Topic: (EASY) Chapter 38 Gastrointestinal Tract

Function
Question 1
A patient reports difficulty chewing due to missing teeth. Which nursing intervention best supports adequate
nutrition?
A. Encourage liquid supplements only
B. Provide soft, easy-to-chew foods
C. Restrict oral intake until dentures are available
D. Offer high-fiber raw vegetables

Question 2
During assessment, a nurse notes that a patient has decreased saliva production. Which complication is most likely?
A. Increased risk of aspiration
B. Enhanced digestion of starches
C. Decreased gastric acid secretion
D. Increased intestinal motility

Question 3
A patient with impaired esophageal motility is at greatest risk for:
A. Constipation
B. Aspiration pneumonia
C. Peptic ulcer disease
D. Hemorrhoids

Question 4
The nurse explains to a patient that the stomach’s primary role in digestion is:
A. Absorption of most nutrients
B. Mechanical breakdown and protein digestion
C. Storage of bile and pancreatic enzymes
D. Neutralization of acidic chyme

Question 5
A patient with reduced gastric acid secretion may experience difficulty absorbing:
A. Vitamin B12
B. Vitamin C
C. Vitamin D
D. Vitamin K

Question 6
A patient reports bloating and excessive gas. Which GI function is most likely impaired?
A. Gastric emptying
B. Small intestine absorption
C. Large intestine water reabsorption
D. Bacterial fermentation

Question 7
The nurse recognizes that the small intestine is the primary site for:
A. Water absorption
B. Protein digestion only
C. Nutrient absorption
D. Vitamin storage

Question 8
A patient with ileal resection is most at risk for deficiency of:
A. Vitamin B12 and bile salts
B. Vitamin C and calcium
C. Vitamin D and phosphorus
D. Vitamin K and folate

Question 9
A patient with impaired peristalsis in the large intestine is most likely to develop:
A. Diarrhea
B. Constipation
C. Malabsorption syndrome
D. Gastric reflux

Question 10
The nurse explains that the liver contributes to digestion by:
A. Producing digestive enzymes
B. Secreting bile for fat emulsification
C. Absorbing glucose directly from chyme
D. Neutralizing gastric acid

Question 11
A patient with gallbladder removal may have difficulty digesting:
A. Carbohydrates
B. Proteins
C. Fats
D. Vitamins

Question 12
The pancreas aids digestion primarily by:
A. Producing bile salts
B. Secreting enzymes for carbohydrates, proteins, and fats
C. Absorbing nutrients directly
D. Neutralizing toxins

Question 13
A patient with impaired intestinal villi function is most likely to experience:
A. Malabsorption
B. Constipation
C. Gastric reflux
D. Hemorrhoids

Question 14
The nurse explains that the large intestine’s main role is:
A. Protein digestion
B. Water and electrolyte absorption
C. Vitamin B12 absorption
D. Fat emulsification

Question 15
A patient with decreased intestinal motility after surgery is at risk for:
A. Diarrhea
B. Constipation and ileus
C. Malabsorption
D. Peptic ulcer disease
Answer Key + Rationales
Q# Correct Answer Rationale
1 B Soft foods reduce
chewing dif culty
and maintain
nutrition.
2 A Saliva lubricates
food; decreased
saliva increases
aspiration risk.
3 B Impaired
esophageal motility
aspiration risk
due to poor
swallowing.
4 B Stomach mixes
food and begins
protein digestion
5 A via pepsin.
Gastric acid is
needed for intrinsic
factor Vitamin
B12 absorption.
6 D Gas/bloating often
due to impaired
bacterial
fermentation in
colon.
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 7 C Small intestine is
the main site for
nutrient
8 A absorption.
Ileum absorbs bile
salts and Vitamin
B12; resection
causes de ciency.
9 B Impaired
peristalsis stool
retention
10 B Liver secretes bile
to emulsify fats for
digestion.
11 C Gallbladder stores
bile; removal fat
digestion dif culty.
12 B Pancreas secretes
enzymes
(amylase, lipase,
proteases) for
13 A digestion.
Damaged villi
impair absorption
malabsorption
syndromes.
14 B Large intestine
absorbs water/
electrolytes, forms
stool.
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 15 B Post-op decreased
motility
constipation/ileus
common.

