water brash is the feeling of saliva secretion as a result of
reflux, and flatulence is gas—all symptoms of GERD 2. Gastroesophageal reflux disease does not cause
weight loss 3. There is no change in abdominal fat, no proteinuria (the result of a filtration problem
inthe kidney), and no alteration in bowel elimination for the client diagnosed with GERD 4. Mid-
epigastric pain, a positive H. pylori test, and melena are associated with gastric ulcer disease
The client with a hiatal hernia chronically experiences heartburn following meals. The nurse planc to
teach the client to avoid which action because it is contraindicated with hiatal hernia?1. Lying
recumbent following meals 2. Taking in small, frequent, bland meals 3. Raising the head of the bed on 6-
inch blocks 4. Taking H2-receptor antagonist medication - (ANSWER)Correct answer: 1Laying recumbant
following meals or at night will cause reflux and pain. Relief is usually achieved with the intake of small,
bland meals, use of H2 receptor antagonists and antacids, and elevation of the thorax after meals and
during sleep
What response should a nurse offer to a client who asks why he's having a vagotomy to treat his ulcer?
1. To repair a hole in the stomach 2. to reduce the ability of the stomach to produce acid 3. to prevent
the stomach from sliding into the chest 4. to remove a potentially malignant lesion in the stomach -
(ANSWER)Answer 2: A vagotomy is perfomred to elimniate the acid-secreting stimulus to gastric cells. a
perforation would be repaired with a gastric resection. Repair of hiatal hernia (fundoplication) prevents
the stomach from sliding through the diaphragm. Removal of a potentially malignant tumor wouldn't
reduce the entire acid-producing mechanism
, Upper GI NCLEX Questions (2025) | High-Yield Practice with Verified Answers & Rationales
The nurse is planning to teach a client with GERD about substances that will increase the LES
pressure.Which item shoud the nurse include on this list.1. Coffee 2. Chocolate 3. Fatty Foods 4. Nonfat
MIlk - (ANSWER)Correct Answer: Nonfat MIlkFoods that will increase LES pressure will decrease reflux
and lessen the symptoms of GERD. The food that will increase LES pressure is nonfat milk. The other
substances listed decrease LES pressure, thus increasing reflux symptoms. Aggravating substances
include the others listed and alcohol
Which assessment data support the client's diagnosis of gastric ulcer?"1. Presence of blood in the
client's stool for the past month.
2.Complaints of a burning sensation that moves like a wave.
3.Sharp pain in the upper abdomen after eating a heavy meal. 4.Comparison of complaints of pain with
ingestion of food and sleep - (ANSWER)"1. The presence of blood does not specifically indicate diagnosis
of an ulcer. The client could have hemorrhoids or cancer that would result in the presence of blood. 2. A
wavelike burning sensation is a symptom of gastroesophageal reflus. 3. Sharp pain in the upper
abdomen after eating a heavy meal is a symptom of gallbladder disease. 4. (CORRECT) In a client
diagosed with a gastric ulcer, pain usually occurs 30-60 minutes after eating, but not at night. In
contrast, a client with duodenal ulcer has pain durin ghte night that is often relieved by eating food. Pain
occurs 1-3 hours after meals
When assessing the client with the diagnosis of peptic ulcer disease, which physical examination should
the nurse implement first? Auscultate the client's bowel sounds in all four quadrants. 2.Palpate the
abdominal area for tenderness. 3.Percuss the abdominal borders to identify organs. 4.Assess the tender
area progressing to nontender - (ANSWER)Correct answer: #1. Auscultation should be used prior to
palpa-tion or percussion when assessing the abdomen. If the nurse manipulates the abdomen, the
bowel sounds can be altered and give false information
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most
likely indicate perforation of the ulcer? 1. Bradycardia 2. Numbness in the legs 3. Nausea and vomiting 4.
A rigid, board-like abdomen - (ANSWER)Answer 4, Perforation of an ulcer is a surgical emergency and is
characterized by sudden, sharp, intolerable severe pain beginning in the midepigastric area and
spreading over the abdomen, which become rigid and board-like. Nausea and vomiting may occur.
Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated
finding
Which of the following nursing interventions should the nurse perform for a female client receiving
enteral feedings through a gastrostomy tube? "a. Change the tube feeding solutions and tubing at least
