ATI MED SURG GASTROINTESTINAL
ACTUAL EXAM QUESTIONS AND ANSWERS
PRACTICE QUESTIONS WITH SOLUTIONS
NEWEST | ALREADY GRADED A+
Section 1: Upper GI Disorders (Questions 1–15)
1. A nurse is caring for a client with gastroesophageal reflux disease (GERD). Which statement by the
client indicates a need for further teaching?
A. “I should avoid lying down for 2–3 hours after eating.”
B. “I can sleep with the head of my bed elevated on blocks.”
C. “I will drink peppermint tea to soothe my stomach.”
D. “I need to stop smoking cigarettes.”
Answer: C
Rationale: Peppermint relaxes the lower esophageal sphincter (LES), worsening GERD. Elevating the
head of the bed, avoiding recumbency after meals, and smoking cessation are recommended.
2. A client with peptic ulcer disease (PUD) reports black, tarry stools. What is the nurse’s priority action?
A. Administer a proton pump inhibitor (PPI).
B. Check vital signs for signs of hypovolemia.
C. Obtain a stool sample for occult blood.
D. Prepare for an upper endoscopy.
Answer: B
Rationale: Black tarry stools (melena) indicate upper GI bleeding. Priority is assessing hemodynamic
stability (tachycardia, hypotension) due to potential hemorrhage.
3. (SATA) Which teaching points are appropriate for a client newly diagnosed with celiac disease?
A. May eat rye crackers.
,B. Rice and corn are safe.
C. Read labels for hidden gluten in soups.
D. Oats are always allowed.
E. Avoid beer and malt beverages.
Answer: B, C, E
Rationale: Celiac requires lifelong gluten-free diet (no wheat, barley, rye). Rice/corn are safe. Oats may
be cross-contaminated unless certified gluten-free. Rye is prohibited. Beer contains barley malt.
4. A nurse is preparing to administer a nasogastric (NG) tube for a client with an intestinal obstruction.
Which action ensures correct placement before feeding?
A. Auscultate over the epigastrium while injecting 30 mL of air.
B. Measure the pH of aspirated fluid (expect <4).
C. Observe for coughing during tube advancement.
D. Confirm with x-ray.
Answer: D
Rationale: X-ray is the gold standard for confirming NG tube placement. pH testing (<4 indicates gastric
but may be unreliable with acid-suppressing meds). Auscultation is no longer recommended as sole
method.
5. A client with a hiatal hernia reports heartburn that worsens when bending over. Which additional
finding is most characteristic?
A. Dysphagia.
B. Weight gain.
C. Constipation.
D. Fever.
Answer: A
Rationale: Hiatal hernia can cause reflux and dysphagia due to esophageal compression or
inflammation. Weight loss (not gain) is common from eating avoidance. Fever suggests complication like
strangulation (rare).
6. Post–gastric bypass surgery, a client develops dizziness, diaphoresis, and palpitations 30 minutes after
a high-carbohydrate meal. What is the most likely cause?
A. Dumping syndrome.
B. Gastric outlet obstruction.
, C. Anastomotic leak.
D. Hypoglycemia.
Answer: A (Early dumping syndrome)
Rationale: Rapid gastric emptying into small intestine causes fluid shift and vasomotor symptoms.
Hypoglycemia occurs later (late dumping). Leak would cause peritonitis/tachycardia/fever.
7. Which laboratory finding would the nurse expect in a client with acute pancreatitis?
A. Hypocalcemia.
B. Elevated serum amylase and lipase.
C. Hyperglycemia.
D. All of the above.
Answer: D
Rationale: Amylase/lipase rise 2–3× normal; hypocalcemia (fat saponification –> calcium binding);
hyperglycemia (glucagon release, insulin impairment).
8. A client with cirrhosis has an ammonia level of 180 mcg/dL (normal 15–60). Which clinical finding
correlates?
A. Asterixis.
B. Jaundice.
C. Petechiae.
D. Ascites.
Answer: A
Rationale: Elevated ammonia causes hepatic encephalopathy → asterixis (liver flap), confusion, altered
mental status. Jaundice = hyperbilirubinemia. Petechiae = thrombocytopenia. Ascites = portal HTN.
