1
ATI Med Surge GI Exam 2026/2027 Actual Exam
| 100+ Questions and Correct Answers with
Detailed Rationales | Gastrointestinal | Graded
A+ | Pass Guaranteed
Section 1: Upper Gastrointestinal Disorders
Q1: A patient with a new colostomy is being discharged home. Which of the following
statements by the patient indicates understanding of stoma care?
A. "I should expect the stoma to be pale and dry."
B. "I will change the appliance daily to prevent infection."
C. "I should notify my provider if the stoma becomes purplish or black." [CORRECT]
D. "I can use hydrogen peroxide to clean around the stoma."
Correct Answer: C
Rationale: A healthy stoma should be red and moist. Color changes to purple or black indicate
ischemia and necrosis, requiring immediate provider notification. Option A is incorrect—a pale,
dry stoma indicates poor perfusion. Option B is incorrect—appliance changes every 3-7 days are
typical; daily changes can irritate skin. Option D is incorrect—hydrogen peroxide is too harsh;
mild soap and water should be used.
Q2: A nurse is caring for a patient with a suspected perforated duodenal ulcer. Which of the
following assessment findings should the nurse expect?
A. Projectile vomiting
B. Rigid, board-like abdomen [CORRECT]
C. Bright red blood in the stool
D. Increased bowel sounds
Correct Answer: B
,2
Rationale: A perforated ulcer leads to peritonitis, causing a rigid, board-like abdomen and severe
pain. Option C (melena) occurs with bleeding but not necessarily perforation. Option D is
incorrect; bowel sounds would be absent or diminished due to ileus.
Q3: A nurse is teaching a patient with gastroesophageal reflux disease (GERD) about dietary
modifications. Which of the following foods should the nurse instruct the patient to avoid?
(Select all that apply.)
A. [ ] Chocolate
B. [ ] Baked chicken
C. [ ] Peppermint
D. [ ] Decaffeinated tea
E. [ ] Fried foods
Correct Answer: A, C, E
Rationale: Chocolate, peppermint, and fried foods relax the lower esophageal sphincter (LES),
exacerbating GERD. Baked chicken is safe. Decaffeinated tea is generally acceptable, though
citrus teas should be avoided.
Q4: A patient is admitted with upper gastrointestinal bleeding. Which of the following is the
priority nursing action?
A. Assessing the abdomen
B. Inserting a nasogastric tube
C. Initiating IV access [CORRECT]
D. Administering oxygen
Correct Answer: C
Rationale: The priority is to ensure hemodynamic stability by establishing IV access for fluid
resuscitation. While oxygen (D) may be needed, IV access is critical for treating hypovolemic
shock.
,3
Q5: A nurse is caring for a patient with a hiatal hernia. Which of the following instructions
should be included in the discharge teaching?
A. "Lie flat for 30 minutes after meals."
B. "Eat three large meals per day."
C. "Avoid wearing tight-fitting clothing." [CORRECT]
D. "Drink fluids with meals to aid digestion."
Correct Answer: C
Rationale: Tight clothing increases intra-abdominal pressure, worsening the hernia. Patients
should remain upright after meals (A), eat small frequent meals (B), and avoid drinking large
amounts with meals (D).
Q6: A patient with peptic ulcer disease (PUD) is prescribed sucralfate. The nurse should instruct
the patient to take this medication:
A. With meals
B. 1 hour before meals [CORRECT]
C. Immediately after meals
D. At bedtime only
Correct Answer: B
Rationale: Sucralfate works by forming a protective barrier over the ulcer. It requires an acidic
environment and should be taken on an empty stomach, 1 hour before meals.
Q7: A patient is diagnosed with Helicobacter pylori infection. Which combination of medications
will the nurse expect to be prescribed?
A. Omeprazole and sucralfate
B. Amoxicillin, clarithromycin, and omeprazole [CORRECT]
C. Metronidazole and cimetidine
D. Pantoprazole and misoprostol
, 4
Correct Answer: B
Rationale: Treatment for H. pylori typically involves "triple therapy": two antibiotics
(amoxicillin, clarithromycin, or metronidazole) and a proton pump inhibitor (PPI).
Q8: A patient with a nasogastric (NG) tube connected to low intermittent suction develops
metabolic alkalosis. The nurse expects to see which serum electrolyte value?
A. Potassium 3.0 mEq/L [CORRECT]
B. Sodium 150 mEq/L
C. Chloride 110 mEq/L
D. Calcium 8.5 mg/dL
Correct Answer: A
Rationale: Metabolic alkalosis caused by NG suction results in loss of hydrogen ions and
potassium. Hypokalemia is a common associated finding.
Q9: A nurse is assessing a patient with esophageal varices. Which of the following is the most
important assessment?
A. Monitoring for signs of bleeding [CORRECT]
B. Assessing for dysphagia
C. Monitoring serum albumin
D. Assessing for heartburn
Correct Answer: A
Rationale: Esophageal varices are dilated veins prone to rupture, causing life-threatening
hemorrhage. Monitoring for bleeding is the priority.
