NCLEX GI 2 – Converted Study Guide with Questions & Answers |
Gastrointestinal Nursing Exam Prep 2026 | Various Authors
NCLEX GI System Study Guide
This guide covers high-yield topics related to the Gastrointestinal
system, focusing on pathophysiology, nursing interventions, and
complications you are likely to see on the NCLEX.
1. Upper GI Disorders
• Gastroesophageal Reflux Disease (GERD)
o Pathophysiology: Backflow of gastric or duodenal contents
into the esophagus due to a weakened or relaxed lower
esophageal sphincter (LES).
o Signs & Symptoms: Pyrosis (heartburn), regurgitation,
dysphagia, hypersalivation, chest pain.
o Nursing Management:
▪ Diet: Avoid foods that decrease LES pressure (fatty
foods, chocolate, caffeine, peppermint, alcohol).
▪ Lifestyle: Elevate head of bed (HOB) on 6-8 inch blocks;
avoid lying down for 2-3 hours after meals; maintain
healthy weight; avoid tight-fitting clothing.
, ▪ Medications: Antacids, Histamine-2 (H2) blockers (e.g.,
Famotidine), Proton Pump Inhibitors (PPIs) (e.g.,
Omeprazole).
• Hiatal Hernia
o Pathophysiology: Protrusion of the stomach through the
esophageal hiatus of the diaphragm.
o Two types: Sliding (most common) and Paraesophageal
(more dangerous, risk for strangulation).
o Signs & Symptoms: Often similar to GERD (heartburn,
regurgitation). May experience dysphagia and epigastric
pain.
o Nursing Management: Same as GERD. Post-operative care
(if surgical repair via Nissen fundoplication) includes
managing NG tube (never irrigate or reposition without a
doctor's order).
2. Gastric Disorders
• Peptic Ulcer Disease (PUD)
o Pathophysiology: Erosion of the mucosal lining of the
stomach or duodenum.
o Causes: H. pylori infection (most common) and long-term
use of NSAIDs.
o Signs & Symptoms:
▪ Gastric Ulcer: Pain 30-60 minutes after a meal (eating -
> pain). May experience nausea and vomiting.
▪ Duodenal Ulcer: Pain 2-3 hours after a meal (empty
stomach) and at night (pain -> eating relieves pain).
, o Complications (KEY for NCLEX):
1. Hemorrhage: Hematemesis (coffee-ground emesis),
melena (tarry stools), hypotension, tachycardia.
2. Perforation: Sudden, severe, sharp upper abdominal
pain that radiates to the back (often the right
shoulder). Abdomen becomes rigid and board-like. This
is a surgical emergency.
3. Gastric Outlet Obstruction: N/V, distention, anorexia.
o Nursing Management: Monitor for complications.
Administer medications (PPIs, H2 blockers, antibiotics for H.
pylori). Teach patient to avoid NSAIDs and alcohol.
3. Intestinal Disorders
• Inflammatory Bowel Disease (IBD)
o Ulcerative Colitis (UC): Continuous inflammation of the
mucosal layer of the colon and rectum. Starts at rectum and
moves proximally.
▪ S&S: Bloody diarrhea (often severe), abdominal pain,
urgency, tenesmus.
o Crohn's Disease: Skip lesions (patchy areas) transmural
inflammation (entire wall) affecting any part of the GI tract
from mouth to anus, most commonly the terminal ileum.
▪ S&S: Non-bloody diarrhea, right lower quadrant pain,
weight loss, fistulas, abscesses.
o Nursing Management: Focus on nutrition (high-protein,
high-calorie, low-residue), fluid/electrolyte balance, skin
Gastrointestinal Nursing Exam Prep 2026 | Various Authors
NCLEX GI System Study Guide
This guide covers high-yield topics related to the Gastrointestinal
system, focusing on pathophysiology, nursing interventions, and
complications you are likely to see on the NCLEX.
1. Upper GI Disorders
• Gastroesophageal Reflux Disease (GERD)
o Pathophysiology: Backflow of gastric or duodenal contents
into the esophagus due to a weakened or relaxed lower
esophageal sphincter (LES).
o Signs & Symptoms: Pyrosis (heartburn), regurgitation,
dysphagia, hypersalivation, chest pain.
o Nursing Management:
▪ Diet: Avoid foods that decrease LES pressure (fatty
foods, chocolate, caffeine, peppermint, alcohol).
▪ Lifestyle: Elevate head of bed (HOB) on 6-8 inch blocks;
avoid lying down for 2-3 hours after meals; maintain
healthy weight; avoid tight-fitting clothing.
, ▪ Medications: Antacids, Histamine-2 (H2) blockers (e.g.,
Famotidine), Proton Pump Inhibitors (PPIs) (e.g.,
Omeprazole).
• Hiatal Hernia
o Pathophysiology: Protrusion of the stomach through the
esophageal hiatus of the diaphragm.
o Two types: Sliding (most common) and Paraesophageal
(more dangerous, risk for strangulation).
o Signs & Symptoms: Often similar to GERD (heartburn,
regurgitation). May experience dysphagia and epigastric
pain.
o Nursing Management: Same as GERD. Post-operative care
(if surgical repair via Nissen fundoplication) includes
managing NG tube (never irrigate or reposition without a
doctor's order).
2. Gastric Disorders
• Peptic Ulcer Disease (PUD)
o Pathophysiology: Erosion of the mucosal lining of the
stomach or duodenum.
o Causes: H. pylori infection (most common) and long-term
use of NSAIDs.
o Signs & Symptoms:
▪ Gastric Ulcer: Pain 30-60 minutes after a meal (eating -
> pain). May experience nausea and vomiting.
▪ Duodenal Ulcer: Pain 2-3 hours after a meal (empty
stomach) and at night (pain -> eating relieves pain).
, o Complications (KEY for NCLEX):
1. Hemorrhage: Hematemesis (coffee-ground emesis),
melena (tarry stools), hypotension, tachycardia.
2. Perforation: Sudden, severe, sharp upper abdominal
pain that radiates to the back (often the right
shoulder). Abdomen becomes rigid and board-like. This
is a surgical emergency.
3. Gastric Outlet Obstruction: N/V, distention, anorexia.
o Nursing Management: Monitor for complications.
Administer medications (PPIs, H2 blockers, antibiotics for H.
pylori). Teach patient to avoid NSAIDs and alcohol.
3. Intestinal Disorders
• Inflammatory Bowel Disease (IBD)
o Ulcerative Colitis (UC): Continuous inflammation of the
mucosal layer of the colon and rectum. Starts at rectum and
moves proximally.
▪ S&S: Bloody diarrhea (often severe), abdominal pain,
urgency, tenesmus.
o Crohn's Disease: Skip lesions (patchy areas) transmural
inflammation (entire wall) affecting any part of the GI tract
from mouth to anus, most commonly the terminal ileum.
▪ S&S: Non-bloody diarrhea, right lower quadrant pain,
weight loss, fistulas, abscesses.
o Nursing Management: Focus on nutrition (high-protein,
high-calorie, low-residue), fluid/electrolyte balance, skin
