1
NCLEX PN Exam Bank: Gastrointestinal
Disorders and Nutritional Support
Table of Contents
Subtopic 1: Assessment and Diagnosis of Gastrointestinal Disorders ............................... 2
Subtopic 2: Pharmacologic Management of GI Disorders and Nutritional Support ............. 9
Subtopic 3: Nursing Interventions and Monitoring in GI and Nutritional Disorders ............ 16
Subtopic 4: Nutritional Therapy and Specialized Diets for GI Disorders ........................... 23
Subtopic 5: Gastrointestinal Tubes – Care, Complications, and Patient Education ........... 31
Subtopic 6: Bowel Elimination, Constipation, and Diarrhea Management ....................... 39
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Subtopic 1: Assessment and Diagnosis of
Gastrointestinal Disorders
(Questions 1–20)
1. A client presents with right lower quadrant abdominal pain, nausea, and low-grade fever.
Which condition should the nurse suspect?
A. Peptic ulcer disease
B. Appendicitis
C. Diverticulitis
D. Pancreatitis
Correct Answer: B. Appendicitis
Rationale: Classic symptoms of appendicitis include pain in the right lower quadrant
(McBurney's point), nausea, vomiting, and low-grade fever. Prompt surgical intervention is
usually required.
2. Which lab value would most likely be elevated in a client with acute pancreatitis?
A. Bilirubin
B. Amylase
C. BUN
D. ALT
Correct Answer: B. Amylase
Rationale: Serum amylase is commonly elevated in pancreatitis, often three times above
normal. Lipase may also be elevated and stays elevated longer.
3. A client is admitted with suspected upper GI bleed. Which finding most supports this
diagnosis?
A. Green vomitus
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B. Bright red stool
C. Black, tarry stool (melena)
D. Clay-colored stool
Correct Answer: C. Black, tarry stool (melena)
Rationale: Melena indicates digested blood from an upper GI source, often from the
stomach or duodenum.
4. During assessment, a client reports chronic heartburn and sour taste in the mouth.
These are hallmark signs of which condition?
A. Peptic ulcer disease
B. Gastroesophageal reflux disease (GERD)
C. Crohn’s disease
D. Cholelithiasis
Correct Answer: B. Gastroesophageal reflux disease (GERD)
Rationale: GERD commonly presents with heartburn, regurgitation, and an acidic taste in
the mouth, especially when lying down.
5. Which diagnostic test is most commonly used to confirm peptic ulcer disease?
A. Colonoscopy
B. CT abdomen
C. Esophagogastroduodenoscopy (EGD)
D. Barium enema
Correct Answer: C. Esophagogastroduodenoscopy (EGD)
Rationale: EGD allows direct visualization of ulcers in the stomach and duodenum and is
considered the gold standard for diagnosing PUD.
6. A client with ulcerative colitis is most likely to exhibit which clinical sign?
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A. Right-sided abdominal pain
B. Frequent bloody diarrhea
C. Steatorrhea
D. Weight gain
Correct Answer: B. Frequent bloody diarrhea
Rationale: Ulcerative colitis typically involves the colon and rectum, leading to bloody,
mucus-filled stools and abdominal cramping.
7. A nurse assesses a firm, distended abdomen and absence of bowel sounds in a post-
operative client. What should the nurse suspect?
A. Diarrhea
B. GERD
C. Paralytic ileus
D. Diverticulitis
Correct Answer: C. Paralytic ileus
Rationale: A firm, distended abdomen with absent bowel sounds suggests paralytic ileus,
especially after surgery or anesthesia.
8. Which finding best differentiates Crohn’s disease from ulcerative colitis?
A. Involvement of the entire GI tract in Crohn’s
B. Blood in stool
C. Cramping pain
D. Autoimmune origin
Correct Answer: A. Involvement of the entire GI tract in Crohn’s
Rationale: Crohn’s disease may affect any part of the GI tract from mouth to anus, while
ulcerative colitis is limited to the colon and rectum.
