Med Surg Nursing- GI Disorders Exam Prep Test

Reviewed by Allison Martin
Allison Martin, BSN |
School Nurse
Review Board Member
Allison Martin holds a Bachelor of Science in Nursing (BSN) from Drexel University's College of Nursing and Health Professions, specializing in neuroscience and cardiac care. She is dedicated to providing high-quality care and support to the school community as a School Nurse at St. Bernard's School, drawing on over 20 years of invaluable nursing experience.
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  • 1/37 Questions

    While preparing a client for cholecystectomy, the nurse explains that incentive spirometry will be used after surgery primarily to:

    • Increase respiratory effectiveness.
    • Eliminate the need for nasogastric intubation.
    • Improve nutritional status during recovery.
    • Decrease the amount of postoperative analgesia needed.
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About This Quiz

Med-Surg nurses are tasked with caring for adult patients who have come from surgeries and who are acutely ill. These practitioners give the utmost care to the patient that no other professional in the hospital can. The quiz below will test your knowledge of caring for a patient with GI disorders. Take this quiz and see if you understand what is needed.

Med Surg Nursing- GI Disorders Exam Prep Test - Quiz

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  • 2. 

    A client has a newly created colostomy. After participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is beginning to accept the change in body image?

    • The client asks his wife to leave the room

    • The client closes the eyes when the abdomen is exposed

    • The client avoids talking about the recent surgery

    • The client touches the altered body part

    Correct Answer
    A. The client touches the altered body part
    Explanation
    By touching the altered body part, the client recognizes the body change and establishes that the change is real. Closing the eyes, not looking at the abdomen when the colostomy is exposed, or avoiding talking about the surgery reflects denial.

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  • 3. 

    Which of the following has the least important role in terms of peptic ulcer formation?

    • Acid

    • NSAID use

    • Prescence of H. pylori

    • Hypertension

    Correct Answer
    A. Hypertension
    Explanation
    Hypertension, or high blood pressure, has the least important role in terms of peptic ulcer formation compared to the other options. Peptic ulcers are mainly caused by factors such as excessive acid production, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and the presence of Helicobacter pylori bacteria. Hypertension is not directly linked to peptic ulcers, although it may contribute to the overall health of the gastrointestinal system. However, it is not a primary factor in the formation of peptic ulcers.

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  • 4. 

    A client is diagnosed with Crohn's disease after undergoing two weeks of testing. The client's boss calls the medical-surgical floor requesting to speak with the nurse manager. He expresses concern over the client and explains that he must know the client's diagnosis for insurance purposes. Which response by the nurse is best?

    • "Sure, I understand how demanding insurance companies can be."

    • "I appreciate your concern, but I can't give out any information."

    • "Why don't you come in, and we can further discuss this issue."

    • "He has been diagnosed with Crohn's Disease."

    Correct Answer
    A. "I appreciate your concern, but I can't give out any information."
    Explanation
    The nurse may not release any confidential information to unauthorized individuals, such as the client's boss. Options 1, 3, and 4 breech client confidentiality.

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  • 5. 

    A client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?

    • Lying on the right side with legs straight

    • Lying on the left side with knees bent

    • Prone with the torso elevated

    • Bent over with hands touching the floor

    Correct Answer
    A. Lying on the left side with knees bent
    Explanation
    For a colonoscopy, the nurse initially should position the client on the left side with knees bent to allow proper visualization of the large intestine.

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  • 6. 

    Which item is unnecessary when examining the oral cavity of a patient with candidiasis?

    • Gloves

    • Penlight

    • Gown

    • Tongue blade

    Correct Answer
    A. Gown
    Explanation
    When examining the oral cavity of a patient with candidiasis, a gown is unnecessary. Candidiasis is a fungal infection that primarily affects the mucous membranes, such as the mouth. It does not pose a risk of bodily fluid exposure, so there is no need for a gown. However, gloves are necessary to prevent the spread of infection, a penlight is useful for proper visualization, and a tongue blade can help to examine the tongue and oral tissues.

