5.

​ A client with liver cirrhosis develops

Gastrointestinal Disorders
esophageal varices. What is the priority
1.​ A patient with gastroesophageal reflux nursing action if the client starts vomiting
disease (GERD) reports frequent bright red blood?​
heartburn and regurgitation. Which a) Encourage the client to drink ice water​
lifestyle modification should the nurse b) Prepare for endoscopic variceal ligation​
recommend?​ c) Position the client flat on the back​
a) Eat large meals before bedtime​ d) Check for bowel sounds
b) Sleep in a left lateral position​ 6.​ A client with cholelithiasis is scheduled for
c) Increase caffeine intake​ a cholecystectomy. The nurse explains
d) Lie down immediately after eating that postoperative care includes:​
2.​ A client with peptic ulcer disease suddenly a) A high-fat diet​
reports severe, sharp abdominal pain and b) Splinting the incision when coughing or
a rigid abdomen. What should the nurse deep breathing​
do first?​ c) Lying flat to reduce pain​
a) Administer an antacid​ d) Avoiding ambulation
b) Check vital signs and assess for shock​ 7.​ Which finding indicates peritonitis in a
c) Encourage oral fluids​ patient with ruptured appendix?​
d) Perform abdominal massage a) Hypoactive bowel sounds​
3.​ A patient with a history of alcohol abuse is b) Soft, non-distended abdomen​
diagnosed with acute pancreatitis. Which c) Decreased WBC count​
laboratory value should the nurse monitor d) Increased urine output
closely?​ 8.​ A patient with inflammatory bowel disease
a) Decreased serum calcium​ (IBD) is placed on total parenteral
b) Increased serum sodium​ nutrition (TPN). What is the priority
c) Decreased blood glucose​ assessment?​
d) Increased hemoglobin a) Check for blood in stool​
4.​ The nurse is teaching a patient with b) Monitor daily weight​
dumping syndrome after a Billroth II c) Assess glucose levels​
surgery. Which statement indicates correct d) Check skin turgor
understanding?​ 9.​ A client with acute hepatitis B asks how
a) "I should eat high-carbohydrate meals for the disease is transmitted. The nurse
energy."​ explains that hepatitis B is primarily spread
b) "I should drink fluids with meals to help through:​
digestion."​ a) Contaminated food and water​
c) "I should eat small, frequent meals and lie b) Direct contact with infected blood and
down after eating."​ body fluids​
d) "I should avoid protein and fat in my diet."
 c) Airborne droplets​ 15.​Which statement by a patient with IBD
d) Fecal-oral route requires further teaching?​
10.​Which assessment finding is most a) "I should drink plenty of fluids."​
concerning in a patient with acute b) "I should avoid spicy and greasy
pancreatitis?​ foods."​
a) Cullen’s sign​ c) "I should take NSAIDs for abdominal
b) Nausea and vomiting​ pain."​
c) Epigastric pain​ d) "I should report blood in my stool
d) Increased bowel sounds immediately."
11.​A client with diverticulitis is advised to
modify their diet. Which food should be
avoided?​ Endocrine Disorders
a) Whole wheat bread​
b) Popcorn​ 16.​A patient with hypopituitarism is
c) Lean chicken​ experiencing cold intolerance, weight
d) Cooked vegetables gain, and dry skin. Which hormone is most
12.​A patient with appendicitis reports sudden likely deficient?​
