GI EXAM STUDY GUIDE WITH
COMPLETE SOLUTIONS
While palpating a female client's right upper quadrant (RUQ), the nurse would expect to
find which of the following structures?
a. Sigmoid colon
b. Appendix
c. Spleen
d. Liver - ANSWER-Answer D. The RUQ contains the liver, gallbladder, duodenum,
head of the pancreas, hepatic flexure of the colon, portions of the ascending and
transverse colon, and a portion of the right kidney. The sigmoid colon is located in the
left lower quadrant; the appendix, in the right lower quadrant; and the spleen, in the left
upper quadrant.
1. An adult who has cholecystitis reports clay colored stools and moderate jaundice.
Which is the best explanation for the presence of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct. - ANSWER-(4) Clay colored stools
means bile is not getting through to the duodenum. The bile duct is obstructed so bile
backs up into the bloodstream causing jaundice
A barium enema is ordered for an adult male client. The nurse is teaching him what to
expect regarding the procedure. Which statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure. - ANSWER-1) The bowel must
be free of fecal material for good visualization of the bowel. He will be on a clear liquid
or low residue diet for the day preceding the exam. The client is put in several positions
during the test. Barium is given by enema. It is given by mouth in an upper GI series.
A client is admitted for suspected GI disease. Assessment data reveal muscle wasting,
a decrease in chest and axillary hair, and increased bleeding tendency. The nurse
suspects the client has:
a) cirrhosis.
b) cholelithiasis.
c) appendicitis.
,d) peptic ulcer disease. - ANSWER-A) Cirrhosis Muscle wasting, a decrease in chest
and axillary hair, and increased bleeding tendencies are all symptoms of cirrhosis. The
client may also have mild fever, edema, abdominal pain, and an enlarged liver. Clients
with peptic ulcer disease complain of a dull, gnawing epigastric pain that's relieved by
eating. Appendicitis is characterized by a periumbilical pain that moves to the right lower
quadrant and rebound tenderness. Cholelithiasis is characterized by severe abdominal
pain that presents several hours after a large meal.
A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer.
The nurse expects this client's stools to be:
a) black and tarry.
b) coffee-ground-like.
c) bright red.
d) clay-colored. - ANSWER-A) Black and tarry Black, tarry stools are a sign of bleeding
high in the GI tract, as from a gastric ulcer, and result from the action of digestive
enzymes on the blood. Vomitus associated with upper GI tract bleeding commonly is
described as coffee-ground-like. Clay-colored stools are associated with biliary
obstruction. Bright red stools indicate lower GI tract bleeding.
A client is admitted with a diagnosis of acute appendicitis. When assessing the
abdomen, the nurse would expect to find rebound tenderness at which location?
a) Left lower quadrant
b) Left upper quadrant
c) Right upper quadrant
d) Right lower quadrant - ANSWER-D) Right lower quadrant The pain of acute
appendicitis localizes in the right lower quadrant (RLQ) at McBurney's point, an area
midway between the umbilicus and the right iliac crest. Often, the pain is worse when
manual pressure near the region is suddenly released, a condition called rebound
tenderness.
A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The
physician begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which
substance influences vitamin B12 absorption?
a) Hydrochloric acid
b) Histamine
c) Liver enzyme
d) Intrinsic factor - ANSWER-D) Intrinsic factor Vitamin B12 absorption depends on
intrinsic factor, which is secreted by parietal cells in the stomach. The vitamin binds with
intrinsic factor and is absorbed in the ileum. Hydrochloric acid, histamine, and liver
enzymes don't influence vitamin B12 absorption.