Question 16
A patient reports frequent heartburn after meals. Which nursing teaching is most appropriate?
A. Lie down immediately after eating
B. Avoid spicy and fatty foods
C. Drink large amounts of fluid with meals
D. Increase caffeine intake

Question 17
A patient with prolonged vomiting is most at risk for:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Question 18
The nurse explains that bile salts are essential for:
A. Protein digestion
B. Fat emulsification
C. Carbohydrate absorption
D. Vitamin C metabolism

Question 19
A patient with impaired gastric emptying is most likely to complain of:
A. Early satiety and nausea
B. Constipation
C. Hemorrhoids
D. Rectal bleeding

Question 20
A patient with chronic diarrhea is at risk for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia

Question 21
The nurse explains that the appendix is located at the junction of:
A. Stomach and duodenum
B. Small intestine and large intestine
C. Esophagus and stomach
D. Rectum and anus

Question 22
A patient with impaired lower esophageal sphincter function is most likely to develop:
A. GERD
B. Peptic ulcer disease
C. Constipation
D. Gallstones
Question 23
A patient with decreased pancreatic enzyme secretion is most likely to experience:
A. Fat malabsorption
B. Vitamin B12 deficiency
C. Constipation
D. Gastric reflux

Question 24
The nurse explains that peristalsis is controlled primarily by:
A. Autonomic nervous system
B. Somatic nervous system
C. Voluntary skeletal muscle
D. Endocrine glands only

Question 25
A patient with impaired intestinal absorption of fat is most likely to develop deficiency of:
A. Vitamin B12
B. Vitamin C
C. Vitamin D
D. Vitamin B6

Question 26
A patient with liver dysfunction may develop impaired absorption of:
A. Fat-soluble vitamins
B. Water-soluble vitamins
C. Carbohydrates
D. Proteins

Question 27
The nurse explains that the rectum’s primary role is:
A. Absorption of nutrients
B. Storage of feces before elimination
C. Digestion of proteins
D. Secretion of bile

Question 28
A patient with impaired swallowing (dysphagia) is at greatest risk for:
A. Aspiration
B. Constipation
C. Gastric reflux
D. Hemorrhoids

Question 29
The nurse explains that hydrochloric acid in the stomach is essential for:
A. Neutralizing chyme
B. Activating pepsinogen to pepsin
C. Absorbing carbohydrates
D. Producing bile salts

Question 30
A patient with impaired intestinal motility leading to diarrhea is at risk for:
A. Fluid and electrolyte imbalance
B. Vitamin B12 deficiency only
C. Gastric reflux
D. Constipation
 Answer Key + Rationales
Q# Correct Answer Rationale
16 B Spicy/fatty foods
worsen re ux;
lifestyle
modi cation is key.
17 B Vomiting causes
loss of gastric acid
metabolic
alkalosis.
18 B Bile salts emulsify
fats for digestion/
absorption.
19 A Delayed emptying
early satiety,
nausea, bloating.
20 B Diarrhea
potassium loss
hypokalemia.
21 B Appendix lies at
cecum (small–
large intestine
junction).
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 22 A Weak LES
GERD due to
re ux of gastric
23 A contents.
Pancreatic
enzymes digest
fats; de ciency
steatorrhea.
24 A Peristalsis is
autonomic, not
voluntary.
25 C Fat malabsorption
de ciency of fat-
soluble vitamins
(A, D, E, K).
26 A Liver dysfunction
impairs bile fat-
soluble vitamin
absorption.
27 B Rectum stores
feces until
28 A defecation.
Dysphagia
aspiration risk.
29 B HCl activates
pepsinogen
pepsin for protein
digestion.
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 30 A Diarrhea
dehydration,
electrolyte
imbalance.

