ATI MED SURG GASTROINTESTINAL ACTUAL EXAM QUESTIONS AND
ANSWERS PRACTICE QUESTIONS WITH SOLUTIONS NEWEST | ALREADY
GRADED A+/NEWEST UPDATE!!!
Question 1
A nurse is caring for a client who has just undergone a splenectomy following a motor vehicle
crash. Which of the following client care measures has the highest priority?
A) Monitoring urinary output every hour
B) Promoting lung aeration and incentive spirometry
C) Assessing the surgical site for drainage
D) Administering prescribed opioid analgesics
E) Monitoring for signs of abdominal distension
Correct Answer: B) Promoting lung aeration
Rationale: Following a splenectomy, the surgical incision is located near the diaphragm.
This proximity often leads to guarded, shallow breathing to avoid pain, which significantly
increases the risk of atelectasis and pneumonia. Therefore, respiratory hygiene and
promoting lung expansion are the highest nursing priorities in the immediate postoperative
period.
Question 2
A nurse is caring for a client who is placed on a low-bacteria diet in combination with an oral
selective bowel decontamination solution prior to a liver transplant. The nurse understands that
the client should avoid consuming which of the following?
A) Canned peaches
B) Well-done steak
C) Fresh grapes
D) Pasteurized milk
E) Steamed white rice
Correct Answer: C) Fresh grapes
Rationale: A low-bacteria (neutropenic) diet is designed to protect immunocompromised
clients from foodborne illnesses. Fresh, unpeeled fruits like grapes, berries, and cherries
are difficult to clean thoroughly and can harbor soil-bound bacteria and molds. Canned
fruits, pasteurized dairy, and thoroughly cooked meats/grains are considered safe because
the heating process kills most microorganisms.
Question 3
A client is receiving a tube feeding via a continuous enteral pump at 75 ml/hr. When the nurse
assesses the client at 0800, which of the following nursing observations requires immediate
intervention?
A) The formula is at room temperature
B) The head of the bed is elevated 20 degrees
C) There is 20 ml of gastric residual volume
D) The feeding tube is taped to the client's nose
E) The infusion pump is plugged into a grounded outlet
, 2
Correct Answer: B) The head of the bed is elevated 20 degrees
Rationale: To prevent the aspiration of enteral formula, the head of the bed must be
maintained at a minimum of 30 to 45 degrees for any client receiving continuous tube
feedings. An elevation of only 20 degrees is insufficient and puts the client at high risk for
aspiration pneumonia.
Question 4
A nurse assesses a client's bowel sounds 3 days following a gastroplasty for obesity and notes
that they have returned. A 1 oz serving of which of the following is appropriate as an initial
feeding?
A) Low-fat cream of mushroom soup
B) Apple juice
C) Water
D) Sugar-free protein shake
E) Pureed carrots
Correct Answer: C) Water
Rationale: After bariatric surgery or gastroplasty, the initial intake is limited to clear liquids
in very small amounts (usually 30 ml or 1 oz) to prevent stretching of the small gastric
pouch and to ensure the client can tolerate oral intake without nausea or vomiting. Water is
the least irritating and safest initial choice.
Question 5
A nurse is teaching a client with diverticulitis about preventing acute attacks. The nurse should
advise the client to consume foods that are:
A) Low in fiber and low in residue
B) High in protein and low in fat
C) High in fiber and high in fluids
D) High in calcium and Vitamin D
E) Low in carbohydrates and high in fat
Correct Answer: C) High in fiber
Rationale: While a low-fiber diet is used during acute flare-ups of diverticulitis to allow the
bowel to rest, the prevention of future attacks requires a high-fiber diet. Fiber adds bulk to
the stool and lowers pressure within the colon, preventing the formation of new diverticula
and the inflammation of existing ones.
Question 6
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following
manifestations should the client report?
A) Jaundice of the sclera
B) Dark-colored urine
C) Anorexia
, 3
D) Clay-colored stools
E) Right upper quadrant pain
Correct Answer: C) Anorexia
Rationale: Early (prodromal) manifestations of hepatitis A are often non-specific and flu-
like, including anorexia, fatigue, malaise, nausea, and vomiting. Scleral icterus (jaundice),
dark urine, and clay-colored stools occur later during the icteric phase when bilirubin
levels are significantly elevated.
Question 7
A nurse is caring for a client who is diagnosed with fulminant hepatic failure. Which of the
following procedures should the nurse expect the client to be prepared for?
A) Paracentesis
B) Transjugular intrahepatic portosystemic shunt (TIPS)
C) Liver transplant
D) Endoscopic retrograde cholangiopancreatography (ERCP)
E) Sclerotherapy
Correct Answer: C) Liver transplant
Rationale: Fulminant hepatic failure is a clinical syndrome characterized by the sudden and
severe impairment of liver function in a previously healthy person. Because the liver cannot
regenerate fast enough to sustain life, a liver transplant is often the only definitive life-
saving treatment.
Question 8
A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected
malignancy. Which of the following should the nurse monitor prior to the procedure?