, A client is evaluated for severe pain in the right upper abdominal quadrant, which is
accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and
cholelithiasis. For this client, which nursing diagnosis takes top priority?
a) Imbalanced nutrition: Less than body requirements related to biliary inflammation
b) Anxiety related to unknown outcome of hospitalization
c) Deficient knowledge related to prevention of disease recurrence
d) Acute pain related to biliary spasms - ANSWER-D) Acute pain related to biliary
spasms The chief symptom of cholecystitis is abdominal pain or biliary colic. Typically,
the pain is so severe that the client is restless and changes positions frequently to find
relief. Therefore, the nursing diagnosis of Acute pain related to biliary spasms takes
highest priority. Until the acute pain is relieved, the client can't learn about prevention,
may continue to experience anxiety, and can't address nutritional concerns.
A client is scheduled for an esophagogastroduodenoscopy (EGD) to detect lesions in
the gastrointestinal tract. The nurse would observe for which of the following while
assessing the client during the procedure?
a) Signs of perforation
b) Gag reflex
c) Client's tolerance for pain and discomfort
d) Client's ability to retain the barium - ANSWER-C) Client's tolerance for pain and
discomfort The nurse has to assess the client's tolerance for pain and discomfort during
the procedure. The nurse should assess the signs of perforation and the gag reflex after
the procedure of EGD and not during the procedure. Assessing the client's level for
retaining barium is important for a diagnostic test that involves the use of barium. EGD
does not involve the use of barium.
A client is to have an upper GI procedure with barium ingestion and abdominal
ultrasonography. While scheduling these diagnostic tests, the nurse must consider
which factor?
a) The client may eat a light meal before either test.
b) Both tests need to be done before breakfast
c) The upper GI should be scheduled before the ultrasonography.
d) The ultrasonography should be scheduled before the GI procedure. - ANSWER-
STUDY
PLAY
A client presents with complaints of blood in her stools. Upon inspection, the nurse
notes streaks of bright red blood visible on the outer surface of formed stool. Which of
the following will the nurse further investigate with this client? a) Ingestion of cherry
sodab) Ingestion of cocoac) Presence or history of hemorrhoidsd) Recent barium
studies
C) Presence or history of hemorrhoids Stool is normally light to dark brown. Blood in the
stool can present in various ways and must be investigated. Lower rectal or anal
COMPLETE SOLUTIONS
While palpating a female client's right upper quadrant (RUQ), the nurse would expect to
find which of the following structures?
a. Sigmoid colon
b. Appendix
c. Spleen
d. Liver - ANSWER-Answer D. The RUQ contains the liver, gallbladder, duodenum,
head of the pancreas, hepatic flexure of the colon, portions of the ascending and
transverse colon, and a portion of the right kidney. The sigmoid colon is located in the
left lower quadrant; the appendix, in the right lower quadrant; and the spleen, in the left
upper quadrant.
1. An adult who has cholecystitis reports clay colored stools and moderate jaundice.
Which is the best explanation for the presence of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct. - ANSWER-(4) Clay colored stools
means bile is not getting through to the duodenum. The bile duct is obstructed so bile
backs up into the bloodstream causing jaundice
A barium enema is ordered for an adult male client. The nurse is teaching him what to
expect regarding the procedure. Which statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure. - ANSWER-1) The bowel must
be free of fecal material for good visualization of the bowel. He will be on a clear liquid
or low residue diet for the day preceding the exam. The client is put in several positions
during the test. Barium is given by enema. It is given by mouth in an upper GI series.
A client is admitted for suspected GI disease. Assessment data reveal muscle wasting,
a decrease in chest and axillary hair, and increased bleeding tendency. The nurse
suspects the client has:
a) cirrhosis.
b) cholelithiasis.
c) appendicitis.
,d) peptic ulcer disease. - ANSWER-A) Cirrhosis Muscle wasting, a decrease in chest
and axillary hair, and increased bleeding tendencies are all symptoms of cirrhosis. The
client may also have mild fever, edema, abdominal pain, and an enlarged liver. Clients
with peptic ulcer disease complain of a dull, gnawing epigastric pain that's relieved by
eating. Appendicitis is characterized by a periumbilical pain that moves to the right lower
quadrant and rebound tenderness. Cholelithiasis is characterized by severe abdominal
pain that presents several hours after a large meal.
