ATI MED SURG GI SYSTEM EXAM
NEWEST 2026 | ATI MEDICAL SURGICAL
GASTROINTESTINAL TEST BANK | 200+
REAL EXAM Q&A + DETAILED
RATIONALES | NG TUBE ,GERD ,
IBD,LIVER | A+ BUNDLE 2026
Question
A nurse is preparing a community education program about Hepatitis B. Which of the
following statements should the nurse include in the teaching?
A) Hepatitis B immune globulin is given as part of the standard childhood immunizations.
B) It can be administered as early as birth, especially in infants born to hepatitis B surface
antigen (HBsAg) negative mothers.
C) Infants should receive the second dose between 1 and 4 months of age.
D) All of the above are correct statements.
Expert Rationale: Hepatitis B immune globulin (HBIG) and the hepatitis B vaccine are part
of standard childhood immunizations. The vaccine can be given at birth, particularly for
infants born to HBsAg-negative mothers. The second dose is typically administered
between 1 and 4 months of age. All statements are accurate and should be included in
client teaching. The nurse must emphasize the importance of completing the full
vaccination series for optimal protection against hepatitis B.
Question
A nurse is assessing a client who was admitted with a bowel obstruction. The client reports
severe abdominal pain. Which of the following findings should indicate to the nurse that a
possible bowel perforation has occurred?
A) Abdominal tenderness and rigidity with hypotension
B) Hyperactive bowel sounds and mild distension
,C) Nausea and vomiting with normal vital signs
D) Intermittent cramping pain and flatus
Expert Rationale: Bowel perforation is a life-threatening emergency. Abdominal
tenderness and rigidity (board-like abdomen) indicate peritoneal irritation. As fluid escapes
into the peritoneal cavity, there is a reduction in circulating blood volume leading to
hypotension. Hyperactive bowel sounds and mild distension are more consistent with early
obstruction. Perforation requires immediate surgical intervention and aggressive fluid
resuscitation.
Question
A nurse is caring for a client who is scheduled to undergo an
esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is used
to do which of the following?
A) Visualize the esophagus, stomach, and duodenum to detect tumors, ulcerations, or
obstructions
B) Assess gallbladder function and biliary duct patency
C) Evaluate colonic mucosa for polyps and malignancies
D) Measure gastric acid secretion and pH levels
Expert Rationale: An EGD uses a lighted flexible endoscope to directly visualize the
esophagus, stomach, and duodenum. It is a diagnostic tool used to detect tumors,
ulcerations, strictures, and other abnormalities. It also allows for tissue biopsy and
therapeutic interventions such as banding of varices. It does not evaluate the gallbladder,
colon, or measure gastric acid secretion.
Question
A nurse is caring for a client who is receiving total parenteral nutrition (TPN) therapy and
has just returned to the room following physical therapy. The nurse notes that the infusion
pump for the client's TPN is turned off. After restarting the infusion pump, the nurse should
monitor the client for which of the following findings?
A) Hyperglycemia and polyuria
B) Hypoglycemia with diaphoresis, weakness, and anxiety
C) Fluid overload with crackles and edema
D) Electrolyte imbalance with muscle cramping
,Expert Rationale: TPN solutions are highly concentrated in dextrose. Sudden withdrawal of
TPN can cause rebound hypoglycemia because the pancreas continues to produce insulin
in response to the high glucose load. Manifestations include diaphoresis, weakness,
anxiety, confusion, and hunger. The nurse should monitor blood glucose closely and restart
the infusion gradually. Hyperglycemia occurs with rapid infusion, not sudden withdrawal.
Question
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following
manifestations should the nurse expect?
A) Jaundice and dark urine
B) Severe anorexia and malaise
C) Right upper quadrant pain and hepatomegaly
D) Clay-colored stools and pruritus
Expert Rationale: Anorexia is an early manifestation of hepatitis A and is often severe,
thought to result from the release of a toxin by the damaged liver or failure of damaged liver
cells to detoxify an abnormal product. Jaundice, dark urine, clay-colored stools, and
pruritus are typically later manifestations associated with cholestasis. Early symptoms
also include malaise, nausea, and low-grade fever.
Question
A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the
following manifestations should the nurse expect?