Question 31
A patient with decreased gastric motility is most likely to experience:
A. Early satiety
B. Constipation
C. Hemorrhoids
D. Rectal bleeding

Question 32
The nurse explains that the duodenum receives digestive secretions from:
A. Liver and pancreas
B. Stomach only
C. Large intestine
D. Gallbladder only

Question 33
A patient with impaired bile secretion is most likely to develop:
A. Fat malabsorption
B. Protein deficiency
C. Carbohydrate intolerance
D. Vitamin B12 deficiency

Question 34
The nurse explains that the stomach lining is protected from acid by:
A. Bile salts
B. Mucus secretion
C. Pancreatic enzymes
D. Peristalsis

Question 35
A patient with impaired intestinal absorption of calcium is at risk for:
A. Osteoporosis
B. Anemia
C. Constipation
D. GERD

Question 36
The nurse explains that the pyloric sphincter regulates:
A. Entry of food into esophagus
B. Passage of chyme into duodenum
C. Secretion of bile into stomach
D. Absorption of nutrients in jejunum

Question 37
A patient with impaired gastric mucosa may develop deficiency of:
A. Intrinsic factor and Vitamin B12
B. Vitamin C
C. Vitamin D
D. Vitamin K

Question 38
The nurse explains that the jejunum is primarily responsible for:
A. Water absorption
B. Nutrient absorption
C. Bile storage
D. Protein digestion only

Question 39
A patient with impaired intestinal motility leading to prolonged transit time is most likely to develop:
A. Constipation
B. Diarrhea
C. Malabsorption
D. GERD

Question 40
The nurse explains that the colon’s bacterial flora contributes to:
A. Vitamin K synthesis
B. Protein digestion
C. Carbohydrate absorption
D. Bile salt production

Question 41
A patient with impaired gastric acid secretion may have difficulty digesting:
A. Proteins
B. Carbohydrates
C. Fats
D. Water

Question 42
The nurse explains that the ileocecal valve prevents:
A. Reflux of colonic contents into small intestine
B. Gastric acid secretion
C. Bile storage in gallbladder
D. Pancreatic enzyme release

Question 43
A patient with impaired liver function may develop:
A. Jaundice and fat malabsorption
B. Constipation only
C. GERD
D. Vitamin C deficiency

Question 44
The nurse explains that the esophagus transports food by:
A. Peristalsis
B. Active absorption
C. Enzyme secretion
D. Diffusion
Question 45
A patient with impaired intestinal absorption of iron is most likely to develop:
A. Anemia
B. Osteoporosis
C. Constipation
D. GERD

Question 46
The nurse explains that the gallbladder’s primary role is:
A. Storage and release of bile
B. Production of digestive enzymes
C. Absorption of nutrients
D. Neutralization of gastric acid

Question 47
A patient with impaired intestinal absorption of folate is most likely to develop:
A. Megaloblastic anemia
B. Osteoporosis
C. Constipation
D. GERD

Question 48
The nurse explains that the rectal sphincters control:
A. Defecation
B. Gastric emptying
C. Bile secretion
D. Pancreatic enzyme release

Question 49
A patient with impaired intestinal absorption of water is most likely to develop:
A. Diarrhea
B. Constipation
C. GERD
D. Hemorrhoids

Question 50
The nurse explains that the stomach’s parietal cells secrete:
A. Hydrochloric acid and intrinsic factor
B. Pepsinogen
C. Bile salts
D. Pancreatic enzymes
 Answer Key + Rationales
Q# Correct Answer Rationale
31 A Delayed gastric
emptying early
satiety.
32 A Duodenum
receives bile (liver/
gallbladder) +
enzymes
(pancreas).
33 A Bile needed for fat
digestion
de ciency causes
steatorrhea.
34 B Mucus protects
stomach lining
from acid.
35 A Calcium
malabsorption
osteoporosis risk.
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 36 B Pyloric sphincter
regulates chyme
passage into
duodenum.
37 A Parietal cells
intrinsic factor
Vitamin B12
absorption.
38 B Jejunum absorbs
most nutrients.
39 A Slow transit
stool retention
constipation.
40 A Colon ora
synthesize Vitamin
K.
41 A Acid activates
pepsin protein
digestion.
42 A Ileocecal valve
prevents re ux of
colonic contents.
43 A Liver dysfunction
bile impairment
jaundice, fat
malabsorption.
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 44 A Esophagus uses
peristalsis to move
food.
45 A Iron absorption
impaired
46 A Gallbladder stores/
releases bile.
47 A Folate de ciency
megaloblastic
anemia.
48 A Rectal sphincters
regulate
49 A defecation.
Poor water
absorption
diarrhea.
50 A Parietal cells
secrete HCl +
intrinsic factor.
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 Topic: (HARD) Chapter 38 Gastrointestinal Tract
Function

