MED SURG GASTROINTESTINAL NCLEX
QUESTIONS 2026 COMPLETE REVIEW
WITH VERIFIED ANSWERS | GRADED A+
| GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,The nurse is planning to teach a client with A. Coffee
gastroesophageal reflux disease (GERD) about B. Chocolate
substances to avoid. Which items should the nurse C. Peppermint
include on this list? Select all that apply. E. Fried chicken
A. Coffee Rationale:
B. Chocolate Foods that decrease lower esophageal sphincter (LES) pressure and irritate the
C. Peppermint esophagus will increase reflux and exacerbate the symptoms of GERD and
D. Nonfat milk therefore should be avoided. Aggravating substances include coffee, chocolate,
E. Fried chicken peppermint, fried or fatty foods, carbonated beverages, and alcohol. Options 4
F. Scrambled eggs and 6 do not promote this effect.
A client has undergone esophagogastroduodenoscopy. 4. Assessing for the return of the gag reflex
The nurse should place highest priority on which item as
part of the client's care plan? Rationale:
The nurse places highest priority on assessing for return of the gag reflex. This
1. Monitoring the temperature assessment addresses the client's airway. The nurse also monitors the client's vital
2. Monitoring complaints of heartburn signs and for a sudden increase in temperature, which could indicate perforation
3. Giving warm gargles for a sore throat of the gastrointestinal tract. This complication would be accompanied by other
4. Assessing for the return of the gag reflex signs as well, such as pain. Monitoring for sore throat and heartburn are also
important; however, the client's airway is the priority.
The nurse is providing dietary teaching for a client with a A. Nuts
diagnosis of chronic gastritis. The nurse instructs the C. Liver
client to include which foods rich in vitamin B12 in the E. Lentils
diet? Select all that apply.
Rationale:
A. Nuts Chronic gastritis causes deterioration and atrophy of the lining of the stomach,
B. Corn leading to the loss of function of the parietal cells. The source of intrinsic factor is
C. Liver lost, which results in an inability to absorb vitamin B12, leading to development of
D. Apples pernicious anemia. Clients must increase their intake of vitamin B12 by increasing
E. Lentils consumption of foods rich in this vitamin, such as nuts, organ meats, dried beans,
F. Bananas citrus fruits, green leafy vegetables, and yeast.
The nurse is monitoring a client with a diagnosis of peptic D. A rigid, boardlike abdomen
ulcer. Which assessment finding would most likely
indicate perforation of the ulcer? Rationale:
Perforation of an ulcer is a surgical emergency and is characterized by sudden,
A. Bradycardia sharp, intolerable severe pain beginning in the mid-epigastric area and spreading
B. Numbness in the legs over the abdomen, which becomes rigid and boardlike. Nausea and vomiting may
C. Nausea and vomiting occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the
D. A rigid, boardlike abdomen legs is not an associated finding.
The nurse is caring for a client following a C. Irrigating the nasogastric tube
gastrojejunostomy (Billroth II procedure). Which
postoperative prescription should the nurse question and Rationale:
verify? In a gastrojejunostomy (Billroth II procedure), the proximal remnant of the
stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube
A. Leg exercises is critical for preventing the retention of gastric secretions. The nurse should never
B. Early ambulation irrigate or reposition the gastric tube after gastric surgery, unless specifically
C. Irrigating the nasogastric tube prescribed by the health care provider. In this situation, the nurse should clarify
D. Coughing and deep-breathing exercises the prescription. Options 1, 2, and 4 are appropriate postoperative interventions.
, The nurse is providing discharge instructions to a client C. Limit the fluids taken with meals.
following gastrectomy and should instruct the client to
take which measure to assist in preventing dumping Rationale:
syndrome? Dumping syndrome is a term that refers to a constellation of vasomotor symptoms
that occurs after eating, especially following a gastrojejunostomy (Billroth II
A. Ambulate following a meal. procedure). Early manifestations usually occur within 30 minutes of eating and
B. Eat high-carbohydrate foods. include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the
C. Limit the fluids taken with meals. desire to lie down. The nurse should instruct the client to decrease the amount of
D. Sit in a high Fowler's position during meals. fluid taken at meals and to avoid high-carbohydrate foods, including fluids such
as fruit nectars; to assume a low Fowler's position during meals; to lie down for 30
minutes after eating to delay gastric emptying; and to take antispasmodics as
prescribed.
The nurse is providing discharge teaching for a client with A. "I should increase the fiber in my diet."
newly diagnosed Crohn's disease about dietary measures
to implement during exacerbation episodes. Which Rationale:
statement made by the client indicates a need for further Crohn's disease is an inflammatory disease that can occur anywhere in the
instruction? gastrointestinal tract but most often affects the terminal ileum and leads to
thickening and scarring, a narrowed lumen, fistulas, ulcerations, and abscesses. It
A. "I should increase the fiber in my diet." is characterized by exacerbations and remissions. If stress increases the symptoms
B. "I will need to avoid caffeinated beverages." of the disease, the client is taught stress management techniques and may require
C. "I'm going to learn some stress reduction techniques." additional counseling. The client is taught to avoid gastrointestinal stimulants
D. "I can have exacerbations and remissions with Crohn's containing caffeine and to follow a high-calorie and high-protein diet. A low-fiber
disease." diet may be prescribed, especially during periods of exacerbation.
