NCLEX-Style Test Bank — Digestive
System (100 Questions)
1–10: Esophagus / GERD / Swallowing
1. A client with GERD reports nighttime regurgitation and chronic cough.
Which instruction should the nurse include?
A. Eat a large snack before bedtime.
B. Sleep with the head of the bed elevated 6–12 inches.cc
C. Avoid chewing gum.
D. Increase intake of peppermint tea.
2. A client who had an esophagogastroduodenoscopy (EGD) asks when
they can eat. The nurse’s best response is:
A. “You may eat immediately.”
B. “Wait until your gag reflex returns.”
C. “Only clear liquids for 24 hours.”
D. “You must fast for 12 more hours.”
3. Which finding is most concerning for an esophageal variceal bleed?
A. Dark tarry stool with stable vitals
B. Bright red emesis with hypotension and tachycardia
C. Epigastric discomfort after meals
D. Mild throat soreness after endoscopy
4. Priority: A client with dysphagia chokes while eating and becomes
cyanotic. What is the nurse’s first action?
A. Begin abdominal thrusts (Heimlich) if conscious
B. Call for the speech therapist
C. Offer small sips of water to clear the throat
D. Recline the client and observe
5. Which medication would the nurse expect to be prescribed for long-
term GERD management?
A. Proton pump inhibitor (PPI)
B. Intravenous broad-spectrum antibiotic
C. Mu-opioid agonist
D. Oral contraceptive
6. A barium swallow test is scheduled for a client with suspected
esophageal stricture. Which preprocedure instruction is essential?
A. Take bisacodyl the night before
B. Do not eat or drink for 6–8 hours prior
C. Avoid all medications for 48 hours prior
D. Increase fluid intake before the test
7. A nursing student asks which symptom is classic for GERD. The correct
reply is:
A. Left lower quadrant pain
, B. Heartburn worse after eating and when lying down
C. Increased bowel sounds and diarrhea
D. Hematemesis without prior symptoms
8. SATA: Which interventions help reduce GERD symptoms?
☐ Avoid meals 2–3 hours before lying down
☐ Lose weight if overweight
☐ Wear tight clothing around the abdomen
☐ Elevate the head of the bed
9. A client with achalasia has difficulty passing food into the stomach. The
nurse expects which diagnostic finding?
A. Decreased lower esophageal sphincter tone on manometry
B. Increased LES tone and failure of relaxation on manometry
C. Accelerated gastric emptying on gastric emptying study
D. Large gastric ulcer on EGD
10. A patient receiving nasogastric (NG) tube feedings complains of
sore throat and nasal irritation. Which action should the nurse take
first?
A. Remove and replace the NG tube with a new size immediately
B. Reposition the tube and provide oral care
C. Stop feeding and obtain an x-ray
D. Suction the tube and continue feeding
11–20: Stomach / PUD / Gastritis
11. A client with peptic ulcer disease reports epigastric pain that is
relieved by eating. This pattern is most consistent with:
A. Duodenal ulcer
B. Gastric ulcer
C. Pancreatic cancer
D. Cholelithiasis
12. Which lab result is most helpful in diagnosing H. pylori infection?
A. Serum amylase
B. Urea breath test or stool antigen test
C. Serum bilirubin
D. Fecal leukocytes
13. Priority: A client with a known peptic ulcer suddenly reports
severe abdominal pain and rigid abdomen. What is the nurse’s priority
action?
A. Administer antacid and observe
B. Prepare for possible emergency surgery and notify the provider
C. Encourage oral fluids to dilute stomach acid
D. Schedule an upper endoscopy tomorrow
14. The nurse is teaching a client about taking sucralfate. Which
statement by the client indicates understanding?
A. “I should take it with an antacid for faster action.”
B. “I will take it one hour before meals.”
, C. “I will take it right before bedtime only.”
D. “It is safe to crush and take with all my other meds at once.”
15. Client education for chronic gastritis should include avoidance of:
A. Nonsteroidal anti-inflammatory drugs (NSAIDs)
B. High-fiber cereals
C. Low-sodium diets
D. Sleeping on the left side
16. Which symptom is most suggestive of an upper GI bleed from a
peptic ulcer?
A. Melena and orthostatic hypotension
B. Bright red rectal bleeding with fever
C. Chronic constipation without pain
D. Intermittent dysphagia
17. SATA: Risk factors for peptic ulcer disease include:
☐ Helicobacter pylori infection
☐ Chronic NSAID use
☐ Low-fat diet
☐ Smoking and alcohol use
18. A client is prescribed a triple therapy regimen for H. pylori. Which
teaching point is essential?
A. Stopping therapy early is okay once you feel better
B. Finish the full course of antibiotics as prescribed
C. Take all medications on an empty stomach only
D. Avoid all fluids while taking the regimen
19. Which nursing assessment finding suggests gastric outlet
obstruction?
A. Projectile vomiting of partially digested food hours after eating
B. Immediate watery diarrhea after meals
C. Hyperactive bowel sounds and flat abdomen
D. Frequent belching with no vomiting
20. Which pain description should the nurse associate most strongly
with a perforated peptic ulcer?
A. Vague epigastric discomfort relieved by food
B. Sudden, severe generalized abdominal pain with boardlike rigidity
C. Mild left lower quadrant cramping
D. Intermittent chest pain worse with exertion
21–30: Small & Large Intestine / IBS / IBD
21. A client with Crohn’s disease most commonly has inflammation
involving:
A. Only the rectum
B. Any part of the GI tract from mouth to anus, often with skip lesions
C. Only the colon in a continuous pattern
D. The esophagus exclusively
System (100 Questions)
1–10: Esophagus / GERD / Swallowing
1. A client with GERD reports nighttime regurgitation and chronic cough.
Which instruction should the nurse include?
