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Med Surg Gastrointestinal NCLEX
2026/2027 exams. Complete Practice Test
with 100% Verified Answers and rationales
already graded A+, Exams of Nursing.
After undergoing Billroth I gastric surgery, the client experiences fatigue and complains of
numbness and tingling in the feet and difficulties with balance. On the basis of these symptoms,
the nurse suspects which postoperative complication?
A. Stroke
B. Pernicious anemia
C. Bacterial meningitis
D. Peripheral arterial disease - answer..,B. Pernicious anemia
Rationale:
Billroth I surgery involves removing one half to two thirds of the stomach and reanastomosing
the remaining segment of the stomach to the duodenum. With the loss of this much of the
stomach, development of pernicious anemia is not uncommon. Pernicious anemia is a macrocytic
anemia that most commonly is caused by the lack of intrinsic factor. During a Billroth I
procedure, a large portion of the parietal cells, which are responsible for producing intrinsic
factor (a necessary component for vitamin B12 absorption), are removed. In this anemia, the red
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blood cell is larger than usual and hence does not last as long in the circulation as normal red
blood cells do, causing the client to have anemia with resultant fatigue. Vitamin B12 also is
necessary for normal nerve function. Because of the lack of the necessary intrinsic factor,
persons with pernicious anemia also experience paresthesias, impaired gait, and impaired
balance. Although the symptoms could possibly indicate the other options listed, pernicious
anemia is the most logical based on the surgery the client underwent.
A client experiencing chronic dumping syndrome makes the following comments to the nurse.
Which one indicates the need for further teaching?
A. "I eat at least 3 large meals each day."
B. "I eat while lying in a semirecumbent position."
C. "I have eliminated taking liquids with my meals."
D. "I eat a high-protein, low- to moderate-carbohydrate diet." - answer..,A. "I eat at least 3 large
meals each day."
Rationale:
Dumping syndrome describes a group of symptoms that occur after eating. It is believed to result
from rapid dumping of gastric contents into the small intestine, which causes fluid to shift into
the intestine. Signs and symptoms of dumping syndrome include diarrhea, abdominal distention,
sweating, pallor, palpitations, and syncope. To manage this syndrome, clients are encouraged to
decrease the amount of food taken at each sitting, eat in a semirecumbent position, eliminate
ingesting fluids with meals, and avoid consumption of high-carbohydrate meals.
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The nurse obtains an admission history for a client with suspected peptic ulcer disease (PUD).
Which client factor documented by the nurse would increase the risk for PUD?
A. Recently retired from a job
B. Significant other has a gastric ulcer
C. Occasionally drinks 1 cup of coffee in the morning
D. Takes nonsteroidal antiinflammatory drugs (NSAIDs) for osteoarthritis - answer..,D. Takes
nonsteroidal antiinflammatory drugs (NSAIDs) for osteoarthritis
Rationale:
Risk factors for PUD include Helicobacter pylori infection, smoking (nicotine), chewing
tobacco, corticosteroids, aspirin, NSAIDs, caffeine, alcohol, and stress. When an NSAID is taken
as often as is typical for osteoarthritis, it will cause problems with the stomach. Certain medical
conditions such as Crohn's disease, Zollinger-Ellison syndrome, and hepatic and biliary disease
also can increase the risk for PUD by changing the amount of gastric and biliary acids produced.
Recent retirement should decrease stress levels rather than increase them. Ulcer disease in a first-
degree relative also is associated with increased risk for an ulcer. A significant other is not a
first-degree relative; therefore, no genetic connection is noted in this relationship. Although
caffeinated drinks are a known risk factor for PUD, the option states that the client drinks 1 cup
of coffee occasionally.
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A client who has undergone gastric surgery has a nasogastric (NG) tube connected to low
intermittent suction that is not draining properly. Which action should the nurse take initially?
A. Call the surgeon to report the problem.
B. Reposition the NG tube to the proper location.
C. Check the suction device to make sure it is working.
D. Irrigate the NG tube with saline to remove the obstruction. - answer..,C. Check the suction
device to make sure it is working.
Rationale:
After gastric surgery, the client will have an NG tube in place until bowel function returns. It is
important for the NG tube to drain properly to prevent abdominal distention and vomiting. The
nurse must ensure that the NG tube is attached to suction at the level prescribed and that the
suction device is working correctly. The tip of the NG tube may be placed near the suture line.
Because of this possibility, the nurse should never reposition the NG tube or irrigate it. If the NG
tube needs to be repositioned, the nurse should call the surgeon, who would do this repositioning
under fluoroscopy.
The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is
consistent with this diagnosis?
