gastrointestinal nclex questions

Gastrointestinal disorders encompass a variety of diseases ranging from mild to severe. These conditions involve the digestive tract or the gastrointestinal (GI) tract. The GI tract includes the esophagus, liver, stomach, small and large intestines, gallbladder, and pancreas.

Read and analyze each question carefully and chose the best answer/s from the choices provided. At the end of these practice tests, correct answers along with the explanation are given.

Gastrointestinal Disorder NCLEX-RN Practice Questions

1. A postoperative client with pelvic access drainage had a rupture of the postoperative wound after a bout of violent coughing. A small segment of the bowel is protruding. Which actions are the nurse’s priority?

A. Ask a nursing assistant to hold the wound together; take the client’s vital signs and call the healthcare provider.
B. Call the healthcare provider while remaining with the client, flex the knees and cover the wound with sterile gauze soaked in sterile saline.
C. Assess the client’s vital signs, call the healthcare provider, and take emergency orders.
D. Ask the client about the precipitating events, then call the healthcare provider and cover the wound with a saline-soaked bed cover.

2. The nurse is caring for a client with a T-tube after gallbladder surgery. Which home care instructions will the nurse provide?

A. “Notify the surgeon immediately if the drainage continues.”
B. “The drainage is greenish in color at first, then turns dark yellow.”
C. “The drainage amount will decrease daily until the bile duct heals.”
D. “Milk the tube toward the wound when the drainage stops.”

3. The nurse assesses a client diagnosed with a retractable gastric peptic ulcer and has undergone gastric vagotomy. Which factor does the nurse identify as increasing due to vagotomy?

A. Gastric motility
B. Gastric acidity
C. Peristalsis
D. Gastric pH

4. A client who underwent partial gastrectomy has a nasogastric tube connected to low continuous suction. Which color of the gastric secretions does the nurse expect during the immediate postoperative period?

A. Clear
B. Brown
C. Red
D. Yellow

5. The nurse is caring for a client receiving continuous enteral feedings via a Salem pump tube with an average of 30 to 40 mL of gastric residual volume (GRV) every four hours. After the next four hours, the nurse checks the GRV and notes an amount of 220 mL. Which action is a priority?

A. Discard the 220 mL and clamp the NG tube.
B. Stop the feeding and clamp the NG tube.
C. Inform the healthcare provider urgently.
D. Administer metoclopramide as prescribed.

6. The nurse is caring for a client diagnosed with severe exacerbation of ulcerative colitis. Which medication will the nurse administer to induct remission?

A. Corticosteroids
B. Antacids
C. Histamine-2 receptor blockers
D. Antibiotics

7. A client diagnosed with ulcerative colitis reports severe abdominal pain intensified by movement. Upon assessment, the nurse notes that the client has fever, rebound tenderness, and decreased urine output. Which complication of ulcerative colitis is the client experiencing?

A. Bowel obstruction
B. Fistula
C. Abscess
D. Bowel perforation

8. A client was rushed into the Emergency Department due to an acute upper GI hemorrhage. Which action by the nurse is correct?

A. Manage the client’s hypervolemia.
B. Control the source of bleeding.
C. Perform interventions for hypovolemia.
D. Diagnose the source of bleeding.

9. The nurse is caring for a client who underwent an endoscopic examination. The results show that there is a cobblestone appearance on the colon. This finding indicates which disorder?

A. Crohn disease
B. Ulcerative colitis
C. Chronic gastritis
D. Peptic ulcer disease

10. The nurse is caring for a client diagnosed with hepatic encephalopathy. After receiving the client’s laboratory test results, which levels would the nurse anticipate as increased?

A. Potassium
B. Ammonia
C. Amylase
D. Calcium

11. The nurse is caring for a client diagnosed with pancreatic cancer. Which action by the nurse is most important regarding laboratory testing?

A. Monitoring for creatinine phosphokinase (CPK)
B. Monitoring for serum glucose
C. Monitoring for carcinoembryonic antigen (CEA)
D. Monitoring for radioimmunoassay (RIA)

12. A client with a lacerated liver due to blunt abdominal trauma is admitted to the medical-surgical unit. Which action by the nurse should not be implemented?

A. Monitor for coagulation studies.
B. Administer crystalloids as indicated.
C. Monitor for respiratory distress.
D. Administer NSAIDs as prescribed.

13. The nurse provides discharge instructions to a client diagnosed with hepatitis B. Which client statement shows an understanding of health teaching?

A. “I will be able to donate blood safely after three months.”
B. “My liver has already healed enough for me to drink alcohol again.”
C. “I might be getting sick again when I start vomiting and easily tires.”
D. “My body has now developed immunity from hepatitis B.”

14. A client scheduled for proctoscopy is prescribed 5 mg of IV diazepam. Which action by the nurse is correct when administering this drug?

A. Clarify the order with the healthcare provider.
B. Infuse IV diazepam rapidly to avoid dilution.
C. Mix IV diazepam with dextrose 5% in water.
D. Administer IV diazepam to the IV port proximal to the vein.

15. The nurse is caring for a client who underwent abdominal surgery. The client reports a popping sensation in the incision after a coughing episode. The nurse anticipates an evisceration. Which supplies will the nurse prepare initially?