The nurse is doing an admission assessment on a client C. Pain relieved by food intake
with a history of duodenal ulcer. To determine whether
the problem is currently active, the nurse should assess Rationale:
the client for which sign(s)/symptom(s) of duodenal A frequent symptom of duodenal ulcer is pain that is relieved by food intake.
ulcer? These clients generally describe the pain as a burning, heavy, sharp, or "hungry"
pain that often localizes in the mid-epigastric area. The client with duodenal ulcer
A. Weight loss usually does not experience weight loss or nausea and vomiting. These symptoms
B. Nausea and vomiting are more typical in the client with a gastric ulcer.
C. Pain relieved by food intake
D. Pain radiating down the right arm
A client with hiatal hernia chronically experiences A. Lying recumbent following meals
heartburn following meals. The nurse should plan to
teach the client to avoid which action because it is Rationale:
contraindicated with a hiatal hernia? Hiatal hernia is caused by a protrusion of a portion of the stomach above the
diaphragm where the esophagus usually is positioned. The client usually
A. Lying recumbent following meals experiences pain from reflux caused by ingestion of irritating foods, lying flat
B. Consuming small, frequent, bland meals following meals or at night, and eating large or fatty meals. Relief is obtained with
C. Taking H2-receptor antagonist medication the intake of small, frequent, and bland meals; use of H2-receptor antagonists
D. Raising the head of the bed on 6-inch (15 cm) blocks and antacids; and elevation of the thorax following meals and during sleep.
The nurse is providing care for a client with a recent B. Purple discoloration of the stoma
transverse colostomy. Which observation requires
immediate notification of the health care provider? Rationale:
Ischemia of the stoma would be associated with a dusky or bluish or purple color.
A. Stoma is beefy red and shiny A beefy red and shiny stoma is normal and expected. Skin excoriation needs to
B. Purple discoloration of the stoma be addressed and treated but does not require as immediate attention as purple
C. Skin excoriation around the stoma discoloration of the stoma. Semi-formed stool is a normal finding.
D. Semi-formed stool noted in the ostomy pouch
QUESTIONS 2026 COMPLETE REVIEW
WITH VERIFIED ANSWERS | GRADED A+
| GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,The nurse is planning to teach a client with A. Coffee
gastroesophageal reflux disease (GERD) about B. Chocolate
substances to avoid. Which items should the nurse C. Peppermint
include on this list? Select all that apply. E. Fried chicken
A. Coffee Rationale:
B. Chocolate Foods that decrease lower esophageal sphincter (LES) pressure and irritate the
C. Peppermint esophagus will increase reflux and exacerbate the symptoms of GERD and
D. Nonfat milk therefore should be avoided. Aggravating substances include coffee, chocolate,
E. Fried chicken peppermint, fried or fatty foods, carbonated beverages, and alcohol. Options 4
F. Scrambled eggs and 6 do not promote this effect.
A client has undergone esophagogastroduodenoscopy. 4. Assessing for the return of the gag reflex
The nurse should place highest priority on which item as
part of the client's care plan? Rationale:
The nurse places highest priority on assessing for return of the gag reflex. This
1. Monitoring the temperature assessment addresses the client's airway. The nurse also monitors the client's vital
2. Monitoring complaints of heartburn signs and for a sudden increase in temperature, which could indicate perforation
3. Giving warm gargles for a sore throat of the gastrointestinal tract. This complication would be accompanied by other
4. Assessing for the return of the gag reflex signs as well, such as pain. Monitoring for sore throat and heartburn are also
important; however, the client's airway is the priority.
The nurse is providing dietary teaching for a client with a A. Nuts
diagnosis of chronic gastritis. The nurse instructs the C. Liver
client to include which foods rich in vitamin B12 in the E. Lentils
diet? Select all that apply.