Question 51
A 65-year-old patient with chronic GERD presents with hoarseness and frequent coughing at night.
Which complication should the nurse suspect?
A. Aspiration pneumonia
B. Barrett’s esophagus
C. Peptic ulcer disease
D. Gallstones

Question 52
A patient with partial gastrectomy reports fatigue and pallor. Lab results show macrocytic anemia. Which
de ciency is most likely?
A. Vitamin C
B. Vitamin B12
C. Iron
D. Folate

Question 53
A patient with cirrhosis develops ascites. Which mechanism best explains this nding?
A. Increased bile secretion
B. Portal hypertension and hypoalbuminemia
C. Excess gastric acid secretion
D. Pancreatic enzyme de ciency

Question 54
A patient with ileal resection presents with chronic diarrhea and weight loss. Which nursing intervention
is most appropriate?
A. Encourage high-fat diet
B. Administer bile salt replacement therapy
C. Restrict oral uids
D. Provide high- ber diet
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 Question 55
A patient with pancreatitis develops steatorrhea. Which nursing teaching is most appropriate?
A. Increase intake of fatty foods
B. Supplement with pancreatic enzymes
C. Restrict carbohydrate intake
D. Encourage high-protein diet only

Question 56
A patient with esophageal varices suddenly vomits blood. What is the nurse’s priority action?
A. Administer antiemetics
B. Maintain airway and initiate IV access
C. Provide oral uids
D. Encourage ambulation

Question 57
A patient with chronic liver disease presents with confusion and asterixis ( apping tremor). Which
complication is most likely?
A. Hepatic encephalopathy
B. Peptic ulcer disease
C. GERD
D. Pancreatitis

Question 58
A patient with prolonged diarrhea develops muscle weakness and irregular heart rhythm. Which
electrolyte imbalance is most likely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia

Question 59
A patient with gastric ulcer reports sharp epigastric pain that worsens after meals. Which nursing
intervention is most appropriate?
A. Encourage frequent small meals
B. Administer proton pump inhibitor
C. Provide high-fat diet
D. Restrict oral uids

Question 60
A patient with Crohn’s disease presents with weight loss and anemia. Which complication explains these
ndings?
A. Malabsorption due to small intestine in ammation
B. Constipation due to colonic stricture
C. GERD due to esophageal involvement
D. Vitamin K de ciency due to bile salt loss

Question 61
A patient with gallstones presents with right upper quadrant pain radiating to the shoulder after eating
fatty meals. Which nursing intervention is most appropriate?
A. Encourage high-fat diet
B. Administer analgesics and monitor for jaundice
C. Provide iron supplements
D. Restrict oral uids
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 Question 62
A patient with acute pancreatitis develops severe abdominal pain radiating to the back. Which nursing
intervention is most appropriate?
A. Place patient NPO and administer IV uids
B. Encourage oral intake of clear liquids
C. Provide high-fat diet
D. Administer laxatives

Question 63
A patient with chronic constipation reports straining during bowel movements. Which complication is
most likely?
A. Hemorrhoids
B. GERD
C. Peptic ulcer disease
D. Pancreatitis

Question 64
A patient with liver cirrhosis develops easy bruising and prolonged bleeding time. Which de ciency
explains this nding?
A. Vitamin C
B. Vitamin K
C. Vitamin B12
D. Iron