A) Board-like abdomen with severe pain radiating to the right shoulder
B) Epigastric pain relieved by food intake
C) Intermittent cramping and diarrhea
D) Nausea and vomiting without abdominal tenderness
Expert Rationale: Perforation of a peptic ulcer is a surgical emergency. It presents with a
board-like (rigid) abdomen and severe pain in the abdomen or back that radiates to the
right shoulder due to diaphragmatic irritation. Vomiting of blood and shock can occur if
hemorrhage is present. Pain relieved by food is typical of duodenal ulcers without
perforation.
, Question
A nurse is caring for a client who has acute pancreatitis. Which of the following serum
laboratory values should the nurse anticipate returning to the expected reference range
within 72 hours after treatment begins?
A) Serum lipase
B) Serum amylase
C) Serum calcium
D) Serum glucose
Expert Rationale: Serum amylase begins to increase about 3 to 6 hours following the onset
of acute pancreatitis, peaks in 20 to 30 hours, and returns to the expected reference range
within 2 to 3 days (72 hours). Serum lipase remains elevated longer and is more specific to
pancreatic injury. Serum calcium may decrease due to saponification; glucose may be
elevated due to impaired insulin release.
Question
A community health nurse is planning an educational program about hepatitis A. When
preparing the materials, the nurse should identify that which of the following groups is
most at risk for developing hepatitis A?
A) Elderly adults in long-term care facilities
B) Children and young adults
C) Healthcare workers in intensive care units
D) Immunocompromised individuals
Expert Rationale: Hepatitis A virus is transmitted via the fecal-oral route, often through
contaminated food, water, or close personal contact. Children and young adults are the
two groups most often affected, typically acquiring the infection at school or through poor
hygiene and hand-to-mouth contact. The virus is also common in daycare settings and
among international travelers. Healthcare workers are at higher risk for hepatitis B and C.
Question
A nurse is teaching a client who has Barrett's esophagus and is scheduled to undergo an
EGD. Which of the following statements should the nurse include in the teaching?
A) "The procedure will assess your gallbladder function."
B) "It is useful in determining the function of the esophageal lining and the extent of
inflammation, potential scarring, and strictures."
NEWEST 2026 | ATI MEDICAL SURGICAL
GASTROINTESTINAL TEST BANK | 200+
REAL EXAM Q&A + DETAILED
RATIONALES | NG TUBE ,GERD ,
IBD,LIVER | A+ BUNDLE 2026
Question
A nurse is preparing a community education program about Hepatitis B. Which of the
following statements should the nurse include in the teaching?
A) Hepatitis B immune globulin is given as part of the standard childhood immunizations.
B) It can be administered as early as birth, especially in infants born to hepatitis B surface
antigen (HBsAg) negative mothers.
C) Infants should receive the second dose between 1 and 4 months of age.
D) All of the above are correct statements.
Expert Rationale: Hepatitis B immune globulin (HBIG) and the hepatitis B vaccine are part
of standard childhood immunizations. The vaccine can be given at birth, particularly for
infants born to HBsAg-negative mothers. The second dose is typically administered
between 1 and 4 months of age. All statements are accurate and should be included in
client teaching. The nurse must emphasize the importance of completing the full
vaccination series for optimal protection against hepatitis B.
Question
A nurse is assessing a client who was admitted with a bowel obstruction. The client reports
severe abdominal pain. Which of the following findings should indicate to the nurse that a
possible bowel perforation has occurred?
A) Abdominal tenderness and rigidity with hypotension
B) Hyperactive bowel sounds and mild distension
,C) Nausea and vomiting with normal vital signs
D) Intermittent cramping pain and flatus
Expert Rationale: Bowel perforation is a life-threatening emergency. Abdominal
tenderness and rigidity (board-like abdomen) indicate peritoneal irritation. As fluid escapes
into the peritoneal cavity, there is a reduction in circulating blood volume leading to
hypotension. Hyperactive bowel sounds and mild distension are more consistent with early
obstruction. Perforation requires immediate surgical intervention and aggressive fluid
resuscitation.
Question
A nurse is caring for a client who is scheduled to undergo an
esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is used
to do which of the following?
