NCLEX Gastrointestinal Practice Questions

15 free NCLEX-RN gastrointestinal questions with answers and rationales — perfect for gastrointestinal nclex questions practice. Want them as an interactive timed quiz?

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1. A 55-year-old patient with a history of cirrhosis presents with confusion, lethargy, and asterixis. What is the priority nursing action?
- A. Administer lactulose as prescribed. ✓
- B. Encourage a high-protein diet.
- C. Restrict fluid intake to 1,500 mL per day.
- D. Prepare the patient for a paracentesis.
Answer: A. Administer lactulose as prescribed. — Lactulose is used to reduce ammonia levels in the blood, which can cause hepatic encephalopathy in patients with cirrhosis.
2. A patient with pancreatitis reports severe abdominal pain radiating to the back. Which medication should the nurse anticipate administering for pain management?
- A. Ibuprofen
- B. Acetaminophen
- C. Morphine ✓
- D. Aspirin
Answer: C. Morphine — Morphine is an opioid analgesic commonly used to manage severe pain associated with pancreatitis.
3. A patient is admitted with upper GI bleeding. Which finding is most indicative of hypovolemic shock?
- A. Tachycardia and hypotension ✓
- B. Bradycardia and hypertension
- C. Jugular vein distention
- D. Polyuria
Answer: A. Tachycardia and hypotension — Tachycardia and hypotension are classic signs of hypovolemic shock due to decreased circulating blood volume.
4. A patient with Crohn's disease is receiving total parenteral nutrition (TPN). What is the most important nursing action?
- A. Monitor blood glucose levels regularly. ✓
- B. Change the TPN solution every 48 hours.
- C. Use a clean technique for TPN administration.
- D. Administer TPN through a peripheral IV line.
Answer: A. Monitor blood glucose levels regularly. — Regular monitoring of blood glucose levels is crucial because TPN can cause hyperglycemia due to its high glucose content.
5. After insertion of a nasogastric (NG) tube, the nurse needs to verify its placement. What is the best method to confirm correct placement?
- A. Auscultate air insufflation over the abdomen.
- B. Check the pH of aspirated gastric contents. ✓
- C. Ask the patient to speak and assess for hoarseness.
- D. Secure the tube and wait for a chest X-ray.
Answer: B. Check the pH of aspirated gastric contents. — Checking the pH of gastric contents is a reliable bedside method to confirm NG tube placement; a pH of 4 or less indicates gastric placement.
6. A patient with peptic ulcer disease is being discharged. Which instruction is most important to include in the teaching plan?
- A. Avoid NSAIDs and aspirin. ✓
- B. Increase intake of spicy foods.
- C. Limit fluid intake to 1 liter per day.
- D. Consume a diet high in dairy products.
Answer: A. Avoid NSAIDs and aspirin. — NSAIDs and aspirin can exacerbate peptic ulcer disease by further irritating the gastric mucosa.
7. A patient with ulcerative colitis is experiencing severe diarrhea. What dietary recommendation should the nurse provide?
- A. Increase fiber intake to bulk stools.
- B. Follow a low-residue, low-fiber diet. ✓
- C. Consume a high-fat diet.
- D. Adopt a ketogenic diet.
Answer: B. Follow a low-residue, low-fiber diet. — A low-residue, low-fiber diet can help reduce the frequency of stools in patients with ulcerative colitis.
8. A patient with a colostomy asks about the best way to prevent skin irritation around the stoma. What should the nurse recommend?
- A. Change the ostomy appliance every 7 days.
- B. Use soap and water to clean the stoma and surrounding skin.
- C. Apply a skin barrier around the stoma. ✓
- D. Avoid using any products around the stoma.
Answer: C. Apply a skin barrier around the stoma. — A skin barrier helps protect the skin from the digestive enzymes in the ostomy output, preventing irritation.
9. A patient with liver failure presents with jaundice and ascites. What is the priority nursing intervention?
- A. Administer diuretics as ordered. ✓
- B. Restrict sodium intake.
- C. Encourage high-protein foods.
- D. Prepare for liver biopsy.
Answer: A. Administer diuretics as ordered. — Diuretics help reduce fluid accumulation in ascites, providing symptomatic relief in liver failure.
10. A patient with a history of peptic ulcer disease presents with sudden, severe abdominal pain and a rigid abdomen. What is the nurse's priority action?
- A. Administer pain medication.
- B. Prepare the patient for emergency surgery. ✓
- C. Insert an NG tube.
- D. Place the patient in a high Fowler's position.
Answer: B. Prepare the patient for emergency surgery. — Sudden, severe abdominal pain and a rigid abdomen suggest perforation, a surgical emergency in peptic ulcer disease.
11. A patient with pancreatitis is on NPO status. The patient asks why they can't have anything to eat or drink. What is the nurse's best response?
- A. Eating will help relieve your pain.
- B. Fasting allows the pancreas to rest and heal. ✓
- C. Liquids are allowed, but solids are not.
- D. NPO status is temporary until surgery is done.
Answer: B. Fasting allows the pancreas to rest and heal. — Keeping the patient NPO reduces pancreatic stimulation and enzyme secretion, promoting healing.
12. A patient receiving TPN reports excessive thirst and frequent urination. Which complication should the nurse suspect?
- A. Infection
- B. Electrolyte imbalance
- C. Hyperglycemia ✓
- D. Dehydration
Answer: C. Hyperglycemia — Excessive thirst and frequent urination are signs of hyperglycemia, a common complication of TPN due to its high glucose content.
13. A nurse is caring for a patient with an ileostomy. Which observation requires immediate intervention?
- A. The stoma is pink and moist.
- B. The stoma output is 600 mL per day.
- C. The skin around the stoma is red and excoriated. ✓
- D. The appliance is emptied when one-third full.
Answer: C. The skin around the stoma is red and excoriated. — Red and excoriated skin around the stoma may indicate leakage of digestive enzymes causing irritation, requiring immediate intervention to prevent further damage.
14. A patient with liver cirrhosis is prescribed a low-sodium diet. Which menu choice indicates a need for further teaching?
- A. Grilled chicken with steamed vegetables
- B. Baked potato with sour cream
- C. Canned soup and crackers ✓
- D. Fresh fruit salad
Answer: C. Canned soup and crackers — Canned soups and crackers are typically high in sodium, which should be avoided in patients with cirrhosis on a low-sodium diet.
15. A patient with ulcerative colitis is prescribed mesalamine. What is the primary purpose of this medication?
- A. To relieve abdominal pain
- B. To reduce inflammation in the colon ✓
- C. To prevent dehydration
- D. To promote bowel rest
Answer: B. To reduce inflammation in the colon — Mesalamine is an anti-inflammatory drug used to reduce inflammation in the colon in patients with ulcerative colitis.

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