Question 65
A patient with small bowel obstruction presents with abdominal distension, vomiting, and absent bowel
sounds. What is the nurse’s priority action?
A. Insert nasogastric tube for decompression
B. Encourage ambulation
C. Provide oral uids
D. Administer laxatives
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 Answer Key + Rationales
Q# Correct Answer Rationale
51 B Chronic GERD Barrett’s
esophagus, precancerous
complication.
52 B Partial gastrectomy loss of
intrinsic factor Vitamin B12
de ciency macrocytic
anemia.
53 B Cirrhosis portal
hypertension + low albumin
ascites.
54 B Ileum absorbs bile salts
resection de ciency bile
salt replacement needed.
55 B Pancreatitis enzyme
de ciency steatorrhea
enzyme supplementation.
56 B Esophageal varices bleed
airway + IV access priority.
57 A Confusion + asterixis
hepatic encephalopathy due
to ammonia accumulation.
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 58 B Diarrhea potassium loss
hypokalemia arrhythmias,
weakness.
59 B PPI reduces acid, promotes
healing of gastric ulcer.
60 A Crohn’s small intestine
in ammation
malabsorption anemia,
weight loss.
61 B Gallstones RUQ pain
analgesics + monitor for
jaundice.
62 A Acute pancreatitis NPO +
IV uids to rest pancreas.
63 A Straining hemorrhoids
common complication.
64 B Liver dysfunction impaired
bile Vitamin K de ciency
bleeding tendency.
65 A SBO NG tube
decompression priority to
relieve distension/vomiting.
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 Question 66
A patient with acute upper GI bleeding presents with melena and hypotension. What is the nurse’s
priority?
A. Administer oral uids
B. Maintain airway and initiate IV uids
C. Provide antiemetics
D. Encourage ambulation

Question 67
A patient with chronic alcohol use presents with epigastric pain and elevated serum amylase. Which
condition is most likely?
A. Acute pancreatitis
B. Peptic ulcer disease
C. GERD
D. Gallstones

Question 68
A patient with cirrhosis develops spider angiomas and palmar erythema. Which underlying mechanism
explains these ndings?
A. Increased estrogen due to impaired liver metabolism
B. Vitamin C de ciency
C. Portal hypertension only
D. Pancreatic enzyme de ciency

Question 69
A patient with gastric cancer undergoes partial gastrectomy. Postoperatively, the nurse monitors for
dumping syndrome. Which symptom is most characteristic?
A. Bradycardia and constipation
B. Dizziness, tachycardia, and diarrhea after meals
C. Hematemesis and melena
D. Jaundice and ascites

Question 70
A patient with ulcerative colitis presents with bloody diarrhea and abdominal pain. Which complication is
most concerning?
A. Toxic megacolon
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 B. GERD
C. Pancreatitis
D. Gallstones

Question 71
A patient with esophageal cancer reports progressive dysphagia. Which nursing intervention is most
appropriate?
A. Encourage high- ber diet
B. Provide soft or liquid diet and monitor for aspiration
C. Restrict oral uids
D. Encourage large solid meals

Question 72
A patient with liver cirrhosis develops pruritus. Which mechanism explains this symptom?
A. Accumulation of bile salts in the skin
B. Vitamin C de ciency
C. Gastric acid re ux
D. Pancreatic enzyme de ciency

Question 73
A patient with acute cholecystitis presents with fever, right upper quadrant pain, and positive Murphy’s
sign. Which nursing intervention is most appropriate?
A. Administer analgesics and prepare for possible surgery
B. Encourage high-fat diet
C. Provide oral uids
D. Administer laxatives

Question 74
A patient with portal hypertension develops esophageal varices. Which nursing teaching is most
appropriate to prevent bleeding?
A. Avoid straining and coughing
B. Increase intake of spicy foods
C. Encourage heavy lifting
D. Drink alcohol in moderation

Question 75
A patient with small bowel obstruction presents with severe abdominal pain and vomiting. Which nding
indicates possible strangulation?
A. Absent bowel sounds
B. Fever and leukocytosis
C. Constipation
D. Hemorrhoids

Question 76
A patient with chronic pancreatitis reports weight loss and foul-smelling stools. Which de ciency is most
likely?
A. Fat-soluble vitamins (A, D, E, K)
B. Vitamin B12
C. Iron
D. Folate