NCLEX PN Exam Bank: Gastrointestinal
Disorders and Nutritional Support
Table of Contents
Subtopic 1: Assessment and Diagnosis of Gastrointestinal Disorders ............................... 2
Subtopic 2: Pharmacologic Management of GI Disorders and Nutritional Support ............. 9
Subtopic 3: Nursing Interventions and Monitoring in GI and Nutritional Disorders ............ 16
Subtopic 4: Nutritional Therapy and Specialized Diets for GI Disorders ........................... 23
Subtopic 5: Gastrointestinal Tubes – Care, Complications, and Patient Education ........... 31
Subtopic 6: Bowel Elimination, Constipation, and Diarrhea Management ....................... 39
, 2
Subtopic 1: Assessment and Diagnosis of
Gastrointestinal Disorders
(Questions 1–20)
1. A client presents with right lower quadrant abdominal pain, nausea, and low-grade fever.
Which condition should the nurse suspect?
A. Peptic ulcer disease
B. Appendicitis
C. Diverticulitis
D. Pancreatitis
Correct Answer: B. Appendicitis
Rationale: Classic symptoms of appendicitis include pain in the right lower quadrant
(McBurney's point), nausea, vomiting, and low-grade fever. Prompt surgical intervention is
usually required.
2. Which lab value would most likely be elevated in a client with acute pancreatitis?
A. Bilirubin
B. Amylase
C. BUN
D. ALT
Correct Answer: B. Amylase
Rationale: Serum amylase is commonly elevated in pancreatitis, often three times above
normal. Lipase may also be elevated and stays elevated longer.
3. A client is admitted with suspected upper GI bleed. Which finding most supports this
diagnosis?
A. Green vomitus
, 3
B. Bright red stool
C. Black, tarry stool (melena)
D. Clay-colored stool
Correct Answer: C. Black, tarry stool (melena)
Rationale: Melena indicates digested blood from an upper GI source, often from the
stomach or duodenum.
4. During assessment, a client reports chronic heartburn and sour taste in the mouth.
These are hallmark signs of which condition?
A. Peptic ulcer disease
B. Gastroesophageal reflux disease (GERD)
C. Crohn’s disease
D. Cholelithiasis
Correct Answer: B. Gastroesophageal reflux disease (GERD)
Rationale: GERD commonly presents with heartburn, regurgitation, and an acidic taste in
the mouth, especially when lying down.
5. Which diagnostic test is most commonly used to confirm peptic ulcer disease?
A. Colonoscopy
B. CT abdomen
C. Esophagogastroduodenoscopy (EGD)
D. Barium enema
Correct Answer: C. Esophagogastroduodenoscopy (EGD)
Rationale: EGD allows direct visualization of ulcers in the stomach and duodenum and is
considered the gold standard for diagnosing PUD.
6. A client with ulcerative colitis is most likely to exhibit which clinical sign?
, 4
A. Right-sided abdominal pain
B. Frequent bloody diarrhea
C. Steatorrhea
D. Weight gain
Correct Answer: B. Frequent bloody diarrhea
Rationale: Ulcerative colitis typically involves the colon and rectum, leading to bloody,
mucus-filled stools and abdominal cramping.
7. A nurse assesses a firm, distended abdomen and absence of bowel sounds in a post-
operative client. What should the nurse suspect?
A. Diarrhea
B. GERD
C. Paralytic ileus
D. Diverticulitis
Correct Answer: C. Paralytic ileus
Rationale: A firm, distended abdomen with absent bowel sounds suggests paralytic ileus,
especially after surgery or anesthesia.
8. Which finding best differentiates Crohn’s disease from ulcerative colitis?
A. Involvement of the entire GI tract in Crohn’s
B. Blood in stool
C. Cramping pain
D. Autoimmune origin
Correct Answer: A. Involvement of the entire GI tract in Crohn’s
Rationale: Crohn’s disease may affect any part of the GI tract from mouth to anus, while
ulcerative colitis is limited to the colon and rectum.