relief of pain followed by severe a) Growth hormone​
abdominal tenderness. The nurse b) Thyroid-stimulating hormone​
suspects:​ c) Antidiuretic hormone​
a) Normal recovery​ d) Adrenocorticotropic hormone
b) Bowel obstruction​ 17.​The nurse is monitoring a client with
c) Perforation and peritonitis​ diabetes insipidus (DI). Which finding
d) Appendiceal abscess requires immediate intervention?​
13.​In a patient with esophageal varices, which a) Urine output of 3,000 mL in 24 hours​
medication is most likely to be prescribed to b) Blood pressure of 88/40 mmHg​
reduce portal hypertension?​ c) Specific gravity of 1.015​
a) Furosemide​ d) Serum sodium of 138 mEq/L
b) Propranolol​ 18.​A client with Cushing's syndrome presents
c) Metoclopramide​ with moon face, buffalo hump, and purple
d) Omeprazole striae. What is the priority nursing
14.​A patient with ulcerative colitis is diagnosis?​
experiencing frequent, bloody diarrhea. a) Risk for injury​
Which nutritional intervention is best?​ b) Impaired skin integrity​
a) High-fiber diet​ c) Fluid volume excess​
b) High-fat diet​ d) Altered nutrition
c) Low-residue diet​ 19.​Which symptom would the nurse expect in a
d) High-dairy diet client with hypoglycemia?​
 a) Flushed, dry skin​ c) Reduce carbohydrate intake​
b) Tachycardia and diaphoresis​ d) Limit water intake
c) Deep, rapid respirations​ 25.​The most concerning complication of
d) Increased thirst and polyuria untreated acromegaly is:​
20.​The nurse is educating a client with a) Joint pain​
hypopituitarism about growth hormone b) Hypertension and heart failure​
replacement therapy. The nurse should c) Enlarged hands and feet​
instruct the patient to:​ d) Facial feature changes
a) Take the hormone before bedtime​
b) Take the hormone early in the morning​
c) Stop taking it if height increases​
d) Expect immediate results
21.​A client with SIADH (Syndrome of
Inappropriate Antidiuretic Hormone) is at
risk for which complication?​
a) Hyperkalemia​
b) Severe hyponatremia​
c) Polyuria​
d) Hyperglycemia
22.​A nurse is monitoring a client with
hyperthyroidism (Graves' disease).
Which symptom requires immediate
action?​
a) Restlessness and weight loss​
b) Tachycardia and fever​
c) Heat intolerance and tremors​
d) Exophthalmos and diarrhea
23.​A patient with hypoparathyroidism is at
risk for which electrolyte imbalance?​
a) Hypercalcemia​
b) Hypocalcemia​
c) Hypernatremia​
d) Hypokalemia
24.​The nurse is caring for a client with
Addison’s disease. Which dietary
instruction should the nurse include?​
a) Increase sodium intake​
b) Avoid high-protein foods​
ANSWER KEYS and RATIONALES​ Correct Answer: C) Eat small, frequent meals
1. GERD Lifestyle Modification and lie down after eating.​
Rationale: Small meals prevent sudden fluid shifts,
Correct Answer: B) Sleep in a left lateral
and lying down slows gastric emptying.​
position​
Rationale: Sleeping on the left side helps keep the
✅ Test-Taking Tip: Avoid extreme options like
“high-carb meals” (A) or “drink fluids with meals”
stomach contents lower than the esophagus,
(B)—these worsen symptoms.
reducing acid reflux. Lying down immediately or
eating large meals before bed worsens reflux.​
✅ Test-Taking Tip: Avoid answers that worsen
the condition (e.g., caffeine, large meals before 5. Esophageal Varices Bleeding