Question 77
A patient with cirrhosis develops gynecomastia. Which mechanism explains this nding?
A. Increased estrogen due to impaired liver metabolism
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 B. Vitamin D de ciency
C. Portal hypertension
D. Pancreatic enzyme de ciency

Question 78
A patient with peptic ulcer disease presents with sudden severe abdominal pain, rigid abdomen, and
absent bowel sounds. Which complication is most likely?
A. Perforation
B. GERD
C. Constipation
D. Pancreatitis

Question 79
A patient with Crohn’s disease develops stula formation. Which nursing intervention is most
appropriate?
A. Monitor for infection and provide nutritional support
B. Encourage high-fat diet
C. Restrict oral uids
D. Provide laxatives

Question 80
A patient with cirrhosis develops ascites and dyspnea. Which nursing intervention is most appropriate?
A. Position patient in semi-Fowler’s and administer diuretics
B. Encourage high-sodium diet
C. Provide oral uids
D. Administer laxatives
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Answer Key + Rationales
Q# Correct Answer Rationale
66 B GI bleed airway + IV uids
priority to prevent shock.
67 A Alcohol use + amylase
acute pancreatitis.
68 A Cirrhosis impaired
estrogen metabolism
vascular changes.
69 B Dumping syndrome rapid
gastric emptying dizziness,
tachycardia, diarrhea.
70 A Ulcerative colitis risk of
toxic megacolon, life-
threatening.
71 B Dysphagia soft/liquid diet
+ aspiration precautions.
72 A Cirrhosis bile salts
accumulate pruritus.
73 A Cholecystitis analgesics +
surgical prep.
74 A Varices bleed easily avoid
straining/coughing.
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 75 B SBO with fever/leukocytosis
strangulation risk.
76 A Pancreatic insu ciency fat
malabsorption fat-soluble
vitamin de ciency.
77 A Cirrhosis impaired
estrogen metabolism
gynecomastia.
78 A Sudden severe pain + rigid
abdomen perforation.
79 A Crohn’s stulas
infection risk + nutrition
support.
80 A Ascites semi-Fowler’s +
diuretics relieve dyspnea.
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 Question 81
A patient with cirrhosis presents with ascites and serum albumin of 2.0 g/dL. Which intervention best
addresses the underlying cause?
A. Administer albumin infusion
B. Encourage high-sodium diet
C. Provide laxatives
D. Restrict oral uids

Question 82
A patient with acute GI bleed has hematemesis and BP 80/50 mmHg. What is the nurse’s priority?
A. Administer proton pump inhibitor
B. Initiate rapid IV uid resuscitation
C. Provide oral uids
D. Encourage ambulation

Question 83
A patient with Crohn’s disease develops strictures in the small intestine. Which complication is most
likely?
A. Bowel obstruction
B. GERD
C. Peptic ulcer disease
D. Pancreatitis

Question 84
A patient with cirrhosis develops confusion and elevated ammonia levels. Which dietary teaching is most
appropriate?
A. Restrict protein intake
B. Encourage high-protein diet
C. Increase sodium intake
D. Provide high-fat meals

Question 85
A patient with acute pancreatitis develops hypocalcemia. Which clinical sign should the nurse monitor?
A. Chvostek’s sign
B. Cullen’s sign
C. Murphy’s sign
D. Grey-Turner’s sign

Question 86
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 A patient with ulcerative colitis develops severe abdominal distension, fever, and tachycardia. Which
complication is most likely?
A. Toxic megacolon
B. GERD
C. Pancreatitis
D. Gallstones

Question 87
A patient with cirrhosis develops esophageal varices. Which medication is most appropriate to reduce
portal hypertension?
A. Propranolol
B. Omeprazole
C. Loperamide
D. Pancrelipase

Question 88
A patient with gastric ulcer reports sudden severe abdominal pain and rigid abdomen. Which
complication is most likely?
A. Perforation
B. Constipation
C. GERD
D. Pancreatitis

