ATI Medical-Surgical Gastrointestinal Exam
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is teaching a client who has gastroesophageal reflux
disease (GERD). Which instruction should the nurse include?
A. Eat a large meal immediately before bedtime.
B. Drink peppermint tea after meals.
C. Avoid eating for several hours before bedtime.
D. Lie flat for 30 minutes after eating.
Rationale: Remaining upright after meals and avoiding food
close to bedtime decreases the likelihood that gastric contents
will reflux into the esophagus. Large meals increase gastric
distention, while lying down soon after eating promotes reflux.
Peppermint can relax the lower esophageal sphincter and may
worsen symptoms. Elevating the head of the bed can also be
helpful for clients who experience nighttime symptoms.
Question 2
Which finding is most consistent with a hiatal hernia?
A. Right lower-quadrant abdominal pain
B. Heartburn that worsens when lying down
,C. Profuse watery diarrhea
D. Severe left lower-quadrant tenderness
Rationale: A hiatal hernia occurs when part of the stomach
protrudes through the diaphragm into the thoracic cavity. This
can impair the lower esophageal sphincter and contribute to
reflux, producing heartburn and regurgitation that may worsen
when the client lies down.
Question 3
A client with esophageal varices suddenly begins vomiting a
large amount of bright-red blood. What is the nurse's priority
action?
A. Give the client an oral antacid.
B. Place the client in a supine position.
C. Assess the client's airway and respiratory status.
D. Encourage the client to drink water.
Rationale: Massive bleeding from esophageal varices can
rapidly compromise airway protection and circulation. The
nurse should prioritize airway, breathing, and circulation. Oral
intake is inappropriate during active hemorrhage, and
positioning should support airway protection rather than
increase aspiration risk.
Question 4
,Which medication history places a client at increased risk for
peptic ulcer disease?
A. Acetaminophen use
B. Frequent NSAID use
C. Daily multivitamin use
D. Calcium supplementation
Rationale: NSAIDs inhibit cyclooxygenase enzymes and decrease
protective prostaglandins in the gastric mucosa. This reduces
mucosal protection and increases the risk for gastritis, gastric
ulceration, and gastrointestinal bleeding, particularly with
prolonged or high-dose use.
Question 5
A client with peptic ulcer disease reports black, tarry stools.
How should the nurse interpret this finding?
A. It indicates lower urinary tract bleeding.
B. It is an expected effect of a high-fiber diet.
C. It may indicate an upper gastrointestinal hemorrhage.
D. It indicates that the ulcer has healed.
Rationale: Melena refers to black, tarry, often foul-smelling stool
caused by digestion of blood as it passes through the
gastrointestinal tract. It commonly indicates bleeding from an
upper GI source such as a peptic ulcer. The finding requires
, prompt assessment for hemodynamic instability and ongoing
blood loss.
Question 6
A client with a gastric ulcer asks why testing for Helicobacter
pylori is important. Which response is best?
A. “The organism causes pancreatic obstruction.”
B. “The organism can contribute to gastric mucosal
inflammation and ulcer formation.”
C. “The organism causes gallstones.”
D. “The organism prevents gastric acid production.”
Rationale: H. pylori infection damages gastric mucosal defenses
and contributes to chronic gastritis and peptic ulcer disease.
Eradication therapy, typically involving acid suppression plus
appropriate antibiotics, can reduce recurrence when infection is
present.
Question 7
Which finding should the nurse expect in a client experiencing
an upper gastrointestinal bleed?
A. Clay-colored stool only
B. Increased urine output
C. Tachycardia and hypotension
D. Bradycardia and hypertension
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is teaching a client who has gastroesophageal reflux
disease (GERD). Which instruction should the nurse include?
A. Eat a large meal immediately before bedtime.
B. Drink peppermint tea after meals.
C. Avoid eating for several hours before bedtime.
D. Lie flat for 30 minutes after eating.
Rationale: Remaining upright after meals and avoiding food
close to bedtime decreases the likelihood that gastric contents
will reflux into the esophagus. Large meals increase gastric
distention, while lying down soon after eating promotes reflux.
Peppermint can relax the lower esophageal sphincter and may
worsen symptoms. Elevating the head of the bed can also be
helpful for clients who experience nighttime symptoms.
Question 2
Which finding is most consistent with a hiatal hernia?
A. Right lower-quadrant abdominal pain
B. Heartburn that worsens when lying down
,C. Profuse watery diarrhea
D. Severe left lower-quadrant tenderness
Rationale: A hiatal hernia occurs when part of the stomach
protrudes through the diaphragm into the thoracic cavity. This
can impair the lower esophageal sphincter and contribute to
reflux, producing heartburn and regurgitation that may worsen
when the client lies down.
Question 3
A client with esophageal varices suddenly begins vomiting a
large amount of bright-red blood. What is the nurse's priority
action?
A. Give the client an oral antacid.
B. Place the client in a supine position.
C. Assess the client's airway and respiratory status.
D. Encourage the client to drink water.
Rationale: Massive bleeding from esophageal varices can
rapidly compromise airway protection and circulation. The
nurse should prioritize airway, breathing, and circulation. Oral
intake is inappropriate during active hemorrhage, and
positioning should support airway protection rather than
increase aspiration risk.
Question 4
,Which medication history places a client at increased risk for
peptic ulcer disease?
A. Acetaminophen use
B. Frequent NSAID use
C. Daily multivitamin use
D. Calcium supplementation
Rationale: NSAIDs inhibit cyclooxygenase enzymes and decrease
protective prostaglandins in the gastric mucosa. This reduces
mucosal protection and increases the risk for gastritis, gastric
ulceration, and gastrointestinal bleeding, particularly with
prolonged or high-dose use.
Question 5
A client with peptic ulcer disease reports black, tarry stools.
How should the nurse interpret this finding?
A. It indicates lower urinary tract bleeding.
B. It is an expected effect of a high-fiber diet.
C. It may indicate an upper gastrointestinal hemorrhage.
D. It indicates that the ulcer has healed.
Rationale: Melena refers to black, tarry, often foul-smelling stool
caused by digestion of blood as it passes through the
gastrointestinal tract. It commonly indicates bleeding from an
upper GI source such as a peptic ulcer. The finding requires
, prompt assessment for hemodynamic instability and ongoing
blood loss.
Question 6
A client with a gastric ulcer asks why testing for Helicobacter
pylori is important. Which response is best?
A. “The organism causes pancreatic obstruction.”
B. “The organism can contribute to gastric mucosal
inflammation and ulcer formation.”
C. “The organism causes gallstones.”
D. “The organism prevents gastric acid production.”
Rationale: H. pylori infection damages gastric mucosal defenses
and contributes to chronic gastritis and peptic ulcer disease.
Eradication therapy, typically involving acid suppression plus
appropriate antibiotics, can reduce recurrence when infection is
present.
Question 7
Which finding should the nurse expect in a client experiencing
an upper gastrointestinal bleed?
A. Clay-colored stool only
B. Increased urine output
C. Tachycardia and hypotension
D. Bradycardia and hypertension
