Gastrointestinal (GI) Exam Study Guide Questions, Nursing Course, System-Based Review and
Practice Material
The nurse caring for a client with small-bowel obstruction would plan to implement which
nursing intervention first?
a. Administering pain medication
b. Obtaining a blood sample for laboratory studies
c. Preparing to insert a nasogastric (NG) tube
d. Administering I.V. fluids - correct answer ✔✔Answer D. I.V. infusions containing normal saline
solution and potassium should be given first to maintain fluid and electrolyte balance. For the
client's comfort and to assist in bowel decompression, the nurse should prepare to insert an NG
tube next. A blood sample is then obtained for laboratory studies to aid in the diagnosis of
bowel obstruction and guide treatment. Blood studies usually include a complete blood count,
serum electrolyte levels, and blood urea nitrogen level. Pain medication often is withheld until
obstruction is diagnosed because analgesics can decrease intestinal motility
1. An adult who has cholecystitis reports clay colored stools and moderate jaundice. Which is
the best explanation for the presence of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct. - correct answer ✔✔(4) Clay colored stools
means bile is not getting through to the duodenum. The bile duct is obstructed so bile backs up
into the bloodstream causing jaundice
Atropine 0.5 mg is ordered for a client having an acute attack of cholecystitis. What is the
primary purpose of this drug for this client?
,1. decrease skeletal muscle spasms.
2. increase gastrointestinal peristalsis
3. decrease smooth muscle contractions
4. decrease anxiety - correct answer ✔✔(3) Atropine is an anticholinergic drug , which will
decrease contractions of the gallbladder.
An adult male is admitted to the hospital complaining of burning epigastric pain. He reports to
the nurse that he has gained 14 pounds over the last two months. Which nursing response is
best?
1. "Why were you eating more?"
2. "Has the weight gain been intentional?"
3. "Does your weight usually fluctuate this much?"
4. "How did your eating habits change?" - correct answer ✔✔(4) Weight gain may occur due to
increased consumption of food as the client tries to feed a duodenal ulcer. "Why" questions are
threatening to clients. #3 asks for a yes or no answer. This will not give as much information as
asking about the eating habits.
A barium enema is ordered for an adult male client. The nurse is teaching him what to expect
regarding the procedure. Which statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure. - correct answer ✔✔1) The bowel
must be free of fecal material for good visualization of the bowel. He will be on a clear liquid or
low residue diet for the day preceding the exam. The client is put in several positions during the
test. Barium is given by enema. It is given by mouth in an upper GI series.
,An adult is admitted with a duodenal ulcer. On the second day after admission, the client
develops severe, persistent pain radiating to the shoulder. What action should the nurse take
first?
1. Notify the physician.
2. Place client in a high-Fowler's position to decrease pressure on the gastric area and shoulder.
3. Examine the client for board-like rigidity of the abdomen.
4. Administer ordered prn pain medication. - correct answer ✔✔(3) The nurse should first do a
quick assessment to determine if the cause of the pain is more apt to be perforation of the ulcer
or something else such as cardiac pain. If the ulcer has perforated the client's abdomen will be
tender and rigid - board like.
. During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal
bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to
hypoprothrombinemia?
a. vitamin A
b. vitamin D
c. vitamin E
d. vitamin K - correct answer ✔✔Answer D. Intestinal bacteria synthesize such nutritional
substances as vitamin K, thiamine, riboflavin, vitamin B12, folic acid, biotin, and nicotinic acid.
Therefore, antibiotic therapy may interfere with synthesis of these substances, including vitamin
K. Intestinal bacteria don't synthesize vitamins A, D, or E.
A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How
should the nurse position the client for this test initially?
a. Lying on the right side with legs straight
b. Lying on the left side with knees bent
c. Prone with the torso elevated
, d. Bent over with hands touching the floor - correct answer ✔✔Answer B. For a colonoscopy,
the nurse initially should position the client on the left side with knees bent. Placing the client
on the right side with legs straight, prone with the torso elevated, or bent over with hands
touching the floor wouldn't allow proper visualization of the large intestine.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the
client has deficient vitamin K absorption caused by this hepatic disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura and petechiae
d. Gynecomastia and testicular atrophy - correct answer ✔✔Answer C. A hepatic disorder, such
as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting
factor). Consequently, the nurse should monitor the client for signs of bleeding, including
purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and orthopnea are
unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from decreased
estrogen metabolism by the diseased liver.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
a. Appendicitis
b. Pancreatitis
c. Cholecystitis
d. Gastric ulcer - correct answer ✔✔Answer B. Hypovolemic shock from fluid shifts is a major
factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume deficit.
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube
becomes clogged. To remedy this problem and teach the client's family how to deal with it at
home, what should the nurse do?
