NCLEX RN Gastrointestinal Disorders
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with a peptic ulcer is prescribed omeprazole. Which explanation
should the nurse provide about this medication?
A. It neutralizes stomach acid immediately.
B. It stimulates mucus production.
C. It decreases gastric acid secretion.
D. It increases gastric motility.
Answer: It decreases gastric acid secretion.
Rationale: Omeprazole is a proton pump inhibitor (PPI) that suppresses
gastric acid secretion by inhibiting the hydrogen-potassium ATPase pump in
gastric parietal cells.
2. A client with a gastric ulcer reports sudden severe abdominal pain and a
rigid abdomen. Which complication should the nurse suspect?
A. Gastric obstruction
B. Perforation
C. Constipation
D. Pancreatitis
Answer: Perforation
Rationale: Sudden severe abdominal pain with a rigid, board-like abdomen is
characteristic of perforation and peritonitis, which requires immediate
intervention.
, 3. Which assessment finding is most concerning in a client with an upper
gastrointestinal hemorrhage?
A. Heart rate of 76/min
B. Blood pressure of 128/78 mm Hg
C. Blood pressure of 86/52 mm Hg
D. Temperature of 37°C (98.6°F)
Answer: Blood pressure of 86/52 mm Hg
Rationale: Hypotension in a client with gastrointestinal bleeding may indicate
significant blood loss and hypovolemic shock.
4. A client with cirrhosis develops hematemesis. Which complication
should the nurse suspect?
A. Appendicitis
B. Esophageal varices
C. Diverticulitis
D. Cholecystitis
Answer: Esophageal varices
Rationale: Portal hypertension associated with cirrhosis can cause
esophageal varices, which may rupture and produce life-threatening
hematemesis.
5. Which laboratory finding is commonly associated with significant liver
dysfunction?
A. Increased serum albumin
B. Increased prothrombin time
C. Decreased bilirubin
D. Increased platelet count
Answer: Increased prothrombin time
,Rationale: The liver produces many clotting factors. Liver dysfunction can
reduce clotting-factor production, resulting in prolonged prothrombin time.
6. A client with hepatic encephalopathy is prescribed lactulose. Which
finding indicates that the medication is effective?
A. Urine output increases.
B. Abdominal pain decreases.
C. Level of consciousness improves.
D. Serum glucose increases.
Answer: Level of consciousness improves.
Rationale: Lactulose reduces ammonia absorption in the intestine, helping
decrease neurologic manifestations of hepatic encephalopathy.
7. Which food should the nurse recommend to a client with
gastroesophageal reflux disease (GERD)?
A. Fried chicken
B. Chocolate cake
C. Oatmeal
D. Peppermint candy
Answer: Oatmeal
Rationale: Oatmeal is generally low in fat and less likely to worsen reflux.
High-fat foods, chocolate, and peppermint can relax the lower esophageal
sphincter and aggravate GERD.
8. Which instruction is most appropriate for a client with GERD?
A. Lie down immediately after meals.
B. Eat large meals before bedtime.
C. Remain upright for several hours after eating.
D. Drink peppermint tea after meals.
, Answer: Remain upright for several hours after eating.
Rationale: Remaining upright after meals uses gravity to reduce reflux of
gastric contents into the esophagus.
9. A client with acute pancreatitis reports severe epigastric pain radiating to
the back. Which intervention is appropriate?
A. Encourage a high-fat diet.
B. Maintain prescribed bowel rest and administer IV fluids.
C. Encourage alcohol intake.
D. Administer oral laxatives.
Answer: Maintain prescribed bowel rest and administer IV fluids.
Rationale: Acute pancreatitis requires supportive management, including
fluid replacement, pain control, and reducing pancreatic stimulation as
prescribed.
10.Which laboratory value is particularly associated with acute pancreatitis?
A. Decreased amylase
B. Decreased lipase
C. Increased lipase
D. Decreased bilirubin
Answer: Increased lipase
Rationale: Serum lipase is commonly elevated in acute pancreatitis and is
more specific for pancreatic injury than amylase.
11.A client with acute pancreatitis develops hypotension, tachycardia, and
oliguria. What complication should the nurse suspect?