A. Hypercalcemia
B. Hypernatremia
Med Surg Gastrointestinal NCLEX
2026/2027 exams. Complete Practice Test
with 100% Verified Answers and rationales
already graded A+, Exams of Nursing.
After undergoing Billroth I gastric surgery, the client experiences fatigue and complains of
numbness and tingling in the feet and difficulties with balance. On the basis of these symptoms,
the nurse suspects which postoperative complication?
A. Stroke
B. Pernicious anemia
C. Bacterial meningitis
D. Peripheral arterial disease - answer..,B. Pernicious anemia
Rationale:
Billroth I surgery involves removing one half to two thirds of the stomach and reanastomosing
the remaining segment of the stomach to the duodenum. With the loss of this much of the
stomach, development of pernicious anemia is not uncommon. Pernicious anemia is a macrocytic
anemia that most commonly is caused by the lack of intrinsic factor. During a Billroth I
procedure, a large portion of the parietal cells, which are responsible for producing intrinsic
factor (a necessary component for vitamin B12 absorption), are removed. In this anemia, the red
,2|Page
blood cell is larger than usual and hence does not last as long in the circulation as normal red
blood cells do, causing the client to have anemia with resultant fatigue. Vitamin B12 also is
necessary for normal nerve function. Because of the lack of the necessary intrinsic factor,
persons with pernicious anemia also experience paresthesias, impaired gait, and impaired
balance. Although the symptoms could possibly indicate the other options listed, pernicious
anemia is the most logical based on the surgery the client underwent.
A client experiencing chronic dumping syndrome makes the following comments to the nurse.
Which one indicates the need for further teaching?
A. "I eat at least 3 large meals each day."
B. "I eat while lying in a semirecumbent position."
C. "I have eliminated taking liquids with my meals."
D. "I eat a high-protein, low- to moderate-carbohydrate diet." - answer..,A. "I eat at least 3 large
meals each day."
Rationale:
Dumping syndrome describes a group of symptoms that occur after eating. It is believed to result
from rapid dumping of gastric contents into the small intestine, which causes fluid to shift into
the intestine. Signs and symptoms of dumping syndrome include diarrhea, abdominal distention,
sweating, pallor, palpitations, and syncope. To manage this syndrome, clients are encouraged to
decrease the amount of food taken at each sitting, eat in a semirecumbent position, eliminate
ingesting fluids with meals, and avoid consumption of high-carbohydrate meals.
,3|Page
The nurse obtains an admission history for a client with suspected peptic ulcer disease (PUD).
Which client factor documented by the nurse would increase the risk for PUD?
A. Recently retired from a job
B. Significant other has a gastric ulcer
C. Occasionally drinks 1 cup of coffee in the morning
D. Takes nonsteroidal antiinflammatory drugs (NSAIDs) for osteoarthritis - answer..,D. Takes
nonsteroidal antiinflammatory drugs (NSAIDs) for osteoarthritis
Rationale:
Risk factors for PUD include Helicobacter pylori infection, smoking (nicotine), chewing
tobacco, corticosteroids, aspirin, NSAIDs, caffeine, alcohol, and stress. When an NSAID is taken
as often as is typical for osteoarthritis, it will cause problems with the stomach. Certain medical
conditions such as Crohn's disease, Zollinger-Ellison syndrome, and hepatic and biliary disease
also can increase the risk for PUD by changing the amount of gastric and biliary acids produced.
Recent retirement should decrease stress levels rather than increase them. Ulcer disease in a first-
degree relative also is associated with increased risk for an ulcer. A significant other is not a
first-degree relative; therefore, no genetic connection is noted in this relationship. Although
caffeinated drinks are a known risk factor for PUD, the option states that the client drinks 1 cup
of coffee occasionally.
, 4|Page
A client who has undergone gastric surgery has a nasogastric (NG) tube connected to low
intermittent suction that is not draining properly. Which action should the nurse take initially?
A. Call the surgeon to report the problem.
B. Reposition the NG tube to the proper location.
C. Check the suction device to make sure it is working.
D. Irrigate the NG tube with saline to remove the obstruction. - answer..,C. Check the suction
device to make sure it is working.
Rationale:
After gastric surgery, the client will have an NG tube in place until bowel function returns. It is
important for the NG tube to drain properly to prevent abdominal distention and vomiting. The
nurse must ensure that the NG tube is attached to suction at the level prescribed and that the
suction device is working correctly. The tip of the NG tube may be placed near the suture line.
Because of this possibility, the nurse should never reposition the NG tube or irrigate it. If the NG
tube needs to be repositioned, the nurse should call the surgeon, who would do this repositioning
under fluoroscopy.
The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is
consistent with this diagnosis?
A. Hypercalcemia
B. Hypernatremia