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  • 7. 

    A client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to:

    • Call the physician

    • Place saline-soaked sterile dressings on the wound

    • Take a blood pressure and pulse

    • Take a blood pressure and pulse

    Correct Answer
    A. Place saline-soaked sterile dressings on the wound
    Explanation
    The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection. Then the nurse should call the physician and take the client's vital signs.

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  • 8. 

    Which outcome indicates effective client teaching to prevent constipation?

    • The client verbalizes consumption of low-fiber foods

    • The client maintains a sedentary lifestyle

    • The client limits water intake to three glasses per day

    • The client reports engaging in a regular exercise regimen

    Correct Answer
    A. The client reports engaging in a regular exercise regimen
    Explanation
    A regular exercise regimen promotes peristalsis and contributes to regular bowel elimination patterns. A low-fiber diet, a sedentary lifestyle, and limited water intake would predispose the client to constipation.

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  • 9. 

    A 72-year-old client seeks help for chronic constipation. This is a common problem for elderly clients due to several factors related to aging. Which is one such factor?  

    • Increased intestinal motility

    • Decreased abdominal strength

    • Increased gastric aid production

    • Hyperactive bowel sounds

    Correct Answer
    A. Decreased abdominal strength
    Explanation
    Decreased abdominal strength, muscle tone of the intestinal wall, and motility all contribute to chronic constipation in the elderly.

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  • 10. 

    Which drug class does not treat GERD?

    • Antacids

    • Histamine receptor antagonists

    • Beta blockers

    • Proton pump inhibitors

    Correct Answer
    A. Beta blockers
    Explanation
    Beta-blockers do not treat GERD (gastroesophageal reflux disease) because they primarily work to block the effects of adrenaline on the heart and blood vessels. They are commonly used to treat conditions such as high blood pressure and heart disease, but they do not have any direct effect on reducing stomach acid production or relieving the symptoms of GERD. Antacids, histamine receptor antagonists, and proton pump inhibitors are all commonly used to treat GERD by reducing stomach acid production or neutralizing the acid already present in the stomach.

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  • 11. 

    To verify the placement of a gastric feeding tube, the nurse should perform at least two tests. One test requires instilling air into the tube with a syringe and listening with a stethoscope for air passing into the stomach. Which is another test method?

    • Aspiration of gastric contents and testing for a pH less than 6

    • Instillation of 30 ml of water while listening with a stethoscope

    • Cessation of reflex gagging

    • Ensuring proper measurement of the tube before insertion

    Correct Answer
    A. Aspiration of gastric contents and testing for a pH less than 6
    Explanation
    Aspiration of gastric secretions with a pH less than 6 indicates placement in the stomach.

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  • 12. 

    To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction?

    • Lie down after meals to promote digestion

    • Avoid coffee and alcoholic beverages

    • Take antacids with meals

    • Limit fluid intake with meals

    Correct Answer
    A. Avoid coffee and alcoholic beverages
    Explanation
    To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that increase stomach acid, such as coffee and alcohol.

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  • 13. 

    Which of the following would you NOT teach a patient recently diagnosed with irritable bowel syndrome?

    • Identifying food intolerances and needed dietary modifications

    • Decreasing fiber intake

    • Avoiding coffee and and limiting alcohol intake

    • Stress management

    Correct Answer
    A. Decreasing fiber intake
    Explanation
    Fiber supplements are usually recommended

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  • 14. 

    Which task can the nurse delegate to a nursing assistant?

    • Irrigating a nasogastric (NG) tube

    • Assisting a client who had surgery three days ago walk down the hallway

    • Helping a client who just returned from surgery to the bathroom

    • Administering an antacid to a client complaining of heartburn

    Correct Answer
    A. Assisting a client who had surgery three days ago walk down the hallway
    Explanation
    Because the client had surgery three days ago, the nurse can safely delegate the task of helping the client walk down the hallway.

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  • 15. 

    The graduate nurse and her preceptor are establishing priorities for their morning assessments. Which client should they assess first?

