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UPPER GI EXAM 2025 LATEST QUESTIONS AND CORRECT
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During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia? a. vitamin A
b. vitamin D
c. vitamin E
d. vitamin K - CORRECT ANSWER 1. Answer D. Intestinal bacteria
synthesize such nutritional substances as vitamin K, thiamine, riboflavin, vitamin B12, folic acid, biotin, and nicotinic acid. Therefore, antibiotic therapy may interfere with synthesis of these substances, including vitamin K. Intestinal bacteria don't synthesize vitamins A, D, or E. The nurse is caring for a client who asks why his stools are the color of tar. The nurse responds that "Tarry stools indicates: - CORRECT ANSWER an upper or lower gastrointestinal bleed." A patient is just returning from the endoscopy suite after having an EGD (esophagogastroduodenoscopy). She asks the nurse for a glass of water. The best response by the nurse is: - CORRECT ANSWER "Let me check your throat to see if your gag reflex has come back."
- What laboratory finding is the primary diagnostic indicator for pancreatitis?
a. Elevated blood urea nitrogen (BUN)
b. Elevated serum lipase
c. Elevated aspartate aminotransferase (AST)
d. Increased lactate dehydrogenase (LD) - CORRECT
ANSWER 1) B
- Elevation of serum lipase is the most reliable indicator of pancreatitis because this enzyme is produced solely by the pancreas. A client's BUN is typically elevated in relation to renal dysfunction; the AST, in relation to liver dysfunction; and LD, in relation to damaged cardiac muscle.
- When evaluating a client for complications of acute pancreatitis, the nurse would observe for: a. increased intracranial pressure. b. decreased urine output. c. bradycardia. d. hypertension. - CORRECT ANSWER 2) B
- Acute pancreatitis can cause decreased urine output, which results from the renal failure that sometimes accompanies this condition. Intracranial pressure neither increases nor decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with pulmonary or hypovolemic complications of pancreatitis. Hypotension can be caused by a
ANSWER 4) D
- A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for adequate hydration, reduces the amount of bulk ingested with meals, and aids in the prevention of rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals.
- Why are antacids administered regularly, rather than as needed, to treat peptic ulcer disease?
a. To keep gastric pH at 3.0 to 3.
b. To promote client compliance
c. To maintain a regular bowel pattern
d. To increase pepsin activity - CORRECT ANSWER
5) A
- To maintain a gastric pH of 3.0 to 3.5 throughout each 24-hour period, regular (not as needed) doses of an antacid are needed to treat peptic ulcer disease. Frequent administration of an antacid tends to decrease client compliance. Antacids don't regulate bowel patterns, and they decrease pepsin activity.
- 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 of the following is one such factor?
a. Increased intestinal motility
b. Decreased abdominal strength
c. Increased intestinal bacteria
d. Decreased production of hydrochloric acid -
CORRECT ANSWER 6) B
- Decreased abdominal strength, muscle tone of the intestinal wall, and motility all contribute to chronic constipation in the elderly. A decrease in hydrochloric acid causes a decrease in absorption of iron and B12, while an increase in intestinal bacteria actually causes diarrhea.
- The nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?
a. Kussmaul's respirations
b. Increased urine output
c. Decreased appetite
d. Diaphoresis - CORRECT ANSWER 7) B
- Glucose supplies most of the calories in TPN; if the glucose infusion rate exceeds the client's rate of glucose metabolism, hyperglycemia arises. When the renal threshold for glucose reabsorption is exceeded,
a. "Eat a low-residue diet for 2 days before the test."
b. "Eat a clear liquid diet for 2 days before the test."
c. "Take a potent laxative the day before the test."
d. "Avoid eating or drinking anything for 6 to 8 hours before the test."
- CORRECT ANSWER 9) D - The client must refrain from eating or drinking for 6 to 8 hours before an upper GI series. No other preparation is needed. Before a lower GI series, the client should eat a low-residue or clear liquid diet for 2 days and take a potent laxative (along with an oral liquid preparation).
- A client with mild diarrhea, fever, and abdominal discomfort is being evaluated for inflammatory bowel disease (IBD). Which statement about IBD is true?
a. Diarrhea is the most common sign of IBD.
b. Transmural inflammation with fistula formation occurs in ulcerative
colitis, one form of IBD.
c. Abscesses may occur in IBD as poor nutrition causes breakdown of
cells in the GI tract.
d. Bowel cancer is common in clients with a history of
Crohn's disease, one form of IBD. - CORRECT ANSWER 10) A
- IBD is a collective term for several GI inflammatory diseases with unknown causes. The most prominent sign of IBD is mild diarrhea, which sometimes is accompanied by fever and abdominal discomfort.