bed).
Correct Answer: B) Prepare for endoscopic
variceal ligation​
Rationale: This is a life-threatening emergency,
2. Peptic Ulcer Disease with Rigid Abdomen requiring immediate intervention (ligation or
sclerotherapy).​
Correct Answer: B) Check vital signs and
assess for shock​
✅ Test-Taking Tip: Look for answers that STOP
the cause of bleeding, not just symptoms.
Rationale: A rigid abdomen with severe pain
suggests perforation, which can cause shock.​
✅ Test-Taking Tip: When a patient’s condition
suddenly worsens, assess first, then intervene. 6. Cholecystectomy Post-Op Care

Correct Answer: B) Splinting the incision when

coughing or deep breathing​
3. Acute Pancreatitis Lab Monitoring Rationale: Splinting reduces pain and prevents
wound dehiscence.​
Correct Answer: A) Decreased serum calcium​
Rationale: Fat necrosis binds calcium, leading to
✅ Test-Taking Tip: Post-op questions often
involve preventing complications (e.g.,
hypocalcemia, which can cause tetany (muscle
pneumonia).
cramps, Chvostek’s sign).​
✅ Test-Taking Tip: If electrolytes are mentioned,
consider the organ’s effect on balance (pancreas
→ calcium loss). 7. Peritonitis in Ruptured Appendix

Correct Answer: A) Hypoactive bowel sounds​

Rationale: Peritonitis causes paralytic ileus,
4. Dumping Syndrome Management reducing bowel sounds.​
✅ Test-Taking Tip: Recognize expected vs.
abnormal findings—bowel sounds should Correct Answer: B) Popcorn​
increase, not decrease, in early GI conditions. Rationale: Small, hard foods like seeds and
popcorn can get trapped in diverticula, causing
inflammation and infection.​

8. TPN Priority Assessment

✅ Test-Taking Tip: Avoid foods that can “clog”
the diverticula.
Correct Answer: C) Assess glucose levels​
Rationale: TPN is high in glucose, increasing the
risk for hyperglycemia.​
✅ Test-Taking Tip: When choosing a “priority” 12. Appendicitis with Sudden Pain Relief

answer, look for metabolic complications Correct Answer: C) Perforation and peritonitis​
(glucose). Rationale: Sudden pain relief → rupture! This
leads to peritonitis, which is life-threatening.​
✅ Test-Taking Tip: “Sudden relief” followed by
worsening pain = emergency!
9. Hepatitis B Transmission

Correct Answer: B) Direct contact with infected

blood and body fluids​
13. Medication for Esophageal Varices
Rationale: Hepatitis B is bloodborne (IV drug use,
sex, perinatal transmission).​ Correct Answer: B) Propranolol​
✅ Test-Taking Tip: Know transmission routes: Rationale: Beta-blockers reduce portal
Hepatitis A = fecal-oral, Hepatitis B = bloodborne. hypertension, lowering the risk of variceal
bleeding.​
✅ Test-Taking Tip: Choose medications that
prevent worsening (not just symptom relief).
10. Acute Pancreatitis – Most Concerning Sign

Correct Answer: A) Cullen’s sign​

Rationale: Cullen’s sign (bruising around the
14. Ulcerative Colitis Diet
umbilicus) suggests retroperitoneal
hemorrhage, a severe complication.​ Correct Answer: C) Low-residue diet​
✅ Test-Taking Tip: Prioritize life-threatening Rationale: A low-residue diet reduces bowel
complications over common symptoms (pain, stimulation and prevents flare-ups.​
nausea). ✅ Test-Taking Tip: Low-residue = low fiber!
Avoid roughage, nuts, and raw vegetables.

11. Diverticulitis – Food to Avoid

15. IBD – Requires Further Teaching
Correct Answer: C) “I should take NSAIDs for complications (fluid overload) over local ones
abdominal pain.”​ (skin).
Rationale: NSAIDs worsen GI inflammation and
increase bleeding risk.​
✅ Test-Taking Tip: Eliminate answers that 19. Hypoglycemia Symptoms
worsen the condition!
Correct Answer: B) Tachycardia and
diaphoresis​

🩺 ENDOCRINE DISORDERS Rationale: Low glucose → adrenergic response

(sweating, tremors, rapid heart rate).​

16. Hypopituitarism – Deficient Hormone

✅ Test-Taking Tip: Hypo = sweaty/shaky, Hyper
= dry/thirsty.
Correct Answer: B) Thyroid-stimulating
hormone (TSH)​
Rationale: Low TSH → hypothyroidism (fatigue,
20. Growth Hormone Therapy Timing
cold intolerance, weight gain).​
✅ Test-Taking Tip: Match symptoms with Correct Answer: B) Take early in the morning​
hormone deficiency. Rationale: GH follows a natural circadian
rhythm, peaking in the morning.​
✅ Test-Taking Tip: Look for “natural body
cycles” when choosing timing.
17. Diabetes Insipidus – Emergency Sign

