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Quizzes > Health & Medicine

NCLEX GI Questions: Practice Quiz on Gastrointestinal Disorders

Quick GI nursing quiz with instant results and brief rationales.

Editorial: Review CompletedCreated By: Katheryn BaldwinUpdated Aug 24, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration of stethoscope intestine and test papers on dark blue background for GI NCLEX quiz

This quiz helps you practice NCLEX GI questions and check your grasp of common gastrointestinal disorders. Work through exam-style items with instant feedback and brief rationales. For targeted review, try cirrhosis nclex questions and explore more gastrointestinal nclex practice to strengthen topics like small bowel and colitis.

What is the normal pH range of the stomach?
4.5 - 5.5
6.0 - 7.0
1.5 - 3.5
7.4 - 8.0
The stomach normally maintains a highly acidic environment with a pH between 1.5 and 3.5, which is necessary for protein digestion and defense against pathogens. Deviations from this range can lead to digestive issues or increased infection risk.
Which cranial nerve primarily stimulates parotid salivary secretion?
Facial (VII)
Glossopharyngeal (IX)
Vagus (X)
Trigeminal (V)
The glossopharyngeal nerve (IX) carries parasympathetic fibers that stimulate the parotid gland to produce saliva. The facial nerve (VII) supplies submandibular and sublingual glands, while the vagus (X) has minimal direct salivary function.
The majority of nutrient absorption occurs in which segment of the small intestine?
Jejunum
Duodenum
Colon
Ileum
While the duodenum initiates digestion and the ileum absorbs specific nutrients like bile salts and B12, the jejunum is responsible for the bulk of nutrient absorption due to its villi structure.
Which enzyme in saliva begins carbohydrate digestion?
Lipase
Trypsin
Pepsin
Amylase
Salivary amylase (ptyalin) starts the breakdown of starches into simpler sugars in the mouth, initiating carbohydrate digestion. Proteolytic enzymes like pepsin and trypsin act later in the stomach and small intestine.
Which part of the gastrointestinal tract absorbs the greatest volume of water?
Duodenum
Colon
Small intestine
Stomach
Approximately 90% of water is absorbed in the small intestine (primarily in the jejunum), with the colon reclaiming much of the remainder. The stomach absorbs minimal water.
What is the normal frequency of bowel sounds per minute?
1 - 5
5 - 30
30 - 60
60 - 90
Normal bowel sounds occur at a rate of 5 to 30 per minute. Fewer sounds may indicate ileus or obstruction, while very frequent sounds can suggest diarrhea or hypermotility.
Which lab value is most specific for assessing liver cell injury?
LDH
ALP
AST
ALT
Alanine aminotransferase (ALT) is found predominantly in the liver and is a more specific indicator of hepatocellular injury than AST, which is also present in muscle and other tissues.
A positive Murphy's sign is indicative of inflammation in which organ?
Gallbladder
Pancreas
Appendix
Spleen
A positive Murphy's sign (pain and inspiratory arrest on palpation of the RUQ) suggests acute cholecystitis, an inflammation of the gallbladder often due to gallstones.
Hematemesis refers to which clinical finding?
Vomiting blood
Difficulty swallowing
Black, tarry stool
Abdominal cramping
Hematemesis is defined as vomiting of blood, which can be bright red or coffee-ground in appearance, indicating upper GI bleeding.
Melena indicates bleeding from which part of the gastrointestinal tract?
Oropharynx
Esophagus
Upper GI tract
Lower GI tract
Melena is the passage of black, tarry stools resulting from digestion of blood in the upper GI tract, typically proximal to the ligament of Treitz.
Which adverse effect is most associated with long-term omeprazole use?
Pulmonary fibrosis
Increased risk of Clostridioides difficile infection
Hypoglycemia
Stevens-Johnson syndrome
Proton pump inhibitors like omeprazole can increase gastric pH, altering gut flora and predisposing patients to C. difficile infection.
Which dietary item should a patient with GERD avoid?
Chocolate
Rice
Apples
Oatmeal
Chocolate relaxes the lower esophageal sphincter, allowing acid reflux into the esophagus, which can exacerbate GERD symptoms.
Which finding best distinguishes Crohn's disease from ulcerative colitis?
Continuous colonic mucosal ulceration
Positive stool culture
Submucosal pseudopolyps
Transmural inflammation on biopsy
Crohn's disease is characterized by transmural inflammation, whereas ulcerative colitis involves only mucosal layers. Endoscopic biopsy showing full-thickness involvement indicates Crohn's.
A patient with lactose intolerance should avoid which beverage?
Cow's milk
Almond milk
Rice milk
Soy milk
Cow's milk contains lactose, which lactose-intolerant patients cannot digest due to low lactase activity. Plant-based milks are lactose-free.
Steatorrhea is most commonly a sign of dysfunction of which organ?
Stomach
Colon
Pancreas
Liver
Fatty stools (steatorrhea) result from inadequate pancreatic enzyme secretion needed for fat digestion, as seen in chronic pancreatitis or cystic fibrosis.
Which laboratory value is most specific and remains elevated longest in acute pancreatitis?
AST
Bilirubin
Serum lipase
Alkaline phosphatase