Question 89
A patient with acute cholecystitis presents with right upper quadrant pain, fever, and positive Murphy’s
sign. Which diagnostic test is most appropriate?
A. Abdominal ultrasound
B. Chest X-ray
C. Colonoscopy
D. Endoscopy

Question 90
A patient with cirrhosis develops ascites and dyspnea. Which intervention is most appropriate?
A. Paracentesis
B. Encourage high-sodium diet
C. Provide oral uids
D. Administer laxatives

Question 91
A patient with Crohn’s disease develops stula formation. Which complication is most concerning?
A. Infection and sepsis
B. GERD
C. Constipation
D. Hemorrhoids

Question 92
A patient with cirrhosis develops prolonged bleeding time. Which de ciency explains this?
A. Vitamin K
B. Vitamin C
C. Vitamin B12
D. Iron

Question 93
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 A patient with acute pancreatitis develops Grey-Turner’s sign ( ank ecchymosis). Which complication is
most likely?
A. Retroperitoneal hemorrhage
B. GERD
C. Constipation
D. Peptic ulcer disease

Question 94
A patient with ulcerative colitis presents with bloody diarrhea and anemia. Which nursing intervention is
most appropriate?
A. Monitor hemoglobin and administer iron supplements
B. Encourage high-fat diet
C. Restrict oral uids
D. Provide laxatives

Question 95
A patient with cirrhosis develops hepatic encephalopathy. Which medication is most appropriate?
A. Lactulose
B. Omeprazole
C. Propranolol
D. Pancrelipase

Question 96
A patient with small bowel obstruction presents with vomiting and absent bowel sounds. Which
intervention is most appropriate?
A. Insert nasogastric tube for decompression
B. Encourage ambulation
C. Provide oral uids
D. Administer laxatives

Question 97
A patient with cirrhosis develops jaundice. Which mechanism explains this nding?
A. Impaired bilirubin metabolism by the liver
B. Vitamin C de ciency
C. Pancreatic enzyme de ciency
D. Gastric acid re ux

Question 98
A patient with acute pancreatitis develops Cullen’s sign (periumbilical ecchymosis). Which complication
is most likely?
A. Hemorrhagic pancreatitis
B. GERD
C. Constipation
D. Peptic ulcer disease

Question 99
A patient with Crohn’s disease presents with weight loss and steatorrhea. Which de ciency is most
likely?
A. Fat-soluble vitamins (A, D, E, K)
B. Vitamin B12 only
C. Iron only
D. Folate only

Question 100
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A patient with cirrhosis develops ascites and is prescribed spironolactone. Which lab value should the
nurse monitor closely?
A. Serum potassium
B. Serum calcium
C. Serum sodium
D. Serum iron

Answer Key + Rationales

Q# Correct Answer Rationale
81 A Low albumin ascites;
albumin infusion restores
oncotic pressure.
82 B Acute GI bleed with
hypotension uid
resuscitation priority.
83 A Crohn’s strictures
obstruction risk.
84 A High ammonia restrict
protein to reduce nitrogen
load.
85 A Hypocalcemia Chvostek’s
sign indicates neuromuscular
irritability.
86 A UC toxic megacolon, life-
threatening.
87 A Propranolol reduces portal
hypertension prevents
variceal bleed.
88 A Sudden severe pain + rigid
abdomen perforation.
89 A Ultrasound best for
gallbladder disease.
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 90 A Ascites + dyspnea
paracentesis relieves
pressure.
91 A Crohn’s stulas infection/
sepsis risk.
92 A Cirrhosis impaired bile
Vitamin K de ciency
bleeding.
93 A Grey-Turner’s sign
retroperitoneal hemorrhage in
pancreatitis.
94 A UC anemia monitor Hb
+ iron supplementation.
95 A Lactulose reduces ammonia
treats encephalopathy.
96 A SBO NG tube
decompression priority.
97 A Cirrhosis impaired bilirubin
metabolism jaundice.
98 A Cullen’s sign hemorrhagic
pancreatitis.
99 A Crohn’s fat malabsorption
fat-soluble vitamin
de ciency.
100 A Spironolactone potassium-
sparing monitor
hyperkalemia risk.
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