A. Sterile saline solution and sterile gauze
B. A suture kit
C. Sterile water and a suture kit
D. Sterile water and sterile dressings

16. The nurse is caring for a client diagnosed with upper GI bleeding. Which action by the nurse promotes hemodynamic stability in the client?

A. Monitoring central venous pressure.
B. Administration of blood and fluids.
C. Promotion of increased oral intake.
D. Monitoring laboratory test results

17. A client diagnosed with peritonitis and on NPO reports thirst. Which nursing action is a priority?

A. Provide ice chips every 15 minutes.
B. Provide frequent mouth care.
C. Increase the rate of IV infusion.
D. Promote diversional activities.

18. The nurse assesses a client’s stoma. Which output characteristics will the nurse expect from an ileostomy?

A. Liquid to semiliquid output and frequent gas emission
B. Pasty to formed consistency of the output
C. Liquid to pasty consistency of the output
D. Malodorous, enzyme-rich, yellowish or brownish liquid output

19. The nurse is caring for clients in the medical-surgical unit. Which of these clients have risk factors for colon cancer that may participate in a colorectal cancer screening program?

A. A middle-aged male who has a paternal history of colon cancer
B. An older adult male with a low-fat, high-fiber diet
C. An older adult female with a history of breast cancer
D. A middle-aged female with a history of ulcerative colitis

20. The nurse is caring for a client diagnosed with peptic ulcer disease due to excessive NSAID intake. Which drug will the nurse anticipate to be prescribed?

A. famotidine
B. misoprostol
C. sucralfate
D. calcium carbonate

21. The nurse is caring for a client with a history of peptic ulcer. During the assessment, the client vomited coffee-ground emesis. Which indication does this assessment finding suggest?

A. The client needs a transfusion of packed RBCs.
B. The client has fresh, active upper GI bleeding.
C. The client needs an immediate gastric lavage.
D. The client’s bleeding occurred two hours earlier.

22. The nurse provides discharge health teaching to a client diagnosed with acute liver failure. Which client statement indicates an understanding of the teaching about diet?

A. “I’ll exclude meat and beans from my diet.”
B. “Cake or pastries should be included in every meal.”
C. “I can keep eating more of my favorite pasta dishes.”
D. “Butter and gravy are my favorite; now I get to eat more.”

23. A client who will undergo colorectal surgery reports anxiousness to the nurse. Which nursing action will be done initially for the anxious client?

A. Provide pictures of successful colostomies.
B. Arrange for a visit of someone with a colostomy.
C. Assess the client’s knowledge of the procedure.
D. Provide written materials about colostomy care.

24. The nurse notes that a client has been eliminating dark, tarry stools. In which location of the GI tract is the bleeding happening according to these characteristics?

A. Lower GI tract
B. Small intestines
C. Upper colon
D. Upper GI tract

25. The nurse is caring for a client diagnosed with stomach cancer. Which information about stomach cancer will the nurse provide the client?

A. “Abdominal surgery is often a successful treatment.”
B. “Abdominal pain is usually a late symptom of the disease.”
C. “Both chemotherapy and radiation can be successful.”
D. “Total parenteral nutrition will help you live longer.”

26. The nurse is caring for a client who underwent abdominal surgery but had delayed wound healing. As a result, the client has an open surgical wound. Which action by the nurse during wound irrigation is correct?

A. Moisten the wound area with normal saline after irrigation.
B. Irrigate the wound with normal saline solution rapidly.
C. Irrigate continuously until the solution is clear.
D. Apply a dry dressing on the wound after irrigation.

27. The nurse provides health teaching to a client with a colostomy. Which statement about a healthy stoma is correct?

A. “The stoma remains swelling away from the abdomen.”
B. “A burning sensation under the stoma plate is normal.”
C. “The stoma must appear dark or bluish in color.”
D. “The stoma may bleed at first when slightly touched.”

28. The nurse is caring for a client diagnosed with hepatitis B. The client asks about the duration of her recovery. Which response by the nurse is incorrect?

A. “Don’t worry about the future; just focus on your recovery now.”
B. “I have some sources about financial counseling to help you.”
C. “I’m here if you want to talk about what you are feeling right now.”
D. “I can provide you with information about future complications.”

29. A client who underwent cholecystectomy states to the nurse, “I don’t want to feel pain, so I’ll stay on the least painful side as much as possible.” Which response by the nurse is best?

A. “It’s a good idea to have a long rest after surgery.”
B. “You will need to lie flat as ordered by the surgeon.”
C. “We can decide on that when your return from the recovery room.”
D. “I will be assisting you in turning from side to side every two hours.”

30. A client is admitted to the medical-surgical unit due to a suspected diagnosis of hepatitis B. during the assessment, the nurse notes that the client has jaundice and reports weakness. Which action by the nurse must be included in the care plan?

A. Allow the client to choose every meal.
B. Promote rest after small, frequent meals.
C. Encourage the client to exercise regularly.
D. Include foods low in protein in the diet.

Answers and Rationale

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Marianne Belleza has been a registered nurse for seven years and has worked as an outpatient department and emergency department nurse in the Philippines for over three years. Her career as a nurse writer began nearly eight years ago. Since then, she has worked on feature stories and nursing care plans. She began creating NCLEX review questions more than a year ago and is now working on Next-Generation NCLEX. She also passed the B2 Telc Exam for Nurses and hopes to work as a nurse in Germany later this year.

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