The pathophysiology of ulcerative colitis involves vascular congestion, hemorrhage, and edema — usually affecting the rectum and left colon. Although abscesses may occur in IBD, they result from buildup of lymphocytes and cellular debris in crypts, which may serve as abscess sites. Only about 3% of clients with a long history of Crohn's disease develop bowel cancer. When evaluating a male client for complications of acute pancreatitis, the nurse would observe for: a. increased intracranial pressure.
b. decreased urine output.
c. bradycardia.
d. hypertension. - CORRECT ANSWER 2. Answer B. Acute pancreatitis
can cause decreased urine output, which results from the renal failure that sometimes accompanies this condition. Intracranial pressure neither increases nor decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with pulmonary or hypovolemic complications of pancreatitis. Hypotension can be caused by a hypovolemic complication, but hypertension usually isn't related to acute pancreatitis. A male 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?
a. Lying on the right side with legs straight
b. Lying on the left side with knees bent
Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?
a. Change the tube feeding solutions and tubing at least every 24
hours.
b. Maintain the head of the bed at a 15-degree elevation
continuously.
c. Check the gastrostomy tube for position every 2 days.
d. Maintain the client on bed rest during the feedings. - CORRECT
ANSWER 5. Answer A. Tube feeding solutions and tubing should be changed every 24 hours, or more frequently if the feeding requires it. Doing so prevents contamination and bacterial growth. The head of the bed should be elevated 30 to 45 degrees continuously to prevent aspiration. Checking for gastrostomy tube placement is performed before initiating the feedings and every 4 hours during continuous feedings. Clients may ambulate during feedings. A male client is recovering from a small-bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine's onset of action occur?
a. 5 to 10 minutes
b. 15 to 30 minutes
c. 30 to 60 minutes
d. 2 to 4 hours - CORRECT ANSWER 6. Answer B. Meperidine's onset
of action is 15 to 30 minutes. It peaks between 30 and 60 minutes and has a duration of action of 2 to 4 hours.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura and petechiae
d. Gynecomastia and testicular atrophy - CORRECT ANSWER 7.
Answer C. A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from decreased estrogen metabolism by the diseased liver. Which condition is most likely to have a nursing diagnosis of fluid volume deficit? a. Appendicitis
b. Pancreatitis
c. Cholecystitis
d. Gastric ulcer - CORRECT ANSWER 8. Answer B. Hypovolemic shock
from fluid shifts is a major factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume deficit. While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach
a. meperidine provides a better, more prolonged analgesic effect.
b. morphine may cause spasms of Oddi's sphincter.
c. meperidine is less addictive than morphine.
d. morphine may cause hepatic dysfunction. - CORRECT ANSWER 10.
Answer B. For a client with pancreatitis, the physician will probably avoid prescribing morphine because this drug may trigger spasms of the sphincter of Oddi (a sphincter at the end of the pancreatic duct), causing irritation of the pancreas. Meperidine has a somewhat shorter duration of action than morphine. The two drugs are equally addictive. Morphine isn't associated with hepatic dysfunction. Mandy, an adolescent girl is admitted to an acute care facility with severe malnutrition. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the plan of care for this client, the nurse is most likely to include which nursing diagnosis? a. Hopelessness
b. Powerlessness
c. Chronic low self esteem
d. Deficient knowledge - CORRECT ANSWER 11. Answer C. Young
women with Chronic low self esteem — are at highest risk for anorexia nervosa because they perceive being thin as a way to improve their self-confidence. Hopelessness and Powerlessness are inappropriate nursing diagnoses because clients with anorexia nervosa seldom feel hopeless or powerless; instead, they
use food to control their desire to be thin and hope that restricting food intake will achieve this goal. Anorexia nervosa doesn't result from a knowledge deficit, such as one regarding good nutrition. Which diagnostic test would be used first to evaluate a client with upper GI bleeding? a. Endoscopy
b. Upper GI series
c. Hemoglobin (Hb) levels and hematocrit (HCT)
d. Arteriography - CORRECT ANSWER 12. Answer A. Endoscopy
permits direct evaluation of the upper GI tract and can detect 90% of bleeding lesions. An upper GI series, or barium study, usually isn't the diagnostic method of choice, especially in a client with acute active bleeding who's vomiting and unstable. An upper GI series is also less accurate than endoscopy. Although an upper GI series might confirm the presence of a lesion, it wouldn't necessarily reveal whether the lesion is bleeding. Hb levels and HCT, which indicate loss of blood volume, aren't always reliable indicators of GI bleeding because a decrease in these values may not be seen for several hours. Arteriography is an invasive study associated with life-threatening complications and wouldn't be used for an initial evaluation. A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response?
