NURS 120 | Medical-Surgical Nursing | Gastrointestinal Disorders
2026 |WCU
1. A patient is scheduled for an Esophagogastroduodenoscopy (EGD). Which
nursing intervention is the highest priority post-procedure?
A. Encouraging the patient to use throat lozenges for soreness.
B. Monitoring for signs of perforated bowel such as abdominal distention.
C. Assessing for the return of the gag reflex before allowing oral intake.
D. Placing the patient in a High-Fowler’s position to prevent aspiration.
Answer: C
Rationale: Post-EGD, the topical anesthetic used to numb the throat impairs the gag reflex.
To prevent aspiration, the nurse must verify the return of the gag reflex before the patient
consumes anything by mouth.
2. A patient with suspected Peptic Ulcer Disease (PUD) suddenly develops a
rigid, board-like abdomen and complains of severe pain radiating to the
shoulder. What is the nurse’s immediate action?
A. Notify the healthcare provider immediately of suspected perforation.
B. Place the patient in a supine position and apply heat.
C. Administer the prescribed PRN antacid.
D. Increase the IV fluid rate to compensate for potential shock.
Answer: A
Rationale: A rigid, board-like abdomen and referred shoulder pain are classic signs of
perforation, a medical emergency. The nurse must notify the provider immediately as
surgical intervention is likely required.
,3. A nurse is teaching a patient with Gastroesophageal Reflux Disease (GERD)
about lifestyle modifications. Which instruction should be included?
A. Consume three large meals a day to reduce stomach acidity.
B. Avoid caffeine, chocolate, and peppermint, which lower LES pressure.
C. Lie down for at least 30 minutes after eating to aid digestion.
D. Drink at least 500 mL of water with every meal to dilute acid.
Answer: B
Rationale: GERD management involves avoiding substances that decrease Lower
Esophageal Sphincter (LES) pressure, such as caffeine, chocolate, fatty foods, and
peppermint.
4. Which clinical manifestation would a nurse expect to find in a patient
experiencing the early stages of Dumping Syndrome following a subtotal
gastrectomy?
A. Bradycardia and hypertension.
B. Constipation and extreme hunger.
C. Palpitations, diaphoresis, and diarrhea.
D. Elevated blood glucose levels above 250 mg/dL.
Answer: C
Rationale: Early dumping syndrome occurs 15-30 minutes after eating and is caused by a
rapid shift of fluid into the bowel. Symptoms include palpitations, tachycardia, sweating,
and abdominal cramping.
, 5. A patient with cirrhosis has a significantly elevated serum ammonia level and
is exhibiting confusion. Which medication does the nurse anticipate
administering?
A. Spironolactone
B. Propranolol
C. Vitamin K
D. Lactulose
Answer: D
Rationale: Lactulose is used to reduce serum ammonia levels in patients with hepatic
encephalopathy by promoting ammonia excretion through the stool.
6. During the assessment of a patient with acute pancreatitis, the nurse notes
bluish discoloration around the umbilicus. How should the nurse document this
finding?
A. Grey Turner’s sign
B. Cullen’s sign
C. Murphy’s sign
D. McBurney’s sign
Answer: B
Rationale: Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue
around the umbilicus, indicating retroperitoneal hemorrhage often associated with severe
pancreatitis.
2026 |WCU
1. A patient is scheduled for an Esophagogastroduodenoscopy (EGD). Which
nursing intervention is the highest priority post-procedure?
A. Encouraging the patient to use throat lozenges for soreness.
B. Monitoring for signs of perforated bowel such as abdominal distention.
C. Assessing for the return of the gag reflex before allowing oral intake.
D. Placing the patient in a High-Fowler’s position to prevent aspiration.
Answer: C
Rationale: Post-EGD, the topical anesthetic used to numb the throat impairs the gag reflex.
To prevent aspiration, the nurse must verify the return of the gag reflex before the patient
consumes anything by mouth.
2. A patient with suspected Peptic Ulcer Disease (PUD) suddenly develops a
rigid, board-like abdomen and complains of severe pain radiating to the
shoulder. What is the nurse’s immediate action?
A. Notify the healthcare provider immediately of suspected perforation.
B. Place the patient in a supine position and apply heat.
C. Administer the prescribed PRN antacid.
D. Increase the IV fluid rate to compensate for potential shock.
Answer: A
Rationale: A rigid, board-like abdomen and referred shoulder pain are classic signs of
perforation, a medical emergency. The nurse must notify the provider immediately as
surgical intervention is likely required.
,3. A nurse is teaching a patient with Gastroesophageal Reflux Disease (GERD)
about lifestyle modifications. Which instruction should be included?
A. Consume three large meals a day to reduce stomach acidity.
B. Avoid caffeine, chocolate, and peppermint, which lower LES pressure.
C. Lie down for at least 30 minutes after eating to aid digestion.
D. Drink at least 500 mL of water with every meal to dilute acid.
Answer: B
Rationale: GERD management involves avoiding substances that decrease Lower
Esophageal Sphincter (LES) pressure, such as caffeine, chocolate, fatty foods, and
peppermint.
4. Which clinical manifestation would a nurse expect to find in a patient
experiencing the early stages of Dumping Syndrome following a subtotal
gastrectomy?
A. Bradycardia and hypertension.
B. Constipation and extreme hunger.
C. Palpitations, diaphoresis, and diarrhea.
D. Elevated blood glucose levels above 250 mg/dL.
Answer: C
Rationale: Early dumping syndrome occurs 15-30 minutes after eating and is caused by a
rapid shift of fluid into the bowel. Symptoms include palpitations, tachycardia, sweating,
and abdominal cramping.
, 5. A patient with cirrhosis has a significantly elevated serum ammonia level and
is exhibiting confusion. Which medication does the nurse anticipate
administering?
A. Spironolactone
B. Propranolol
C. Vitamin K
D. Lactulose
Answer: D
Rationale: Lactulose is used to reduce serum ammonia levels in patients with hepatic
encephalopathy by promoting ammonia excretion through the stool.
6. During the assessment of a patient with acute pancreatitis, the nurse notes
bluish discoloration around the umbilicus. How should the nurse document this
finding?
A. Grey Turner’s sign
B. Cullen’s sign
C. Murphy’s sign
D. McBurney’s sign
Answer: B
Rationale: Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue
around the umbilicus, indicating retroperitoneal hemorrhage often associated with severe
pancreatitis.