A. Eat a large snack before bedtime.
B. Sleep with the head of the bed elevated 6–12 inches.cc
C. Avoid chewing gum.
D. Increase intake of peppermint tea.
2. A client who had an esophagogastroduodenoscopy (EGD) asks when
they can eat. The nurse’s best response is:
A. “You may eat immediately.”
B. “Wait until your gag reflex returns.”
C. “Only clear liquids for 24 hours.”
D. “You must fast for 12 more hours.”
3. Which finding is most concerning for an esophageal variceal bleed?
A. Dark tarry stool with stable vitals
B. Bright red emesis with hypotension and tachycardia
C. Epigastric discomfort after meals
D. Mild throat soreness after endoscopy
4. Priority: A client with dysphagia chokes while eating and becomes
cyanotic. What is the nurse’s first action?
A. Begin abdominal thrusts (Heimlich) if conscious
B. Call for the speech therapist
C. Offer small sips of water to clear the throat
D. Recline the client and observe
5. Which medication would the nurse expect to be prescribed for long-
term GERD management?
A. Proton pump inhibitor (PPI)
B. Intravenous broad-spectrum antibiotic
C. Mu-opioid agonist
D. Oral contraceptive
6. A barium swallow test is scheduled for a client with suspected
esophageal stricture. Which preprocedure instruction is essential?
A. Take bisacodyl the night before
B. Do not eat or drink for 6–8 hours prior
C. Avoid all medications for 48 hours prior
D. Increase fluid intake before the test
7. A nursing student asks which symptom is classic for GERD. The correct
reply is:
A. Left lower quadrant pain
, B. Heartburn worse after eating and when lying down
C. Increased bowel sounds and diarrhea
D. Hematemesis without prior symptoms
8. SATA: Which interventions help reduce GERD symptoms?
☐ Avoid meals 2–3 hours before lying down
☐ Lose weight if overweight
☐ Wear tight clothing around the abdomen
☐ Elevate the head of the bed
9. A client with achalasia has difficulty passing food into the stomach. The
nurse expects which diagnostic finding?
A. Decreased lower esophageal sphincter tone on manometry
B. Increased LES tone and failure of relaxation on manometry
C. Accelerated gastric emptying on gastric emptying study
D. Large gastric ulcer on EGD
10. A patient receiving nasogastric (NG) tube feedings complains of
sore throat and nasal irritation. Which action should the nurse take
first?
A. Remove and replace the NG tube with a new size immediately
B. Reposition the tube and provide oral care
C. Stop feeding and obtain an x-ray
D. Suction the tube and continue feeding
11–20: Stomach / PUD / Gastritis
11. A client with peptic ulcer disease reports epigastric pain that is
relieved by eating. This pattern is most consistent with:
A. Duodenal ulcer
B. Gastric ulcer
C. Pancreatic cancer
D. Cholelithiasis
12. Which lab result is most helpful in diagnosing H. pylori infection?
A. Serum amylase
B. Urea breath test or stool antigen test
C. Serum bilirubin
D. Fecal leukocytes
13. Priority: A client with a known peptic ulcer suddenly reports
severe abdominal pain and rigid abdomen. What is the nurse’s priority
action?
A. Administer antacid and observe
B. Prepare for possible emergency surgery and notify the provider
C. Encourage oral fluids to dilute stomach acid
D. Schedule an upper endoscopy tomorrow
14. The nurse is teaching a client about taking sucralfate. Which
statement by the client indicates understanding?
A. “I should take it with an antacid for faster action.”
B. “I will take it one hour before meals.”
, C. “I will take it right before bedtime only.”
D. “It is safe to crush and take with all my other meds at once.”
15. Client education for chronic gastritis should include avoidance of:
A. Nonsteroidal anti-inflammatory drugs (NSAIDs)
B. High-fiber cereals
C. Low-sodium diets
D. Sleeping on the left side
16. Which symptom is most suggestive of an upper GI bleed from a
peptic ulcer?
A. Melena and orthostatic hypotension
B. Bright red rectal bleeding with fever
C. Chronic constipation without pain
D. Intermittent dysphagia
17. SATA: Risk factors for peptic ulcer disease include:
☐ Helicobacter pylori infection
☐ Chronic NSAID use
☐ Low-fat diet
☐ Smoking and alcohol use
18. A client is prescribed a triple therapy regimen for H. pylori. Which
teaching point is essential?
A. Stopping therapy early is okay once you feel better
B. Finish the full course of antibiotics as prescribed
C. Take all medications on an empty stomach only
D. Avoid all fluids while taking the regimen
19. Which nursing assessment finding suggests gastric outlet
obstruction?
A. Projectile vomiting of partially digested food hours after eating
B. Immediate watery diarrhea after meals
C. Hyperactive bowel sounds and flat abdomen
D. Frequent belching with no vomiting
20. Which pain description should the nurse associate most strongly
with a perforated peptic ulcer?
A. Vague epigastric discomfort relieved by food
B. Sudden, severe generalized abdominal pain with boardlike rigidity
C. Mild left lower quadrant cramping
D. Intermittent chest pain worse with exertion
21–30: Small & Large Intestine / IBS / IBD
21. A client with Crohn’s disease most commonly has inflammation
involving:
A. Only the rectum
B. Any part of the GI tract from mouth to anus, often with skip lesions
C. Only the colon in a continuous pattern
D. The esophagus exclusively