Rationale:
A. Nuts Chronic gastritis causes deterioration and atrophy of the lining of the stomach,
B. Corn leading to the loss of function of the parietal cells. The source of intrinsic factor is
C. Liver lost, which results in an inability to absorb vitamin B12, leading to development of
D. Apples pernicious anemia. Clients must increase their intake of vitamin B12 by increasing
E. Lentils consumption of foods rich in this vitamin, such as nuts, organ meats, dried beans,
F. Bananas citrus fruits, green leafy vegetables, and yeast.
The nurse is monitoring a client with a diagnosis of peptic D. A rigid, boardlike abdomen
ulcer. Which assessment finding would most likely
indicate perforation of the ulcer? Rationale:
Perforation of an ulcer is a surgical emergency and is characterized by sudden,
A. Bradycardia sharp, intolerable severe pain beginning in the mid-epigastric area and spreading
B. Numbness in the legs over the abdomen, which becomes rigid and boardlike. Nausea and vomiting may
C. Nausea and vomiting occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the
D. A rigid, boardlike abdomen legs is not an associated finding.
The nurse is caring for a client following a C. Irrigating the nasogastric tube
gastrojejunostomy (Billroth II procedure). Which
postoperative prescription should the nurse question and Rationale:
verify? In a gastrojejunostomy (Billroth II procedure), the proximal remnant of the
stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube
A. Leg exercises is critical for preventing the retention of gastric secretions. The nurse should never
B. Early ambulation irrigate or reposition the gastric tube after gastric surgery, unless specifically
C. Irrigating the nasogastric tube prescribed by the health care provider. In this situation, the nurse should clarify
D. Coughing and deep-breathing exercises the prescription. Options 1, 2, and 4 are appropriate postoperative interventions.
, The nurse is providing discharge instructions to a client C. Limit the fluids taken with meals.
following gastrectomy and should instruct the client to
take which measure to assist in preventing dumping Rationale:
syndrome? Dumping syndrome is a term that refers to a constellation of vasomotor symptoms
that occurs after eating, especially following a gastrojejunostomy (Billroth II
A. Ambulate following a meal. procedure). Early manifestations usually occur within 30 minutes of eating and
B. Eat high-carbohydrate foods. include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the
C. Limit the fluids taken with meals. desire to lie down. The nurse should instruct the client to decrease the amount of
D. Sit in a high Fowler's position during meals. fluid taken at meals and to avoid high-carbohydrate foods, including fluids such
as fruit nectars; to assume a low Fowler's position during meals; to lie down for 30
minutes after eating to delay gastric emptying; and to take antispasmodics as
prescribed.
The nurse is providing discharge teaching for a client with A. "I should increase the fiber in my diet."
newly diagnosed Crohn's disease about dietary measures
to implement during exacerbation episodes. Which Rationale:
statement made by the client indicates a need for further Crohn's disease is an inflammatory disease that can occur anywhere in the
instruction? gastrointestinal tract but most often affects the terminal ileum and leads to
thickening and scarring, a narrowed lumen, fistulas, ulcerations, and abscesses. It
A. "I should increase the fiber in my diet." is characterized by exacerbations and remissions. If stress increases the symptoms
B. "I will need to avoid caffeinated beverages." of the disease, the client is taught stress management techniques and may require
C. "I'm going to learn some stress reduction techniques." additional counseling. The client is taught to avoid gastrointestinal stimulants
D. "I can have exacerbations and remissions with Crohn's containing caffeine and to follow a high-calorie and high-protein diet. A low-fiber
disease." diet may be prescribed, especially during periods of exacerbation.
The nurse is doing an admission assessment on a client C. Pain relieved by food intake
with a history of duodenal ulcer. To determine whether
the problem is currently active, the nurse should assess Rationale:
the client for which sign(s)/symptom(s) of duodenal A frequent symptom of duodenal ulcer is pain that is relieved by food intake.
ulcer? These clients generally describe the pain as a burning, heavy, sharp, or "hungry"
pain that often localizes in the mid-epigastric area. The client with duodenal ulcer
A. Weight loss usually does not experience weight loss or nausea and vomiting. These symptoms
B. Nausea and vomiting are more typical in the client with a gastric ulcer.
C. Pain relieved by food intake
D. Pain radiating down the right arm
A client with hiatal hernia chronically experiences A. Lying recumbent following meals
heartburn following meals. The nurse should plan to
teach the client to avoid which action because it is Rationale:
contraindicated with a hiatal hernia? Hiatal hernia is caused by a protrusion of a portion of the stomach above the
diaphragm where the esophagus usually is positioned. The client usually
A. Lying recumbent following meals experiences pain from reflux caused by ingestion of irritating foods, lying flat
B. Consuming small, frequent, bland meals following meals or at night, and eating large or fatty meals. Relief is obtained with
C. Taking H2-receptor antagonist medication the intake of small, frequent, and bland meals; use of H2-receptor antagonists
D. Raising the head of the bed on 6-inch (15 cm) blocks and antacids; and elevation of the thorax following meals and during sleep.
The nurse is providing care for a client with a recent B. Purple discoloration of the stoma
transverse colostomy. Which observation requires
immediate notification of the health care provider? Rationale:
Ischemia of the stoma would be associated with a dusky or bluish or purple color.
A. Stoma is beefy red and shiny A beefy red and shiny stoma is normal and expected. Skin excoriation needs to
B. Purple discoloration of the stoma be addressed and treated but does not require as immediate attention as purple
C. Skin excoriation around the stoma discoloration of the stoma. Semi-formed stool is a normal finding.
D. Semi-formed stool noted in the ostomy pouch