A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer.
The nurse expects this client's stools to be:
a) black and tarry.
b) coffee-ground-like.
c) bright red.
d) clay-colored. - ANSWER-A) Black and tarry Black, tarry stools are a sign of bleeding
high in the GI tract, as from a gastric ulcer, and result from the action of digestive
enzymes on the blood. Vomitus associated with upper GI tract bleeding commonly is
described as coffee-ground-like. Clay-colored stools are associated with biliary
obstruction. Bright red stools indicate lower GI tract bleeding.
A client is admitted with a diagnosis of acute appendicitis. When assessing the
abdomen, the nurse would expect to find rebound tenderness at which location?
a) Left lower quadrant
b) Left upper quadrant
c) Right upper quadrant
d) Right lower quadrant - ANSWER-D) Right lower quadrant The pain of acute
appendicitis localizes in the right lower quadrant (RLQ) at McBurney's point, an area
midway between the umbilicus and the right iliac crest. Often, the pain is worse when
manual pressure near the region is suddenly released, a condition called rebound
tenderness.
A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The
physician begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which
substance influences vitamin B12 absorption?
a) Hydrochloric acid
b) Histamine
c) Liver enzyme
d) Intrinsic factor - ANSWER-D) Intrinsic factor Vitamin B12 absorption depends on
intrinsic factor, which is secreted by parietal cells in the stomach. The vitamin binds with
intrinsic factor and is absorbed in the ileum. Hydrochloric acid, histamine, and liver
enzymes don't influence vitamin B12 absorption.
, A client is evaluated for severe pain in the right upper abdominal quadrant, which is
accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and
cholelithiasis. For this client, which nursing diagnosis takes top priority?
a) Imbalanced nutrition: Less than body requirements related to biliary inflammation
b) Anxiety related to unknown outcome of hospitalization
c) Deficient knowledge related to prevention of disease recurrence
d) Acute pain related to biliary spasms - ANSWER-D) Acute pain related to biliary
spasms The chief symptom of cholecystitis is abdominal pain or biliary colic. Typically,
the pain is so severe that the client is restless and changes positions frequently to find
relief. Therefore, the nursing diagnosis of Acute pain related to biliary spasms takes
highest priority. Until the acute pain is relieved, the client can't learn about prevention,
may continue to experience anxiety, and can't address nutritional concerns.
A client is scheduled for an esophagogastroduodenoscopy (EGD) to detect lesions in
the gastrointestinal tract. The nurse would observe for which of the following while
assessing the client during the procedure?
a) Signs of perforation
b) Gag reflex
c) Client's tolerance for pain and discomfort
d) Client's ability to retain the barium - ANSWER-C) Client's tolerance for pain and
discomfort The nurse has to assess the client's tolerance for pain and discomfort during
the procedure. The nurse should assess the signs of perforation and the gag reflex after
the procedure of EGD and not during the procedure. Assessing the client's level for
retaining barium is important for a diagnostic test that involves the use of barium. EGD
does not involve the use of barium.
A client is to have an upper GI procedure with barium ingestion and abdominal
ultrasonography. While scheduling these diagnostic tests, the nurse must consider
which factor?
a) The client may eat a light meal before either test.
b) Both tests need to be done before breakfast
c) The upper GI should be scheduled before the ultrasonography.
d) The ultrasonography should be scheduled before the GI procedure. - ANSWER-
STUDY
PLAY
A client presents with complaints of blood in her stools. Upon inspection, the nurse
notes streaks of bright red blood visible on the outer surface of formed stool. Which of
the following will the nurse further investigate with this client? a) Ingestion of cherry
sodab) Ingestion of cocoac) Presence or history of hemorrhoidsd) Recent barium
studies
C) Presence or history of hemorrhoids Stool is normally light to dark brown. Blood in the
stool can present in various ways and must be investigated. Lower rectal or anal