Serum lipase is more specific to pancreatic injury and remains elevated longer than amylase, making it the preferred marker for diagnosing acute pancreatitis.
Pruritus in cholestatic jaundice is primarily caused by accumulation of what?
Bilirubin
Bile salts
Urea
Ammonia
Cholestasis leads to retention of bile salts in the bloodstream, which deposit in the skin and cause intense itching (pruritus).
During an acute diverticulitis flare, which dietary intervention is recommended initially?
High-fiber diet
Ketogenic diet
High-fat diet
Clear liquid diet
A clear liquid diet reduces mechanical irritation of inflamed diverticula during acute flares and allows the colon to rest, preventing further inflammation.
Which is the primary mode of hepatitis B virus transmission?
Airborne
Respiratory droplets
Bloodborne
Fecal - oral
Hepatitis B is primarily transmitted through exposure to infected blood or body fluids, including percutaneous injury, sexual contact, and perinatal transmission.
Portal hypertension often leads to which of the following complications?
Esophageal varices
Appendicitis
Constipation
Steatorrhea
Elevated portal venous pressure causes development of collateral circulation, leading to engorged veins in the esophagus known as varices, which can rupture and bleed.
What best explains the biliary colic pain in cholelithiasis?
Chemical irritation of pancreatic tissue
Inflammation of hepatic capsule
Perforation of the gallbladder wall
Distension of gallbladder due to cystic duct obstruction
A gallstone temporarily blocking the cystic duct increases intraluminal pressure in the gallbladder, causing severe RUQ pain known as biliary colic.
A patient on total parenteral nutrition is at greatest risk for which complication?
Catheter-related bloodstream infection
Acute pancreatitis
Hepatic steatosis
Peptic ulcer disease
TPN requires central venous access, which significantly raises the risk of catheter-related infections; strict aseptic technique and line care are essential.
Which nonpharmacologic intervention is first-line for irritable bowel syndrome?
Antibiotic therapy
Increasing dietary fiber
Total bowel rest
High-fat diet
Dietary fiber helps normalize stool consistency and frequency in IBS. Soluble fiber supplements are often recommended before medications.
The diagnostic test of choice for active upper GI bleeding is:
Abdominal CT scan
Esophagogastroduodenoscopy (EGD)
Colonoscopy
Barium swallow
An urgent EGD allows direct visualization of bleeding sources in the upper GI tract and enables therapeutic intervention during the same procedure.
Zollinger - Ellison syndrome primarily presents with:
Hepatic cirrhosis
Chronic constipation
Malabsorption of bile salts
Recurrent duodenal ulcers due to gastrin-secreting tumors
Gastrinomas in Zollinger - Ellison syndrome secrete excess gastrin, causing profound gastric acid hypersecretion and recurrent, refractory peptic ulcers.
Which position is best for performing large-volume paracentesis in a patient with tense ascites?
Left lateral decubitus
Flat supine position
Prone position
Semi-Fowler's position
Semi-Fowler's position promotes pooling of ascitic fluid in the lower abdomen, improving access and reducing risk of organ injury during paracentesis.
Which agent is first-line to reduce ammonia levels in hepatic encephalopathy?
Furosemide
Metronidazole
Lactulose
Mannitol
Lactulose acidifies the colon, converting ammonia to ammonium, which is then excreted, effectively lowering systemic ammonia levels in hepatic encephalopathy.
Wilson's disease is characterized by accumulation of which element in tissues?
Lead
Iron
Zinc
Copper
A defect in copper excretion leads to copper accumulation in the liver, brain, and cornea (Kayser - Fleischer rings) in Wilson's disease.
Grey Turner's sign is a clinical indicator of which condition?
Ulcerative colitis
Hepatic encephalopathy
Retroperitoneal hemorrhage in acute pancreatitis
Acute appendicitis
Grey Turner's sign - flank ecchymosis - indicates hemorrhagic pancreatitis with retroperitoneal bleeding. It suggests severe disease and carries a poor prognosis.
In Gilbert's syndrome, which laboratory finding is characteristic?
Mild unconjugated hyperbilirubinemia
High serum amylase
Increased alkaline phosphatase
Elevated ALT and AST
Gilbert's syndrome is a benign hereditary condition with reduced UDP-glucuronyl transferase activity, leading to mild, fluctuating elevations in unconjugated bilirubin without other liver abnormalities.
What is the primary pathophysiologic mechanism in hepatorenal syndrome?
Immune complex glomerulonephritis
Acute tubular necrosis from toxins
Obstruction of urinary tract
Renal vasoconstriction due to splanchnic vasodilation
In hepatorenal syndrome, severe portal hypertension and splanchnic vasodilation lead to renal vasoconstriction and reduced glomerular filtration despite structurally normal kidneys.
Adaptive changes in the remaining intestine after massive resection in short bowel syndrome include:
Reduced intestinal transit time
Hypertrophy of villi to increase absorptive surface
Hypersecretion of pancreatic enzymes
Decreased gastric acid secretion
After extensive resection, the small intestine adapts by elongating and hypertrophying villi and microvilli to increase the absorptive surface area and compensate for lost length.
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Study Outcomes

