Med Surg Gastrointestinal NCLEX Actual Exam (2025) comprehensive questions and
verified answers ( detailed & elaborated) 2025-2026 TEST
The nurse is providing dietary instructions to a client with a diagnosis of
irritable bowel syndrome. The nurse determines that education was effective if
the client states the need to avoid which food?
A. Rice
B. Corn
C. Broiled chicken
D. Cream of wheat
B. Corn
Rationale:
The client with irritable bowel should take in a diet that consists of 30 to 40 g of fiber
daily because dietary fiber will help produce bulky, soft stools and establish regular
bowel habits. The client should also drink 8 to 10 glasses of fluid daily and chew food
slowly to promote normal bowel function. Foods that are irritating to the intestines
need to be avoided. Corn is high in fiber but can be very irritating to the intestines
and should be avoided. The food items in the other options are acceptable to eat.
Diphenoxylate hydrochloride with atropine sulfate is prescribed for a client
with ulcerative colitis. The nurse should monitor the client for which
therapeutic effect of this medication?
A. Decreased diarrhea
B. Decreased cramping
C. Improved intestinal tone
D. Elimination of peristalsis
A. Decreased diarrhea
Rationale:
Diphenoxylate hydrochloride with atropine sulfate is an antidiarrheal product that
decreases the frequency of defecation, usually by reducing the volume of liquid in
,the stools. The remaining options are not associated therapeutic effects of this
medication.
Sulfasalazine is prescribed for a client with a diagnosis of ulcerative colitis,
and the nurse instructs the client about the medication. Which statement made
by the client indicates a need for further teaching?
A. "The medication will cause constipation."
B. "I need to take the medication with meals."
C. "I may have increased sensitivity to sunlight."
D. "This medication should be taken as prescribed."
A. "The medication will cause constipation."
Rationale:
Sulfasalazine is an antiinflammatory sulfonamide. Constipation is not associated with
this medication. It can cause photosensitivity, and the client should be instructed to
avoid sun and ultraviolet light. It should be administered with meals, if possible, to
prolong intestinal passage. The client needs to take the medication as prescribed
and continue the full course of treatment even if symptoms are relieved.
A client who has been advanced to a solid diet after undergoing a subtotal
gastrectomy. What is the appropriate nursing intervention in preventing
dumping syndrome?
A. Remove fluids from the meal tray.
B. Give the client 2 large meals per day.
C. Ask the client to sit up for 1 hour after eating.
D. Provide concentrated, high-carbohydrate foods.
A. Remove fluids from the meal tray.
Rationale:
Factors to minimize dumping syndrome after gastric surgery include having the client
lie down for at least 30 minutes after eating; giving small, frequent meals; having the
client maintain a low Fowler's position while eating, if possible; avoiding liquids with
meals; and avoiding high-carbohydrate food sources. Antispasmodic medications
also are prescribed as needed to delay gastric emptying.
, The nurse is caring for a client with gastroesophageal reflux disease (GERD)
and provides client education on measures to decrease GERD. Which
statement made by the client indicates a need for further teaching?
A. "I plan to eat 4 to 6 small meals a day."
B. "I should sleep in the right side-lying position."
C."I plan to have a snack 1 hour before going to bed."
D. "I will stop having a glass of wine each evening with dinner."
C."I plan to have a snack 1 hour before going to bed."
Rationale:
The control of GERD involves lifestyle changes to promote health and control reflux.
These include eating 4 to 6 small meals a day; avoiding alcohol and smoking;
sleeping in the right side-lying position to promote oxygenation and frequent
swallowing to clear the esophagus; and avoiding eating at least 3 hours before going
to bed because reflux episodes are most damaging at night.
The registered nurse is precepting a new nurse who is caring for a client with
pernicious anemia as a result of gastrectomy. Which statement made by the
new nurse indicates understanding of this diagnosis?
A. "It's due to insufficient production of vitamin B12 in the colon."
B. "Increased production of intrinsic factor in the stomach leads to this type of
anemia."
C. "Overproduction of vitamin B12 in the large intestine can result in
pernicious anemia."
D. "Decreased production of intrinsic factor by the stomach affects absorption
of vitamin B12 in the small intestine."
D. "Decreased production of intrinsic factor by the stomach affects absorption of
vitamin B12 in the small intestine."