A) Serum amylase levels
B) Blood urea nitrogen (BUN)
C) Prothrombin time (PT)
D) Serum lipase
E) Indirect bilirubin
Correct Answer: C) PT
Rationale: The liver is responsible for synthesizing clotting factors. In the presence of liver
disease or malignancy, clotting may be impaired. Because a liver biopsy is a highly vascular
procedure, the nurse must monitor coagulation studies (PT/INR and Platelets) to prevent
life-threatening hemorrhage.
Question 9
A nurse is caring for a client who has returned to the unit following a laparoscopic
cholecystectomy and reports severe pain in the left shoulder. The nurse should recognize that the
client's pain is:
A) A sign of internal hemorrhaging
, 4
B) An indicator of a pulmonary embolism
C) Due to carbon dioxide instilled into the abdomen during surgery
D) A result of the positioning of the left arm during the procedure
E) Referred pain from a myocardial infarction
Correct Answer: C) due to carbon dioxide instilled into the abdomen during surgery
Rationale: During laparoscopic surgery, the abdomen is insufflated with carbon dioxide (
𝐶𝑂2
) to create a workspace. Residual gas can irritate the phrenic nerve, causing referred pain
to the shoulder. This is a common and expected finding that is best relieved by early
ambulation.
Question 10
A nurse is preparing a community education program about Hepatitis B. Which of the following
statements should be included in the nurse's discussion?
A) Hep B is primarily transmitted through the fecal-oral route.
B) The Hep B immunization is given to infants and children.
C) There is no vaccine available for Hep B.
D) Hep B is caused by eating raw shellfish.
E) Household bleach is ineffective at killing the Hep B virus.
Correct Answer: B) Hep B immunization is given to infants and children.
Rationale: Hepatitis B is primarily transmitted through blood and body fluids. The Hep B
vaccine is part of the standard childhood immunization schedule in the United States. Hep
A is the virus associated with fecal-oral transmission and raw shellfish.
Question 11
A community health nurse is planning an educational program to prevent the transmission of
Hepatitis A in a community where the virus is becoming endemic. The nurse realizes the
population group likely to become infected with the Hep A virus is:
A) Elderly adults in assisted living
B) Healthcare workers in hospitals
C) Children and young adults
D) Intravenous drug users
E) Clients undergoing hemodialysis
Correct Answer: C) Children and young adults
Rationale: Hepatitis A is transmitted via the fecal-oral route, often through contaminated
food or water, or close personal contact. Children and young adults are the most likely to
be infected due to lower rates of hygiene awareness in settings like daycare centers and
schools.
ANSWERS PRACTICE QUESTIONS WITH SOLUTIONS NEWEST | ALREADY
GRADED A+/NEWEST UPDATE!!!
Question 1
A nurse is caring for a client who has just undergone a splenectomy following a motor vehicle
crash. Which of the following client care measures has the highest priority?
A) Monitoring urinary output every hour
B) Promoting lung aeration and incentive spirometry
C) Assessing the surgical site for drainage
D) Administering prescribed opioid analgesics
E) Monitoring for signs of abdominal distension
Correct Answer: B) Promoting lung aeration
Rationale: Following a splenectomy, the surgical incision is located near the diaphragm.
This proximity often leads to guarded, shallow breathing to avoid pain, which significantly
increases the risk of atelectasis and pneumonia. Therefore, respiratory hygiene and
promoting lung expansion are the highest nursing priorities in the immediate postoperative
period.
Question 2
A nurse is caring for a client who is placed on a low-bacteria diet in combination with an oral
selective bowel decontamination solution prior to a liver transplant. The nurse understands that
the client should avoid consuming which of the following?
A) Canned peaches
B) Well-done steak
C) Fresh grapes
D) Pasteurized milk
E) Steamed white rice
Correct Answer: C) Fresh grapes
Rationale: A low-bacteria (neutropenic) diet is designed to protect immunocompromised
clients from foodborne illnesses. Fresh, unpeeled fruits like grapes, berries, and cherries
are difficult to clean thoroughly and can harbor soil-bound bacteria and molds. Canned
fruits, pasteurized dairy, and thoroughly cooked meats/grains are considered safe because
the heating process kills most microorganisms.
Question 3
A client is receiving a tube feeding via a continuous enteral pump at 75 ml/hr. When the nurse
assesses the client at 0800, which of the following nursing observations requires immediate
intervention?
A) The formula is at room temperature
B) The head of the bed is elevated 20 degrees
C) There is 20 ml of gastric residual volume
D) The feeding tube is taped to the client's nose
E) The infusion pump is plugged into a grounded outlet
, 2
Correct Answer: B) The head of the bed is elevated 20 degrees
Rationale: To prevent the aspiration of enteral formula, the head of the bed must be
maintained at a minimum of 30 to 45 degrees for any client receiving continuous tube
feedings. An elevation of only 20 degrees is insufficient and puts the client at high risk for
aspiration pneumonia.