A) Visualize the esophagus, stomach, and duodenum to detect tumors, ulcerations, or
obstructions
B) Assess gallbladder function and biliary duct patency
C) Evaluate colonic mucosa for polyps and malignancies
D) Measure gastric acid secretion and pH levels
Expert Rationale: An EGD uses a lighted flexible endoscope to directly visualize the
esophagus, stomach, and duodenum. It is a diagnostic tool used to detect tumors,
ulcerations, strictures, and other abnormalities. It also allows for tissue biopsy and
therapeutic interventions such as banding of varices. It does not evaluate the gallbladder,
colon, or measure gastric acid secretion.
Question
A nurse is caring for a client who is receiving total parenteral nutrition (TPN) therapy and
has just returned to the room following physical therapy. The nurse notes that the infusion
pump for the client's TPN is turned off. After restarting the infusion pump, the nurse should
monitor the client for which of the following findings?
A) Hyperglycemia and polyuria
B) Hypoglycemia with diaphoresis, weakness, and anxiety
C) Fluid overload with crackles and edema
D) Electrolyte imbalance with muscle cramping
,Expert Rationale: TPN solutions are highly concentrated in dextrose. Sudden withdrawal of
TPN can cause rebound hypoglycemia because the pancreas continues to produce insulin
in response to the high glucose load. Manifestations include diaphoresis, weakness,
anxiety, confusion, and hunger. The nurse should monitor blood glucose closely and restart
the infusion gradually. Hyperglycemia occurs with rapid infusion, not sudden withdrawal.
Question
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following
manifestations should the nurse expect?
A) Jaundice and dark urine
B) Severe anorexia and malaise
C) Right upper quadrant pain and hepatomegaly
D) Clay-colored stools and pruritus
Expert Rationale: Anorexia is an early manifestation of hepatitis A and is often severe,
thought to result from the release of a toxin by the damaged liver or failure of damaged liver
cells to detoxify an abnormal product. Jaundice, dark urine, clay-colored stools, and
pruritus are typically later manifestations associated with cholestasis. Early symptoms
also include malaise, nausea, and low-grade fever.
Question
A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the
following manifestations should the nurse expect?
A) Board-like abdomen with severe pain radiating to the right shoulder
B) Epigastric pain relieved by food intake
C) Intermittent cramping and diarrhea
D) Nausea and vomiting without abdominal tenderness
Expert Rationale: Perforation of a peptic ulcer is a surgical emergency. It presents with a
board-like (rigid) abdomen and severe pain in the abdomen or back that radiates to the
right shoulder due to diaphragmatic irritation. Vomiting of blood and shock can occur if
hemorrhage is present. Pain relieved by food is typical of duodenal ulcers without
perforation.
, Question
A nurse is caring for a client who has acute pancreatitis. Which of the following serum
laboratory values should the nurse anticipate returning to the expected reference range
within 72 hours after treatment begins?
A) Serum lipase
B) Serum amylase
C) Serum calcium
D) Serum glucose
Expert Rationale: Serum amylase begins to increase about 3 to 6 hours following the onset
of acute pancreatitis, peaks in 20 to 30 hours, and returns to the expected reference range
within 2 to 3 days (72 hours). Serum lipase remains elevated longer and is more specific to
pancreatic injury. Serum calcium may decrease due to saponification; glucose may be
elevated due to impaired insulin release.
Question
A community health nurse is planning an educational program about hepatitis A. When
preparing the materials, the nurse should identify that which of the following groups is
most at risk for developing hepatitis A?
A) Elderly adults in long-term care facilities
B) Children and young adults
C) Healthcare workers in intensive care units
D) Immunocompromised individuals
Expert Rationale: Hepatitis A virus is transmitted via the fecal-oral route, often through
contaminated food, water, or close personal contact. Children and young adults are the
two groups most often affected, typically acquiring the infection at school or through poor
hygiene and hand-to-mouth contact. The virus is also common in daycare settings and
among international travelers. Healthcare workers are at higher risk for hepatitis B and C.
Question
A nurse is teaching a client who has Barrett's esophagus and is scheduled to undergo an
EGD. Which of the following statements should the nurse include in the teaching?
A) "The procedure will assess your gallbladder function."
B) "It is useful in determining the function of the esophageal lining and the extent of
inflammation, potential scarring, and strictures."