a. "You may have eaten contaminated restaurant food."
inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in the appendix and compressing venous outflow drainage. The pressure continues to rise with venous obstruction; arterial blood flow then decreases, leading to ischemia from lack of perfusion. Inflammation and bacterial growth follow, and swelling continues to raise pressure within the appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially susceptible to appendix rupture. A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are: a. whole blood and albumin.
b. platelets and packed red blood cells.
c. fresh frozen plasma and whole blood.
d. cryoprecipitate and fresh frozen plasma. - CORRECT ANSWER 15.
Answer D. The liver is vital in the synthesis of clotting factors, so when it's diseased or dysfunctional, as in hepatitis C, bleeding occurs. Treatment consists of administering blood products that aid clotting. These include fresh frozen plasma containing fibrinogen and cryoprecipitate, which have most of the clotting factors. Although administering whole blood, albumin, and packed cells will contribute to hemostasis, those products aren't specifically used to treat hemostasis. Platelets are helpful, but the best answer is cryoprecipitate and fresh frozen plasma. To prevent gastroesophageal reflux in a male client with hiatal hernia, the nurse should provide which discharge instruction?
a. "Lie down after meals to promote digestion."
b. "Avoid coffee and alcoholic beverages."
c. "Take antacids with meals."
d. "Limit fluid intake with meals." - CORRECT ANSWER 16. Answer B.
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. The nurse also should teach the client to avoid lying down after meals, which can aggravate reflux, and to take antacids after eating. The client need not limit fluid intake with meals as long as the fluids aren't gastric irritants. The nurse caring for a client with small-bowel obstruction would plan to implement which nursing intervention first?
a. Administering pain medication
b. Obtaining a blood sample for laboratory studies
c. Preparing to insert a nasogastric (NG) tube
d. Administering I.V. fluids - CORRECT ANSWER 17. Answer D. I.V.
infusions containing normal saline solution and potassium should be given first to maintain fluid and electrolyte balance. For the client's comfort and to assist in bowel decompression, the nurse should prepare to insert an NG tube next. A blood sample is then obtained for laboratory studies to aid in the diagnosis of bowel obstruction and guide treatment. Blood studies usually include a complete blood count, serum electrolyte levels, and blood urea nitrogen level. Pain medication often is withheld until obstruction is diagnosed because analgesics can decrease intestinal motility.
What laboratory finding is the primary diagnostic indicator for pancreatitis?
a. Elevated blood urea nitrogen (BUN)
b. Elevated serum lipase
c. Elevated aspartate aminotransferase (AST)
d. Increased lactate dehydrogenase (LD) - CORRECT ANSWER 20.
Answer B. Elevation of serum lipase is the most reliable indicator of pancreatitis because this enzyme is produced solely by the pancreas. A client's BUN is typically elevated in relation to renal dysfunction; the AST, in relation to liver dysfunction; and LD, in relation to damaged cardiac muscle. A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: a. yellow sclerae.
b. light amber urine.
c. circumoral pallor.
d. black, tarry stools. - CORRECT ANSWER 21. Answer A. Yellow
sclerae may be the first sign of jaundice, which occurs when the common bile duct is obstructed. Urine normally is light amber. Circumoral pallor and black, tarry stools don't occur in common bile duct obstruction; they are signs of hypoxia and GI bleeding, respectively.
Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a. a sedentary lifestyle and smoking.
b. a history of hemorrhoids and smoking.
c. alcohol abuse and a history of acute renal failure.
d. alcohol abuse and smoking. - CORRECT ANSWER 22. Answer D. Risk
factors for peptic (gastric and duodenal) ulcers include alcohol abuse, smoking, and stress. A sedentary lifestyle and a history of hemorrhoids aren't risk factors for peptic ulcers. Chronic renal failure, not acute renal failure, is associated with duodenal ulcers. While palpating a female client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures? a. Sigmoid colon
b. Appendix
c. Spleen
d. Liver - CORRECT ANSWER 23. Answer D. The RUQ contains the
liver, gallbladder, duodenum, head of the pancreas, hepatic flexure of the colon, portions of the ascending and transverse colon, and a portion of the right kidney. The sigmoid colon is located in the left lower quadrant; the appendix, in the right lower quadrant; and the spleen, in the left upper quadrant. A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to: a. call the physician.