Q10: A patient with an acute upper GI bleed has a hemoglobin of 7 g/dL. The nurse anticipates
an order for:
ATI Med Surge GI Exam 2026/2027 Actual Exam
| 100+ Questions and Correct Answers with
Detailed Rationales | Gastrointestinal | Graded
A+ | Pass Guaranteed
Section 1: Upper Gastrointestinal Disorders
Q1: A patient with a new colostomy is being discharged home. Which of the following
statements by the patient indicates understanding of stoma care?
A. "I should expect the stoma to be pale and dry."
B. "I will change the appliance daily to prevent infection."
C. "I should notify my provider if the stoma becomes purplish or black." [CORRECT]
D. "I can use hydrogen peroxide to clean around the stoma."
Correct Answer: C
Rationale: A healthy stoma should be red and moist. Color changes to purple or black indicate
ischemia and necrosis, requiring immediate provider notification. Option A is incorrect—a pale,
dry stoma indicates poor perfusion. Option B is incorrect—appliance changes every 3-7 days are
typical; daily changes can irritate skin. Option D is incorrect—hydrogen peroxide is too harsh;
mild soap and water should be used.
Q2: A nurse is caring for a patient with a suspected perforated duodenal ulcer. Which of the
following assessment findings should the nurse expect?
A. Projectile vomiting
B. Rigid, board-like abdomen [CORRECT]
C. Bright red blood in the stool
D. Increased bowel sounds
Correct Answer: B
,2
Rationale: A perforated ulcer leads to peritonitis, causing a rigid, board-like abdomen and severe
pain. Option C (melena) occurs with bleeding but not necessarily perforation. Option D is
incorrect; bowel sounds would be absent or diminished due to ileus.
Q3: A nurse is teaching a patient with gastroesophageal reflux disease (GERD) about dietary
modifications. Which of the following foods should the nurse instruct the patient to avoid?
(Select all that apply.)
A. [ ] Chocolate
B. [ ] Baked chicken
C. [ ] Peppermint
D. [ ] Decaffeinated tea
E. [ ] Fried foods
Correct Answer: A, C, E
Rationale: Chocolate, peppermint, and fried foods relax the lower esophageal sphincter (LES),
exacerbating GERD. Baked chicken is safe. Decaffeinated tea is generally acceptable, though
citrus teas should be avoided.
Q4: A patient is admitted with upper gastrointestinal bleeding. Which of the following is the
priority nursing action?
A. Assessing the abdomen
B. Inserting a nasogastric tube
C. Initiating IV access [CORRECT]
D. Administering oxygen
Correct Answer: C
Rationale: The priority is to ensure hemodynamic stability by establishing IV access for fluid
resuscitation. While oxygen (D) may be needed, IV access is critical for treating hypovolemic
shock.
,3
Q5: A nurse is caring for a patient with a hiatal hernia. Which of the following instructions
should be included in the discharge teaching?
A. "Lie flat for 30 minutes after meals."
B. "Eat three large meals per day."
C. "Avoid wearing tight-fitting clothing." [CORRECT]
D. "Drink fluids with meals to aid digestion."
Correct Answer: C
Rationale: Tight clothing increases intra-abdominal pressure, worsening the hernia. Patients
should remain upright after meals (A), eat small frequent meals (B), and avoid drinking large
amounts with meals (D).
Q6: A patient with peptic ulcer disease (PUD) is prescribed sucralfate. The nurse should instruct
the patient to take this medication:
A. With meals
B. 1 hour before meals [CORRECT]
C. Immediately after meals
D. At bedtime only
Correct Answer: B
Rationale: Sucralfate works by forming a protective barrier over the ulcer. It requires an acidic
environment and should be taken on an empty stomach, 1 hour before meals.
Q7: A patient is diagnosed with Helicobacter pylori infection. Which combination of medications
will the nurse expect to be prescribed?
A. Omeprazole and sucralfate
B. Amoxicillin, clarithromycin, and omeprazole [CORRECT]
C. Metronidazole and cimetidine
D. Pantoprazole and misoprostol
, 4
Correct Answer: B
Rationale: Treatment for H. pylori typically involves "triple therapy": two antibiotics
(amoxicillin, clarithromycin, or metronidazole) and a proton pump inhibitor (PPI).
Q8: A patient with a nasogastric (NG) tube connected to low intermittent suction develops
metabolic alkalosis. The nurse expects to see which serum electrolyte value?
A. Potassium 3.0 mEq/L [CORRECT]
B. Sodium 150 mEq/L
C. Chloride 110 mEq/L
D. Calcium 8.5 mg/dL
Correct Answer: A
Rationale: Metabolic alkalosis caused by NG suction results in loss of hydrogen ions and
potassium. Hypokalemia is a common associated finding.
Q9: A nurse is assessing a patient with esophageal varices. Which of the following is the most
important assessment?
A. Monitoring for signs of bleeding [CORRECT]
B. Assessing for dysphagia
C. Monitoring serum albumin
D. Assessing for heartburn
Correct Answer: A
Rationale: Esophageal varices are dilated veins prone to rupture, causing life-threatening
hemorrhage. Monitoring for bleeding is the priority.
Q10: A patient with an acute upper GI bleed has a hemoglobin of 7 g/dL. The nurse anticipates
an order for:
