ATI MED SURG GASTROINTESTINAL ACTUAL REAL EXAM
AND PRACTICE QUESTIONS AND SOLUTIONS | CURRENTLY
TESTING VERSION | ALREADY GRADED A+ | EXPERT
VERIFIED FOR GUARANTEED PASS 2026-2027
The nurse is caring for a client diagnosed with gastroesophageal reflux disease (GERD).
Which client outcomes suggest that treatment has been effective? Select all that apply.
A. Experiences flatulence nightly
B. Absence of cough or hoarseness
C. Reports decreased epigastric pain
D. Experiences belching only after meals
E. Eats a well-balanced diet with no regurgitation
CORRECT ANSWER: B. Absence of cough or hoarseness, C. Reports decreased epigastric
pain, E. Eats a well-balanced diet with no regurgitation
(Note: Flatulence and belching are not specific indicators of GERD treatment effectiveness.
Cough, hoarseness, epigastric pain, and regurgitation are classic GERD symptoms that
should resolve with effective treatment.)
A client is in the hospital for complications after surgery of the gastrointestinal tract. The
nurse reviews the client's chart and learns that the client has lost 15 lbs since the surgery.
Labs reveal low albumin, prealbumin, and transferrin levels. What should the nurse do next?
A. Ask the client about their usual daily intake and preferences
B. Ask the unlicensed assistive personnel to feed the client
C. Request the provider prescribe enteral tube feedings
D. Provide nutritional supplements between each meal
CORRECT ANSWER: A. Ask the client about their usual daily intake and preferences
(Note: Before initiating any nutritional intervention, the nurse should first assess the client's
current dietary intake and preferences to determine the most appropriate intervention. This
is the first step in the nursing process.)
,A client is admitted to the medical floor with a 4-day history of diarrheal vomiting and poor
appetite. You review the following documentation from the patient's chart:
"1700: Mucous membranes pale and dry. Skin warm and dry to touch. Poor turgor with
tenting present. Bowel sounds hyperactive x 4 quadrants. Client states, 'I am unable to keep
anything down.' Vital signs: BP 96/68, HR 96, Temp 101.1F, and spO2 94% on room air."
What is the priority intervention by the nurse?
A. Administer an antipyretic for the fever
B. Provide the client with oral fluids
C. Ensure a patent IV and start IV fluids
D. Administer an antiemetic for the vomiting
CORRECT ANSWER: C. Ensure a patent IV and start IV fluids
(Note: Managing the fever is not a priority action. Oral fluids are not correct because the
patient is vomiting. Administering an antiemetic for the vomiting should happen, but is not
the priority. The patient is experiencing dehydration. The priority action would be IV and IV
fluids.)
A client is receiving total parenteral nutrition (TPN). What is an appropriate nursing
intervention?
A. Checking blood glucose levels
B. Adding electrolytes to the TPN bag
C. Ensuring the bag is replaced every 8 hours
D. Setting the rate of the fat emulsion at 0.20 g/kg/hour
CORRECT ANSWER: A. Checking blood glucose levels
(Note: TPN solutions contain high concentrations of glucose, which can lead to
hyperglycemia. Monitoring blood glucose levels is an essential nursing intervention. Adding
electrolytes should be done by pharmacy, not the nurse. TPN bags are typically changed
every 24 hours, not 8 hours. The fat emulsion rate is calculated based on individual patient
needs.)
A client was admitted with an upper gastrointestinal bleed and the nurse provides discharge
teaching to the client. What statement by the client indicates further teaching is needed?
A. I understand that I should get some help to stop drinking alcohol.
B. I'll contact my health care provider before I start taking any herbal remedies.
,C. I know it will be important to continue taking my daily aspirin to prevent a heart attack.
D. I will need to change my pain medication from naproxen to acetaminophen.
CORRECT ANSWER: C. I know it will be important to continue taking my daily aspirin to
prevent a heart attack.
(Note: Aspirin is an NSAID. This is the response needing further teaching. NSAIDs can cause
gastrointestinal bleeding and should be avoided in clients with a history of GI bleed.
Acetaminophen is a safer alternative for pain management.)
A client presents to the emergency department with a 6-hour history of vomiting that is
'dark brown in appearance.' The client reports a history of gastric ulcers; hypertension;
diabetes; and chronic pain for which naproxen is taken. What is a priority nursing action?
A. Assess the client's abdomen for hardness, tenseness, and rigidity.
B. Insert an indwelling urinary catheter.
C. Place an IV and start lactated ringers.
D. Prepare to start intravenous administration of a proton pump inhibitor.
CORRECT ANSWER: A. Assess the client's abdomen for hardness, tenseness, and rigidity.
(Note: Dark brown vomit (coffee ground emesis) indicates upper GI bleeding. The priority is
to assess for signs of peritoneal irritation such as abdominal rigidity, which may indicate
perforation. This assessment should be done before initiating other interventions.)
An elderly resident is brought to the emergency department via ambulance. The client is
barely able to stand because of weakness and reports several episodes of diarrhea in the
past 2 days. The client describes stools as watery and very foul-smelling. What is the priority
action by the nurse?
A. Collect a stool sample
B. Start an IV
C. Place the client on contact isolation
D. Administer an antidiarrheal agent
CORRECT ANSWER: C. Place the client on contact isolation
(Note: Client symptoms relate to C-Diff. Clostridium difficile is highly contagious and
requires contact isolation precautions to prevent transmission to other patients. Stool
samples can be collected after isolation is initiated.)
, The nurse is caring for a client taking clopidogrel after having an embolic event. The client
shares that since starting the medication he has noticed that his stools are darker in color.
What is an appropriate response by the nurse?
A. That is typical with this medication
B. Tell me what you mean by darker?
C. Often dietary changes cause this
D. When is the last time you had a BM?
CORRECT ANSWER: B. Tell me what you mean by darker?
(Note: Side-effects of this medication does not include dark stools. The nurse should first
assess the client's description of "darker" to determine if it indicates melena (black, tarry
stools) which could be a sign of gastrointestinal bleeding. Clarification is needed before
assuming it is normal.)
The nurse is caring for a client with a nasogastric (NG) tube. Which finding indicates proper
tube placement?
A. The client reports nausea
B. The pH of aspirated fluid is 5.0
C. The tube is taped to the client's nose
D. The tube is connected to suction
CORRECT ANSWER: B. The pH of aspirated fluid is 5.0
(Note: A pH of 5.0 or less confirms gastric placement. Nausea is not a reliable indicator.
Taping and suction do not confirm placement.)
A client with peptic ulcer disease is prescribed omeprazole. Which outcome indicates the
medication is effective?
A. The client reports decreased abdominal pain
B. The client's blood pressure decreases
C. The client's heart rate increases
D. The client reports increased appetite
CORRECT ANSWER: A. The client reports decreased abdominal pain
(Note: Omeprazole is a proton pump inhibitor that reduces gastric acid secretion. Decreased
abdominal pain indicates the medication is effective in reducing gastric acid and promoting
ulcer healing.)
AND PRACTICE QUESTIONS AND SOLUTIONS | CURRENTLY
TESTING VERSION | ALREADY GRADED A+ | EXPERT
VERIFIED FOR GUARANTEED PASS 2026-2027
The nurse is caring for a client diagnosed with gastroesophageal reflux disease (GERD).
Which client outcomes suggest that treatment has been effective? Select all that apply.
A. Experiences flatulence nightly
B. Absence of cough or hoarseness
C. Reports decreased epigastric pain
D. Experiences belching only after meals
E. Eats a well-balanced diet with no regurgitation
CORRECT ANSWER: B. Absence of cough or hoarseness, C. Reports decreased epigastric
pain, E. Eats a well-balanced diet with no regurgitation
(Note: Flatulence and belching are not specific indicators of GERD treatment effectiveness.
Cough, hoarseness, epigastric pain, and regurgitation are classic GERD symptoms that
should resolve with effective treatment.)
A client is in the hospital for complications after surgery of the gastrointestinal tract. The
nurse reviews the client's chart and learns that the client has lost 15 lbs since the surgery.
Labs reveal low albumin, prealbumin, and transferrin levels. What should the nurse do next?
A. Ask the client about their usual daily intake and preferences
B. Ask the unlicensed assistive personnel to feed the client
C. Request the provider prescribe enteral tube feedings
D. Provide nutritional supplements between each meal
CORRECT ANSWER: A. Ask the client about their usual daily intake and preferences
(Note: Before initiating any nutritional intervention, the nurse should first assess the client's
current dietary intake and preferences to determine the most appropriate intervention. This
is the first step in the nursing process.)
,A client is admitted to the medical floor with a 4-day history of diarrheal vomiting and poor
appetite. You review the following documentation from the patient's chart:
"1700: Mucous membranes pale and dry. Skin warm and dry to touch. Poor turgor with
tenting present. Bowel sounds hyperactive x 4 quadrants. Client states, 'I am unable to keep
anything down.' Vital signs: BP 96/68, HR 96, Temp 101.1F, and spO2 94% on room air."
What is the priority intervention by the nurse?
A. Administer an antipyretic for the fever
B. Provide the client with oral fluids
C. Ensure a patent IV and start IV fluids
D. Administer an antiemetic for the vomiting
CORRECT ANSWER: C. Ensure a patent IV and start IV fluids
(Note: Managing the fever is not a priority action. Oral fluids are not correct because the
patient is vomiting. Administering an antiemetic for the vomiting should happen, but is not
the priority. The patient is experiencing dehydration. The priority action would be IV and IV
fluids.)
A client is receiving total parenteral nutrition (TPN). What is an appropriate nursing
intervention?
A. Checking blood glucose levels
B. Adding electrolytes to the TPN bag
C. Ensuring the bag is replaced every 8 hours
D. Setting the rate of the fat emulsion at 0.20 g/kg/hour
CORRECT ANSWER: A. Checking blood glucose levels
(Note: TPN solutions contain high concentrations of glucose, which can lead to
hyperglycemia. Monitoring blood glucose levels is an essential nursing intervention. Adding
electrolytes should be done by pharmacy, not the nurse. TPN bags are typically changed
every 24 hours, not 8 hours. The fat emulsion rate is calculated based on individual patient
needs.)
A client was admitted with an upper gastrointestinal bleed and the nurse provides discharge
teaching to the client. What statement by the client indicates further teaching is needed?
A. I understand that I should get some help to stop drinking alcohol.
B. I'll contact my health care provider before I start taking any herbal remedies.
,C. I know it will be important to continue taking my daily aspirin to prevent a heart attack.
D. I will need to change my pain medication from naproxen to acetaminophen.
CORRECT ANSWER: C. I know it will be important to continue taking my daily aspirin to
prevent a heart attack.
(Note: Aspirin is an NSAID. This is the response needing further teaching. NSAIDs can cause
gastrointestinal bleeding and should be avoided in clients with a history of GI bleed.
Acetaminophen is a safer alternative for pain management.)
A client presents to the emergency department with a 6-hour history of vomiting that is
'dark brown in appearance.' The client reports a history of gastric ulcers; hypertension;
diabetes; and chronic pain for which naproxen is taken. What is a priority nursing action?
A. Assess the client's abdomen for hardness, tenseness, and rigidity.
B. Insert an indwelling urinary catheter.
C. Place an IV and start lactated ringers.
D. Prepare to start intravenous administration of a proton pump inhibitor.
CORRECT ANSWER: A. Assess the client's abdomen for hardness, tenseness, and rigidity.
(Note: Dark brown vomit (coffee ground emesis) indicates upper GI bleeding. The priority is
to assess for signs of peritoneal irritation such as abdominal rigidity, which may indicate
perforation. This assessment should be done before initiating other interventions.)
An elderly resident is brought to the emergency department via ambulance. The client is
barely able to stand because of weakness and reports several episodes of diarrhea in the
past 2 days. The client describes stools as watery and very foul-smelling. What is the priority
action by the nurse?
A. Collect a stool sample
B. Start an IV
C. Place the client on contact isolation
D. Administer an antidiarrheal agent
CORRECT ANSWER: C. Place the client on contact isolation
(Note: Client symptoms relate to C-Diff. Clostridium difficile is highly contagious and
requires contact isolation precautions to prevent transmission to other patients. Stool
samples can be collected after isolation is initiated.)
, The nurse is caring for a client taking clopidogrel after having an embolic event. The client
shares that since starting the medication he has noticed that his stools are darker in color.
What is an appropriate response by the nurse?
A. That is typical with this medication
B. Tell me what you mean by darker?
C. Often dietary changes cause this
D. When is the last time you had a BM?
CORRECT ANSWER: B. Tell me what you mean by darker?
(Note: Side-effects of this medication does not include dark stools. The nurse should first
assess the client's description of "darker" to determine if it indicates melena (black, tarry
stools) which could be a sign of gastrointestinal bleeding. Clarification is needed before
assuming it is normal.)
The nurse is caring for a client with a nasogastric (NG) tube. Which finding indicates proper
tube placement?
A. The client reports nausea
B. The pH of aspirated fluid is 5.0
C. The tube is taped to the client's nose
D. The tube is connected to suction
CORRECT ANSWER: B. The pH of aspirated fluid is 5.0
(Note: A pH of 5.0 or less confirms gastric placement. Nausea is not a reliable indicator.
Taping and suction do not confirm placement.)
A client with peptic ulcer disease is prescribed omeprazole. Which outcome indicates the
medication is effective?
A. The client reports decreased abdominal pain
B. The client's blood pressure decreases
C. The client's heart rate increases
D. The client reports increased appetite
CORRECT ANSWER: A. The client reports decreased abdominal pain
(Note: Omeprazole is a proton pump inhibitor that reduces gastric acid secretion. Decreased
abdominal pain indicates the medication is effective in reducing gastric acid and promoting
ulcer healing.)