    • The newly admitted client with acute abdominal pain

    • The client who needs an abdominal dressing changed (POD 3)

    • The client receiving continuous tube feedings who needs the tube-feeding residual checked

    • The sleeping client who received pain medication 1 hour ago

    Correct Answer
    A. The newly admitted client with acute abdominal pain
    Explanation
    The graduate nurse and her preceptor should assess the new admission with acute abdominal pain first because he just arrived on the floor and might be unstable. Next, they should change the abdominal dressing for the postoperative client or measure the feeding tube residual in the client with continuous tube feedings.

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  • 16. 

    In regards to appendicitis, the location of pain in the lower, right abdominal quadrant is called:

    • Kernig's sign

    • Mc Burney's point

    • Brudzinski's point

    • Schrute's point

    Correct Answer
    A. Mc Burney's point
    Explanation
    Mc Burney's point is the correct answer for the location of pain in the lower, right abdominal quadrant in relation to appendicitis. This point is located approximately two-thirds of the distance between the umbilicus and the anterior superior iliac spine. It is a key landmark used by healthcare professionals to identify the potential presence of appendicitis.

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  • 17. 

    Which of the following is not a common symptom of GERD?

    • Dyspepsia

    • Regurgitation

    • Dysphagia

    • Hyposalivation

    Correct Answer
    A. Hyposalivation
    Explanation
    Hypersalivation, aka water brash, occurs in response to reflux, not hyposalivation.

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  • 18. 

    A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be:

    • Coffee-ground-like

    • Clay-colored

    • Black and tarry

    • Bright red

    Correct Answer
    A. Black and tarry
    Explanation
    Black, tarry stools are a sign of bleeding high in the GI tract, as from a gastric ulcer, and result from the action of digestive enzymes on the blood.

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  • 19. 

    When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as:

    • A canker sore of the oral soft tissues

    • An acute stomach infection

    • Acid indigestion

    • An early sign of peptic ulcer disease

    Correct Answer
    A. A canker sore of the oral soft tissues
    Explanation
    Aphthous stomatitis refers to a canker sore of the oral soft tissues, including the lips, tongue, and inside of the cheeks.

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  • 20. 

    Which of the following is not an appropriate nursing diagnosis related to appendicitis?

    • Disturbed body image

    • Acute pain

    • Risk for infection r/t rupture

    • Deficient knowledge

    Correct Answer
    A. Disturbed body image
    Explanation
    Disturbed body image is not an appropriate nursing diagnosis related to appendicitis because it refers to a person's perception of their own physical appearance, which is not directly affected by appendicitis. Appendicitis is characterized by symptoms such as acute pain, risk for infection due to rupture, and a potential lack of knowledge about the condition. Therefore, disturbed body image does not align with the specific physiological and psychological effects of appendicitis.

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  • 21. 

    Which of the following is not an education tool required prior to an endoscopic procedure?

    • The purpose of the procedure

    • What to expect during the procedure

    • How long the procedure will take

    • Preparation required prior to the surgery

    Correct Answer
    A. How long the procedure will take
    Explanation
    The length of endoscopies varies and it is also the least important education tool for the patient.

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  • 22. 

    How are ulcerative colitis and Chron's disease definitively diagnosed?

    • EGD

    • CBC

    • Stool sample

    • Colonoscopy

    Correct Answer
    A. Colonoscopy
    Explanation
    Ulcerative colitis and Crohn's disease are both inflammatory bowel diseases that can have similar symptoms. To definitively diagnose these conditions, a colonoscopy is often performed. During a colonoscopy, a long, flexible tube with a camera is inserted into the colon to examine the lining and detect any abnormalities or inflammation. This procedure allows for direct visualization and biopsy of the affected areas, providing a more accurate diagnosis compared to other tests such as EGD (esophagogastroduodenoscopy), CBC (complete blood count), or stool sample analysis. Therefore, colonoscopy is the preferred method for definitive diagnosis of ulcerative colitis and Crohn's disease.