  1. Interpret Acid-Base Imbalances -

    Using insights from the gi nclex questions quiz, you'll analyze arterial blood gas results to identify metabolic acidosis or alkalosis caused by gastrointestinal disorders.

  2. Explain GI Pathophysiology -

    Review gastrointestinal nclex questions on ulcerative colitis, Crohn's disease, and peptic ulcer disease to articulate their core pathophysiological mechanisms.

  3. Assess Liver Disease Presentations -

    Differentiate between hepatitis, cirrhosis, and cholestatic conditions in nclex gi questions to determine appropriate clinical assessments and initial interventions.

  4. Apply Diagnostic Criteria -

    Use evidence-based criteria in GI NCLEX review scenarios to select lab tests, imaging, and endoscopic procedures for accurate GI disorder diagnosis.

  5. Formulate Nursing Interventions -

    Develop patient care plans addressing fluid and electrolyte balance, nutrition, and symptom management for common gastrointestinal conditions.

  6. Evaluate Clinical Scenarios -

    Answer scored quiz questions to test your ability to prioritize interventions and make critical decisions under pressure in NCLEX-style GI case studies.

Cheat Sheet

  1. Acid-Base Balance in GI Disorders -

    Review how vomiting leads to metabolic alkalosis and diarrhea causes metabolic acidosis by altering bicarbonate levels; apply the Henderson-Hasselbalch equation (pH = pKa + log [HCO3−]/[H2CO3]) to predict pH changes. Use the ROME mnemonic - Respiratory Opposite, Metabolic Equal - to quickly identify compensatory patterns. Practicing gi nclex questions on this topic cements your confidence in GI NCLEX review.

  2. Liver Function Test Interpretation -

    Differentiate hepatocellular vs cholestatic injury by comparing AST/ALT ratios and alkaline phosphatase levels; an AST/ALT ratio >2 often signals alcoholic hepatitis. Remember the mnemonic "HALT" (Hemochromatosis, Alcohol, Liver, Toxins) for common causes of elevated enzymes. Solid grasp of these labs is essential for gastrointestinal nclex questions.

  3. Peptic Ulcer Disease Pathophysiology & Management -

    Understand H. pylori's role in ulcer formation via urease activity and mucosal damage; memorize triple therapy with the CAP mnemonic - Clarithromycin, Amoxicillin, PPI. Recognize the importance of testing (e.g., urea breath test) before and after treatment for eradication. This foundational nclex gi questions concept frequently appears in GI NCLEX review quizzes.

  4. IBD vs IBS Differentiation -

    Distinguish ulcerative colitis (continuous colon involvement, bloody diarrhea) from Crohn's disease (skip lesions, transmural inflammation) and IBS (no structural damage, pain relieved by defecation). Note systemic signs - fever, weight loss - in true inflammatory bowel disease. Mastering these contrasts boosts your success rate on gastrointestinal nclex questions.

  5. GI Bleed Assessment & Nursing Interventions -

    Prioritize ABCs: monitor vitals for orthostatic changes, track Hgb/Hct trends, and watch for rising BUN as an early bleed indicator. Prepare for NG tube lavage to localize upper GI bleeds and ensure large-bore IV access for fluid resuscitation. Quick, confident action on these nclex gi questions scenarios reinforces your clinical acuity.

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