9. (Ordered Response) Arrange the steps for inserting a small-bore feeding tube using the blind bedside
method:
1. Measure tube length from nose to ear to xiphoid.
2. Lubricate the tube tip.
3. Place client in high Fowler’s position.
4. Advance tube slowly while having client swallow.
ACTUAL EXAM QUESTIONS AND ANSWERS
PRACTICE QUESTIONS WITH SOLUTIONS
NEWEST | ALREADY GRADED A+
Section 1: Upper GI Disorders (Questions 1–15)
1. A nurse is caring for a client with gastroesophageal reflux disease (GERD). Which statement by the
client indicates a need for further teaching?
A. “I should avoid lying down for 2–3 hours after eating.”
B. “I can sleep with the head of my bed elevated on blocks.”
C. “I will drink peppermint tea to soothe my stomach.”
D. “I need to stop smoking cigarettes.”
Answer: C
Rationale: Peppermint relaxes the lower esophageal sphincter (LES), worsening GERD. Elevating the
head of the bed, avoiding recumbency after meals, and smoking cessation are recommended.
2. A client with peptic ulcer disease (PUD) reports black, tarry stools. What is the nurse’s priority action?
A. Administer a proton pump inhibitor (PPI).
B. Check vital signs for signs of hypovolemia.
C. Obtain a stool sample for occult blood.
D. Prepare for an upper endoscopy.
Answer: B
Rationale: Black tarry stools (melena) indicate upper GI bleeding. Priority is assessing hemodynamic
stability (tachycardia, hypotension) due to potential hemorrhage.
3. (SATA) Which teaching points are appropriate for a client newly diagnosed with celiac disease?
A. May eat rye crackers.
,B. Rice and corn are safe.
C. Read labels for hidden gluten in soups.
D. Oats are always allowed.
E. Avoid beer and malt beverages.
Answer: B, C, E
Rationale: Celiac requires lifelong gluten-free diet (no wheat, barley, rye). Rice/corn are safe. Oats may
be cross-contaminated unless certified gluten-free. Rye is prohibited. Beer contains barley malt.
4. A nurse is preparing to administer a nasogastric (NG) tube for a client with an intestinal obstruction.
Which action ensures correct placement before feeding?
A. Auscultate over the epigastrium while injecting 30 mL of air.
B. Measure the pH of aspirated fluid (expect <4).
C. Observe for coughing during tube advancement.
D. Confirm with x-ray.
Answer: D
Rationale: X-ray is the gold standard for confirming NG tube placement. pH testing (<4 indicates gastric
but may be unreliable with acid-suppressing meds). Auscultation is no longer recommended as sole
method.
5. A client with a hiatal hernia reports heartburn that worsens when bending over. Which additional
finding is most characteristic?
A. Dysphagia.
B. Weight gain.
C. Constipation.
D. Fever.
Answer: A
Rationale: Hiatal hernia can cause reflux and dysphagia due to esophageal compression or
inflammation. Weight loss (not gain) is common from eating avoidance. Fever suggests complication like
strangulation (rare).
6. Post–gastric bypass surgery, a client develops dizziness, diaphoresis, and palpitations 30 minutes after
a high-carbohydrate meal. What is the most likely cause?
A. Dumping syndrome.
B. Gastric outlet obstruction.
, C. Anastomotic leak.
D. Hypoglycemia.
Answer: A (Early dumping syndrome)
Rationale: Rapid gastric emptying into small intestine causes fluid shift and vasomotor symptoms.
Hypoglycemia occurs later (late dumping). Leak would cause peritonitis/tachycardia/fever.
7. Which laboratory finding would the nurse expect in a client with acute pancreatitis?
A. Hypocalcemia.
B. Elevated serum amylase and lipase.
C. Hyperglycemia.
D. All of the above.
Answer: D
Rationale: Amylase/lipase rise 2–3× normal; hypocalcemia (fat saponification –> calcium binding);
hyperglycemia (glucagon release, insulin impairment).
8. A client with cirrhosis has an ammonia level of 180 mcg/dL (normal 15–60). Which clinical finding
correlates?
A. Asterixis.
B. Jaundice.
C. Petechiae.
D. Ascites.
Answer: A
Rationale: Elevated ammonia causes hepatic encephalopathy → asterixis (liver flap), confusion, altered
mental status. Jaundice = hyperbilirubinemia. Petechiae = thrombocytopenia. Ascites = portal HTN.
9. (Ordered Response) Arrange the steps for inserting a small-bore feeding tube using the blind bedside
method:
1. Measure tube length from nose to ear to xiphoid.
2. Lubricate the tube tip.
3. Place client in high Fowler’s position.
4. Advance tube slowly while having client swallow.