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  • 23. 

    Which of the following is an inappropriate nursing diagnosis for a client with malignant tumors of the oral cavity?

    • Impaired oral mucous membranes

    • Deficient fluid volume

    • Acute pain

    • Risk for ineffective airway clearance

    Correct Answer
    A. Deficient fluid volume
    Explanation
    The nursing diagnosis "Deficient fluid volume" is inappropriate for a client with malignant tumors of the oral cavity because it does not directly relate to the condition. Malignant tumors of the oral cavity primarily affect the tissues in the mouth, not the fluid volume in the body. Therefore, this diagnosis would not be relevant or helpful in addressing the client's needs.

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  • 24. 

    Which is the least likely to cause constipation?

    • High fiber intake

    • Being over 75

    • Overuse of laxatives

    • Immobilization

    Correct Answer
    A. High fiber intake
    Explanation
    High fiber intake is least likely to cause constipation because fiber adds bulk to the stool and helps to regulate bowel movements. It promotes regularity and prevents constipation by softening the stool and allowing it to pass through the digestive system more easily. On the other hand, being over 75, overuse of laxatives, and immobilization can all contribute to constipation.

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  • 25. 

    An elderly client with Alzheimer's disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for:

    • Hyperglycemia

    • Fluid volume excess

    • Aspiration

    • Constipation

    Correct Answer
    A. Aspiration
    Explanation
    Of the choices listed, aspiration is the most serious potential complication of tube feedings. Dehydration — not fluid volume excess — is a concern because of decreased free water intake.

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  • 26. 

    Which patient is most susceptible to acquiring secondary stomatitis?

    • An AIDS patient suffering from pneumonia

    • An 65 y/o obese female

    • A 45 y/o male suffering from colon cancer

    • A 50 y/o male with CHF

    Correct Answer
    A. An AIDS patient suffering from pneumonia
    Explanation
    Secondary stomatitis results from infection by opportunistic viruses or bacteria. In this case, the patient with AIDS is, most likely, immunosuppressed.

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  • 27. 

    A client who underwent abdominal surgery who has a nasogastric (NG) tube in place begins to complain of abdominal pain that he describes as "feeling full and uncomfortable." Which assessment should the nurse perform first?

    • Measure abdominal girth

    • Auscultate bowel sounds

    • Assess patency of the NG tube

    • Assess vital signs

    Correct Answer
    A. Assess patency of the NG tube
    Explanation
    When an NG tube is no longer patent, stomach contents collect in the stomach giving the client a sensation of fullness

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  • 28. 

    Which foods should a patient with GERD stay away from (multiple answers)?

    • Burger King double cheeseburger

    • Lettuce

    • Candy canes

    • Chocolate espresso

    • White bread

    Correct Answer(s)
    A. Burger King double cheeseburger
    A. Candy canes
    A. Chocolate espresso
    Explanation
    Patients with GERD should avoid peppermint, alcohol, caffeinated beverages, chocolate, tea, and coffee.

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  • 29. 

    When preparing a client, age 50, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?

    • The appendectomy surgery is very invasive and it puts the client at a risk for infection

    • Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

    • Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage

    • The appendix may develop gangrene and rupture, especially in a middle-aged client

    Correct Answer
    A. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
    Explanation
    A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up

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  • 30. 

    Which of the following assessment findings suggests early appendicitis?

    • Nausea and vomiting

    • Periumbilical pain

    • Tense positioning

    • Abdominal rigdity

    Correct Answer
    A. Periumbilical pain
    Explanation
    Periumbilical pain is the initial symptom, followed by nausea and vomiting.

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  • 31. 

    Which of the following are appropriate nursing diagnoses for patients with colorectal cancer (multiple answers)?