A. Mild dehydration
B. Hypovolemic shock
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with a peptic ulcer is prescribed omeprazole. Which explanation
should the nurse provide about this medication?
A. It neutralizes stomach acid immediately.
B. It stimulates mucus production.
C. It decreases gastric acid secretion.
D. It increases gastric motility.
Answer: It decreases gastric acid secretion.
Rationale: Omeprazole is a proton pump inhibitor (PPI) that suppresses
gastric acid secretion by inhibiting the hydrogen-potassium ATPase pump in
gastric parietal cells.
2. A client with a gastric ulcer reports sudden severe abdominal pain and a
rigid abdomen. Which complication should the nurse suspect?
A. Gastric obstruction
B. Perforation
C. Constipation
D. Pancreatitis
Answer: Perforation
Rationale: Sudden severe abdominal pain with a rigid, board-like abdomen is
characteristic of perforation and peritonitis, which requires immediate
intervention.
, 3. Which assessment finding is most concerning in a client with an upper
gastrointestinal hemorrhage?
A. Heart rate of 76/min
B. Blood pressure of 128/78 mm Hg
C. Blood pressure of 86/52 mm Hg
D. Temperature of 37°C (98.6°F)
Answer: Blood pressure of 86/52 mm Hg
Rationale: Hypotension in a client with gastrointestinal bleeding may indicate
significant blood loss and hypovolemic shock.
4. A client with cirrhosis develops hematemesis. Which complication
should the nurse suspect?
A. Appendicitis
B. Esophageal varices
C. Diverticulitis
D. Cholecystitis
Answer: Esophageal varices
Rationale: Portal hypertension associated with cirrhosis can cause
esophageal varices, which may rupture and produce life-threatening
hematemesis.
5. Which laboratory finding is commonly associated with significant liver
dysfunction?
A. Increased serum albumin
B. Increased prothrombin time
C. Decreased bilirubin
D. Increased platelet count
Answer: Increased prothrombin time
,Rationale: The liver produces many clotting factors. Liver dysfunction can
reduce clotting-factor production, resulting in prolonged prothrombin time.
6. A client with hepatic encephalopathy is prescribed lactulose. Which
finding indicates that the medication is effective?
A. Urine output increases.
B. Abdominal pain decreases.
C. Level of consciousness improves.
D. Serum glucose increases.
Answer: Level of consciousness improves.
Rationale: Lactulose reduces ammonia absorption in the intestine, helping
decrease neurologic manifestations of hepatic encephalopathy.
7. Which food should the nurse recommend to a client with
gastroesophageal reflux disease (GERD)?
A. Fried chicken
B. Chocolate cake
C. Oatmeal
D. Peppermint candy
Answer: Oatmeal
Rationale: Oatmeal is generally low in fat and less likely to worsen reflux.
High-fat foods, chocolate, and peppermint can relax the lower esophageal
sphincter and aggravate GERD.
8. Which instruction is most appropriate for a client with GERD?
A. Lie down immediately after meals.
B. Eat large meals before bedtime.
C. Remain upright for several hours after eating.
D. Drink peppermint tea after meals.
, Answer: Remain upright for several hours after eating.
Rationale: Remaining upright after meals uses gravity to reduce reflux of
gastric contents into the esophagus.
9. A client with acute pancreatitis reports severe epigastric pain radiating to
the back. Which intervention is appropriate?
A. Encourage a high-fat diet.
B. Maintain prescribed bowel rest and administer IV fluids.
C. Encourage alcohol intake.
D. Administer oral laxatives.
Answer: Maintain prescribed bowel rest and administer IV fluids.
Rationale: Acute pancreatitis requires supportive management, including
fluid replacement, pain control, and reducing pancreatic stimulation as
prescribed.
10.Which laboratory value is particularly associated with acute pancreatitis?
A. Decreased amylase
B. Decreased lipase
C. Increased lipase
D. Decreased bilirubin
Answer: Increased lipase
Rationale: Serum lipase is commonly elevated in acute pancreatitis and is
more specific for pancreatic injury than amylase.
11.A client with acute pancreatitis develops hypotension, tachycardia, and
oliguria. What complication should the nurse suspect?
A. Mild dehydration
B. Hypovolemic shock