Question 4
A nurse assesses a client's bowel sounds 3 days following a gastroplasty for obesity and notes
that they have returned. A 1 oz serving of which of the following is appropriate as an initial
feeding?
A) Low-fat cream of mushroom soup
B) Apple juice
C) Water
D) Sugar-free protein shake
E) Pureed carrots
Correct Answer: C) Water
Rationale: After bariatric surgery or gastroplasty, the initial intake is limited to clear liquids
in very small amounts (usually 30 ml or 1 oz) to prevent stretching of the small gastric
pouch and to ensure the client can tolerate oral intake without nausea or vomiting. Water is
the least irritating and safest initial choice.
Question 5
A nurse is teaching a client with diverticulitis about preventing acute attacks. The nurse should
advise the client to consume foods that are:
A) Low in fiber and low in residue
B) High in protein and low in fat
C) High in fiber and high in fluids
D) High in calcium and Vitamin D
E) Low in carbohydrates and high in fat
Correct Answer: C) High in fiber
Rationale: While a low-fiber diet is used during acute flare-ups of diverticulitis to allow the
bowel to rest, the prevention of future attacks requires a high-fiber diet. Fiber adds bulk to
the stool and lowers pressure within the colon, preventing the formation of new diverticula
and the inflammation of existing ones.
Question 6
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following
manifestations should the client report?
A) Jaundice of the sclera
B) Dark-colored urine
C) Anorexia
, 3
D) Clay-colored stools
E) Right upper quadrant pain
Correct Answer: C) Anorexia
Rationale: Early (prodromal) manifestations of hepatitis A are often non-specific and flu-
like, including anorexia, fatigue, malaise, nausea, and vomiting. Scleral icterus (jaundice),
dark urine, and clay-colored stools occur later during the icteric phase when bilirubin
levels are significantly elevated.
Question 7
A nurse is caring for a client who is diagnosed with fulminant hepatic failure. Which of the
following procedures should the nurse expect the client to be prepared for?
A) Paracentesis
B) Transjugular intrahepatic portosystemic shunt (TIPS)
C) Liver transplant
D) Endoscopic retrograde cholangiopancreatography (ERCP)
E) Sclerotherapy
Correct Answer: C) Liver transplant
Rationale: Fulminant hepatic failure is a clinical syndrome characterized by the sudden and
severe impairment of liver function in a previously healthy person. Because the liver cannot
regenerate fast enough to sustain life, a liver transplant is often the only definitive life-
saving treatment.
Question 8
A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected
malignancy. Which of the following should the nurse monitor prior to the procedure?
A) Serum amylase levels
B) Blood urea nitrogen (BUN)
C) Prothrombin time (PT)
D) Serum lipase
E) Indirect bilirubin
Correct Answer: C) PT
Rationale: The liver is responsible for synthesizing clotting factors. In the presence of liver
disease or malignancy, clotting may be impaired. Because a liver biopsy is a highly vascular
procedure, the nurse must monitor coagulation studies (PT/INR and Platelets) to prevent
life-threatening hemorrhage.
Question 9
A nurse is caring for a client who has returned to the unit following a laparoscopic
cholecystectomy and reports severe pain in the left shoulder. The nurse should recognize that the
client's pain is:
A) A sign of internal hemorrhaging
, 4
B) An indicator of a pulmonary embolism
C) Due to carbon dioxide instilled into the abdomen during surgery
D) A result of the positioning of the left arm during the procedure
E) Referred pain from a myocardial infarction
Correct Answer: C) due to carbon dioxide instilled into the abdomen during surgery
Rationale: During laparoscopic surgery, the abdomen is insufflated with carbon dioxide (
𝐶𝑂2
) to create a workspace. Residual gas can irritate the phrenic nerve, causing referred pain
to the shoulder. This is a common and expected finding that is best relieved by early
ambulation.
Question 10
A nurse is preparing a community education program about Hepatitis B. Which of the following
statements should be included in the nurse's discussion?
A) Hep B is primarily transmitted through the fecal-oral route.
B) The Hep B immunization is given to infants and children.
C) There is no vaccine available for Hep B.
D) Hep B is caused by eating raw shellfish.
E) Household bleach is ineffective at killing the Hep B virus.
Correct Answer: B) Hep B immunization is given to infants and children.
Rationale: Hepatitis B is primarily transmitted through blood and body fluids. The Hep B
vaccine is part of the standard childhood immunization schedule in the United States. Hep
A is the virus associated with fecal-oral transmission and raw shellfish.
Question 11
A community health nurse is planning an educational program to prevent the transmission of
Hepatitis A in a community where the virus is becoming endemic. The nurse realizes the
population group likely to become infected with the Hep A virus is:
A) Elderly adults in assisted living
B) Healthcare workers in hospitals
C) Children and young adults
D) Intravenous drug users
E) Clients undergoing hemodialysis
Correct Answer: C) Children and young adults
Rationale: Hepatitis A is transmitted via the fecal-oral route, often through contaminated
food or water, or close personal contact. Children and young adults are the most likely to
be infected due to lower rates of hygiene awareness in settings like daycare centers and
schools.