    • Altered level of consciousness

    • Disturbed body image

    • Deficient fluid volume

    • Acute/ chronic pain

    Correct Answer(s)
    A. Disturbed body image
    A. Deficient fluid volume
    A. Acute/ chronic pain
    Explanation
    The appropriate nursing diagnoses for patients with colorectal cancer include disturbed body image, deficient fluid volume, and acute/chronic pain. Colorectal cancer can have a significant impact on a patient's body image, causing distress and a negative self-perception. Deficient fluid volume may occur due to factors such as vomiting, diarrhea, or inadequate intake. Acute or chronic pain is common in colorectal cancer patients due to the disease itself or as a result of treatments such as surgery or radiation. These nursing diagnoses address important aspects of care for patients with colorectal cancer.

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  • 32. 

    Which diagnostic test would be used first to evaluate a client with upper GI bleeding?

    • Endoscopy

    • Upper GI series

    • Hemoglobin (Hb) levels and hematocrit (HCT

    • Arteriography

    Correct Answer
    A. Hemoglobin (Hb) levels and hematocrit (HCT
    Explanation
    Hemoglobin and hematocrit are typically performed first in clients with upper GI bleeding to evaluate the extent of blood loss. Endoscopy is then performed to directly visualize the upper GI tract and locate the source of bleeding.

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  • 33. 

    Which foods should patients with colorectal cancer avoid (multiple answers)?

    • Fish and chips

    • Boiled carrots and broccoli

    • Beef and cabbage

    • Concentrated sweets

    • Whole-grain products

    Correct Answer(s)
    A. Fish and chips
    A. Beef and cabbage
    A. Concentrated sweets
    Explanation
    Patients should avoid red meat, animal fat, fatty foods, fried meats/ fish, and concentrated sweets.

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  • 34. 

    What is toxic megacolon (mulitple answers)?

    • A complication of ulcerative colitis

    • Dilation and paralysis of the colon

    • A fistula

    • A risk factor for pancreatitis

    Correct Answer(s)
    A. A complication of ulcerative colitis
    A. Dilation and paralysis of the colon
    Explanation
    Toxic megacolon is a condition that occurs as a complication of ulcerative colitis. It is characterized by the dilation and paralysis of the colon, leading to a significant enlargement of the colon. This condition can be life-threatening and requires immediate medical intervention. It is not a fistula, which is an abnormal connection between two organs, and it is not a risk factor for pancreatitis, which is inflammation of the pancreas.

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  • 35. 

    Which of the following are goals of drug therapy in the treatment of PUD (multiple answers)?

    • Provide pain relief

    • Prevent recurrence

    • Heal ulcerations

    • Eradicate H. pylori infection

    Correct Answer(s)
    A. Provide pain relief
    A. Prevent recurrence
    A. Heal ulcerations
    A. Eradicate H. pylori infection
    Explanation
    All are goals

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  • 36. 

    Which of the following isn't a complication of peptic ulcer disease?

    • Perforation

    • GI bleeding

    • Pyloric obstruction

    • Pain

    Correct Answer
    A. Pain
    Explanation
    Pain is a symptom of PUD, not a complication

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  • 37. 

    A 28-year-old client is admitted with inflammatory bowel syndrome (Crohn's disease). Which therapies should the nurse expect to be part of the care plan? Check all that apply 

    • Lactulose therapy

    • High-fiber diet

    • High-protein milkshakes

    • Corticosteroid therapy

    • Antidiarrheal medications

    Correct Answer(s)
    A. Corticosteroid therapy
    A. Antidiarrheal medications
    Explanation
    Corticosteroids, such as prednisone, reduce the signs and symptoms of diarrhea, pain, and bleeding by decreasing inflammation. Antidiarrheals, such as diphenoxylate (Lomotil), combat diarrhea by decreasing peristalsis.

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Allison Martin |BSN |
School Nurse
Allison Martin holds a Bachelor of Science in Nursing (BSN) from Drexel University's College of Nursing and Health Professions, specializing in neuroscience and cardiac care. She is dedicated to providing high-quality care and support to the school community as a School Nurse at St. Bernard's School, drawing on over 20 years of invaluable nursing experience.

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  • Mar 07, 2024
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    Expert Reviewed by
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  • Dec 01, 2008
    Quiz Created by
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