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ATI ADULT MEDICAL SURGICAL NURSING – UNIT 6 Gastrointestinal &
Hepatobiliary Disorders 120 Questions with Rationales
SECTION 1: GI ASSESSMENT & DIAGNOSTIC PROCEDURES
1. The nurse is assessing a client's abdomen. Which technique
should be performed first?
A. Auscultation
B. Inspection
C. Palpation
D. Percussion
Answer: B
Rationale: Inspection is always first. Auscultation follows
inspection before palpation and percussion because palpation
and percussion can alter bowel sounds.
2. Which of the following is a normal finding when auscultating
bowel sounds?
A. High-pitched tinkling sounds
B. Absent bowel sounds after listening 5 minutes
C. Soft clicks and gurgles every 5–15 seconds
D. Continuous loud rushes
Answer: C
Rationale: Normal bowel sounds are soft clicks and gurgles
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occurring every 5–15 seconds. High-pitched tinkling suggests
obstruction; absent sounds indicate ileus.
3. A nurse is percussing a client's abdomen. Dullness over the
right upper quadrant is normal because of the:
A. Stomach
B. Liver
C. Spleen
D. Bladder
Answer: B
Rationale: The liver is in the right upper quadrant and produces
dullness to percussion.
4. A client is scheduled for an upper GI series (barium swallow).
Which instruction is appropriate?
A. "You may eat a full meal before the test."
B. "You will be NPO for 8–12 hours before the test."
C. "You will drink a clear liquid contrast."
D. "You will receive IV sedation."
Answer: B
Rationale: An upper GI series requires NPO status to ensure
clear visualization.
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5. After a barium enema, the nurse should instruct the client to:
A. Limit fluids
B. Increase fluids to help expel barium
C. Avoid all fluids
D. Take an antiemetic
Answer: B
Rationale: Fluids help flush barium and prevent
constipation/impaction.
6. A client is scheduled for a colonoscopy. Which instruction is
most important?
A. "You may eat a regular diet the day before."
B. "You will need to complete a bowel preparation and have
clear liquids."
C. "You can drive yourself home after the procedure."
D. "No sedation will be used."
Answer: B
Rationale: Colonoscopy requires bowel prep and clear liquids;
sedation is used; client cannot drive.
7. After a colonoscopy, the nurse should assess for which
complication?
A. Bowel perforation
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B. Constipation only
C. Hypertension
D. Hyperglycemia
Answer: A
Rationale: Perforation is a serious complication; monitor for
severe pain, fever, guarding.
8. A client is scheduled for an endoscopic retrograde
cholangiopancreatography (ERCP). The nurse should monitor
for which complication after the procedure?
A. Pancreatitis
B. Constipation
C. Hypoglycemia
D. Hypotension only
Answer: A
Rationale: ERCP can cause pancreatitis; monitor for abdominal
pain, nausea, elevated amylase/lipase.
9. Which of the following is a sign of gastrointestinal bleeding?
A. Bright red blood in stool or black tarry stools
B. Yellow stools
C. Pale urine
D. Constipation only
ATI ADULT MEDICAL SURGICAL NURSING – UNIT 6 Gastrointestinal &
Hepatobiliary Disorders 120 Questions with Rationales
SECTION 1: GI ASSESSMENT & DIAGNOSTIC PROCEDURES
1. The nurse is assessing a client's abdomen. Which technique
should be performed first?
A. Auscultation
B. Inspection
C. Palpation
D. Percussion
Answer: B
Rationale: Inspection is always first. Auscultation follows
inspection before palpation and percussion because palpation
and percussion can alter bowel sounds.
2. Which of the following is a normal finding when auscultating
bowel sounds?
A. High-pitched tinkling sounds
B. Absent bowel sounds after listening 5 minutes
C. Soft clicks and gurgles every 5–15 seconds
D. Continuous loud rushes
Answer: C
Rationale: Normal bowel sounds are soft clicks and gurgles
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occurring every 5–15 seconds. High-pitched tinkling suggests
obstruction; absent sounds indicate ileus.
3. A nurse is percussing a client's abdomen. Dullness over the
right upper quadrant is normal because of the:
A. Stomach
B. Liver
C. Spleen
D. Bladder
Answer: B
Rationale: The liver is in the right upper quadrant and produces
dullness to percussion.
4. A client is scheduled for an upper GI series (barium swallow).
Which instruction is appropriate?
A. "You may eat a full meal before the test."
B. "You will be NPO for 8–12 hours before the test."
C. "You will drink a clear liquid contrast."
D. "You will receive IV sedation."
Answer: B
Rationale: An upper GI series requires NPO status to ensure
clear visualization.
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5. After a barium enema, the nurse should instruct the client to:
A. Limit fluids
B. Increase fluids to help expel barium
C. Avoid all fluids
D. Take an antiemetic
Answer: B
Rationale: Fluids help flush barium and prevent
constipation/impaction.
6. A client is scheduled for a colonoscopy. Which instruction is
most important?
A. "You may eat a regular diet the day before."
B. "You will need to complete a bowel preparation and have
clear liquids."
C. "You can drive yourself home after the procedure."
D. "No sedation will be used."
Answer: B
Rationale: Colonoscopy requires bowel prep and clear liquids;
sedation is used; client cannot drive.
7. After a colonoscopy, the nurse should assess for which
complication?
A. Bowel perforation
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B. Constipation only
C. Hypertension
D. Hyperglycemia
Answer: A
Rationale: Perforation is a serious complication; monitor for
severe pain, fever, guarding.
8. A client is scheduled for an endoscopic retrograde
cholangiopancreatography (ERCP). The nurse should monitor
for which complication after the procedure?
A. Pancreatitis
B. Constipation
C. Hypoglycemia
D. Hypotension only
Answer: A
Rationale: ERCP can cause pancreatitis; monitor for abdominal
pain, nausea, elevated amylase/lipase.
9. Which of the following is a sign of gastrointestinal bleeding?
A. Bright red blood in stool or black tarry stools
B. Yellow stools
C. Pale urine
D. Constipation only