Practice Material
The nurse caring for a client with small-bowel obstruction would plan to implement which
nursing intervention first?
a. Administering pain medication
b. Obtaining a blood sample for laboratory studies
c. Preparing to insert a nasogastric (NG) tube
d. Administering I.V. fluids - correct answer ✔✔Answer D. I.V. infusions containing normal saline
solution and potassium should be given first to maintain fluid and electrolyte balance. For the
client's comfort and to assist in bowel decompression, the nurse should prepare to insert an NG
tube next. A blood sample is then obtained for laboratory studies to aid in the diagnosis of
bowel obstruction and guide treatment. Blood studies usually include a complete blood count,
serum electrolyte levels, and blood urea nitrogen level. Pain medication often is withheld until
obstruction is diagnosed because analgesics can decrease intestinal motility
1. An adult who has cholecystitis reports clay colored stools and moderate jaundice. Which is
the best explanation for the presence of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct. - correct answer ✔✔(4) Clay colored stools
means bile is not getting through to the duodenum. The bile duct is obstructed so bile backs up
into the bloodstream causing jaundice
Atropine 0.5 mg is ordered for a client having an acute attack of cholecystitis. What is the
primary purpose of this drug for this client?
,1. decrease skeletal muscle spasms.
2. increase gastrointestinal peristalsis
3. decrease smooth muscle contractions
4. decrease anxiety - correct answer ✔✔(3) Atropine is an anticholinergic drug , which will
decrease contractions of the gallbladder.
An adult male is admitted to the hospital complaining of burning epigastric pain. He reports to
the nurse that he has gained 14 pounds over the last two months. Which nursing response is
best?
1. "Why were you eating more?"
2. "Has the weight gain been intentional?"
3. "Does your weight usually fluctuate this much?"
4. "How did your eating habits change?" - correct answer ✔✔(4) Weight gain may occur due to
increased consumption of food as the client tries to feed a duodenal ulcer. "Why" questions are
threatening to clients. #3 asks for a yes or no answer. This will not give as much information as
asking about the eating habits.
A barium enema is ordered for an adult male client. The nurse is teaching him what to expect
regarding the procedure. Which statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure. - correct answer ✔✔1) The bowel
must be free of fecal material for good visualization of the bowel. He will be on a clear liquid or
low residue diet for the day preceding the exam. The client is put in several positions during the
test. Barium is given by enema. It is given by mouth in an upper GI series.
,An adult is admitted with a duodenal ulcer. On the second day after admission, the client
develops severe, persistent pain radiating to the shoulder. What action should the nurse take
first?
1. Notify the physician.
2. Place client in a high-Fowler's position to decrease pressure on the gastric area and shoulder.
3. Examine the client for board-like rigidity of the abdomen.
4. Administer ordered prn pain medication. - correct answer ✔✔(3) The nurse should first do a
quick assessment to determine if the cause of the pain is more apt to be perforation of the ulcer
or something else such as cardiac pain. If the ulcer has perforated the client's abdomen will be
tender and rigid - board like.
. During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal
bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to
hypoprothrombinemia?
a. vitamin A
b. vitamin D
c. vitamin E
d. vitamin K - correct answer ✔✔Answer D. Intestinal bacteria synthesize such nutritional
substances as vitamin K, thiamine, riboflavin, vitamin B12, folic acid, biotin, and nicotinic acid.
Therefore, antibiotic therapy may interfere with synthesis of these substances, including vitamin
K. Intestinal bacteria don't synthesize vitamins A, D, or E.
A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How
should the nurse position the client for this test initially?
a. Lying on the right side with legs straight
b. Lying on the left side with knees bent
c. Prone with the torso elevated
, d. Bent over with hands touching the floor - correct answer ✔✔Answer B. For a colonoscopy,
the nurse initially should position the client on the left side with knees bent. Placing the client
on the right side with legs straight, prone with the torso elevated, or bent over with hands
touching the floor wouldn't allow proper visualization of the large intestine.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the
client has deficient vitamin K absorption caused by this hepatic disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura and petechiae
d. Gynecomastia and testicular atrophy - correct answer ✔✔Answer C. A hepatic disorder, such
as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting
factor). Consequently, the nurse should monitor the client for signs of bleeding, including
purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and orthopnea are
unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from decreased
estrogen metabolism by the diseased liver.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
a. Appendicitis
b. Pancreatitis
c. Cholecystitis
d. Gastric ulcer - correct answer ✔✔Answer B. Hypovolemic shock from fluid shifts is a major
factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume deficit.
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube
becomes clogged. To remedy this problem and teach the client's family how to deal with it at
home, what should the nurse do?