Rationale:
Intrinsic factor is produced in the stomach but is used to aid in the absorption of
vitamin B12 in the small intestine. This vitamin is not produced or absorbed in the
large intestine.
verified answers ( detailed & elaborated) 2025-2026 TEST
The nurse is providing dietary instructions to a client with a diagnosis of
irritable bowel syndrome. The nurse determines that education was effective if
the client states the need to avoid which food?
A. Rice
B. Corn
C. Broiled chicken
D. Cream of wheat
B. Corn
Rationale:
The client with irritable bowel should take in a diet that consists of 30 to 40 g of fiber
daily because dietary fiber will help produce bulky, soft stools and establish regular
bowel habits. The client should also drink 8 to 10 glasses of fluid daily and chew food
slowly to promote normal bowel function. Foods that are irritating to the intestines
need to be avoided. Corn is high in fiber but can be very irritating to the intestines
and should be avoided. The food items in the other options are acceptable to eat.
Diphenoxylate hydrochloride with atropine sulfate is prescribed for a client
with ulcerative colitis. The nurse should monitor the client for which
therapeutic effect of this medication?
A. Decreased diarrhea
B. Decreased cramping
C. Improved intestinal tone
D. Elimination of peristalsis
A. Decreased diarrhea
Rationale:
Diphenoxylate hydrochloride with atropine sulfate is an antidiarrheal product that
decreases the frequency of defecation, usually by reducing the volume of liquid in
,the stools. The remaining options are not associated therapeutic effects of this
medication.
Sulfasalazine is prescribed for a client with a diagnosis of ulcerative colitis,
and the nurse instructs the client about the medication. Which statement made
by the client indicates a need for further teaching?
A. "The medication will cause constipation."
B. "I need to take the medication with meals."
C. "I may have increased sensitivity to sunlight."
D. "This medication should be taken as prescribed."
A. "The medication will cause constipation."
Rationale:
Sulfasalazine is an antiinflammatory sulfonamide. Constipation is not associated with
this medication. It can cause photosensitivity, and the client should be instructed to
avoid sun and ultraviolet light. It should be administered with meals, if possible, to
prolong intestinal passage. The client needs to take the medication as prescribed
and continue the full course of treatment even if symptoms are relieved.
A client who has been advanced to a solid diet after undergoing a subtotal
gastrectomy. What is the appropriate nursing intervention in preventing
dumping syndrome?
A. Remove fluids from the meal tray.
B. Give the client 2 large meals per day.
C. Ask the client to sit up for 1 hour after eating.
D. Provide concentrated, high-carbohydrate foods.
A. Remove fluids from the meal tray.
Rationale:
Factors to minimize dumping syndrome after gastric surgery include having the client
lie down for at least 30 minutes after eating; giving small, frequent meals; having the
client maintain a low Fowler's position while eating, if possible; avoiding liquids with
meals; and avoiding high-carbohydrate food sources. Antispasmodic medications
also are prescribed as needed to delay gastric emptying.
, The nurse is caring for a client with gastroesophageal reflux disease (GERD)
and provides client education on measures to decrease GERD. Which
statement made by the client indicates a need for further teaching?
A. "I plan to eat 4 to 6 small meals a day."
B. "I should sleep in the right side-lying position."
C."I plan to have a snack 1 hour before going to bed."
D. "I will stop having a glass of wine each evening with dinner."
C."I plan to have a snack 1 hour before going to bed."
Rationale:
The control of GERD involves lifestyle changes to promote health and control reflux.
These include eating 4 to 6 small meals a day; avoiding alcohol and smoking;
sleeping in the right side-lying position to promote oxygenation and frequent
swallowing to clear the esophagus; and avoiding eating at least 3 hours before going
to bed because reflux episodes are most damaging at night.
The registered nurse is precepting a new nurse who is caring for a client with
pernicious anemia as a result of gastrectomy. Which statement made by the
new nurse indicates understanding of this diagnosis?
A. "It's due to insufficient production of vitamin B12 in the colon."
B. "Increased production of intrinsic factor in the stomach leads to this type of
anemia."
C. "Overproduction of vitamin B12 in the large intestine can result in
pernicious anemia."
D. "Decreased production of intrinsic factor by the stomach affects absorption
of vitamin B12 in the small intestine."
D. "Decreased production of intrinsic factor by the stomach affects absorption of
vitamin B12 in the small intestine."
Rationale:
Intrinsic factor is produced in the stomach but is used to aid in the absorption of
vitamin B12 in the small intestine. This vitamin is not produced or absorbed in the
large intestine.