Correct Answer: B) Blood pressure of 88/40

mmHg​
21. SIADH Complication
Rationale: Severe dehydration → hypotension
→ shock!​ Correct Answer: B) Severe hyponatremia​
✅ Test-Taking Tip: Low BP = circulation issue Rationale: SIADH causes water retention →
→ priority intervention needed. diluted sodium → brain swelling.​
✅ Test-Taking Tip: Too much ADH = too much
water = low sodium.

18. Cushing’s Syndrome – Priority Nursing

Diagnosis
22. Hyperthyroidism – Emergency Sign
Correct Answer: C) Fluid volume excess​
Rationale: High cortisol → sodium & water Correct Answer: B) Tachycardia and fever​
retention → hypertension, edema.​ Rationale: These indicate thyroid storm, a
✅ Test-Taking Tip: Prioritize systemic life-threatening crisis!​
✅ Test-Taking Tip: Vital sign changes = CONCEPT FLASHCARDS
immediate action!
1️⃣ GERD (Gastroesophageal Reflux Disease)

📌 Cause: Weak lower esophageal sphincter

23. Hypoparathyroidism – Electrolyte Imbalance (LES)​

Correct Answer: B) Hypocalcemia​

📌 Symptoms: Heartburn, regurgitation, chronic
cough​
Rationale: Low PTH → low calcium (tetany,
📌 Treatment:​
muscle cramps).​
✅ Test-Taking Tip: Parathyroid = calcium ✅ Avoid caffeine, alcohol, spicy/fatty foods​
✅ Elevate head of bed​
control!
✅ Small, frequent meals​
✅ Meds: PPIs (omeprazole), H2 blockers
(ranitidine)
24. Addison’s Disease Diet

Correct Answer: A) Increase sodium intake​

Rationale: Low aldosterone → low sodium → 2️⃣ Peptic Ulcer Disease (PUD)

hypotension.​
✅ Test-Taking Tip: “Addison’s = Add Sodium.” 📌 Cause: H. pylori, NSAIDs​
📌 Symptoms: Epigastric pain, nausea, black
stools​
📌 Treatment:​
25. Acromegaly – Most Concerning ✅ Avoid NSAIDs & alcohol​
Complication ✅ Meds: PPIs, antibiotics (if H. pylori)​
✅ Monitor for perforation → Rigid abdomen =
Correct Answer: B) Hypertension and heart
failure​
🚨 Emergency!
Rationale: Excess GH → heart strain →
hypertension, cardiac failure.​
✅ Test-Taking Tip: Choose life-threatening 3️⃣ Acute Pancreatitis

complications over minor ones!

📌 Cause: Alcohol, gallstones​
📌 Symptoms:​
🔹 Severe epigastric pain (radiates to back)​
🔹 Cullen’s sign (umbilical bruising)​
🔹 Low calcium → Tetany, Chvostek’s sign​
📌 Treatment:​
✅ NPO, IV fluids​
✅ Monitor calcium & glucose​ 7️⃣ Appendicitis
✅ Pain control (morphine, fentanyl) 📌 Symptoms: RLQ pain (McBurney’s point),
fever, rebound tenderness​
🚨 If pain suddenly stops → suspect rupture →
4️⃣ Dumping Syndrome peritonitis!​

📌 Cause: Gastric surgery (Billroth II)​ 📌 Treatment: Emergency appendectomy

📌 Symptoms: Dizziness, sweating, diarrhea 30
min after eating​
📌 Treatment:​ 8️⃣ Inflammatory Bowel Disease (IBD)
✅ Small, frequent meals​
✅ Lie down after eating​ Feature Crohn’s Disease Ulcerative

✅ Avoid high-carb meals & fluids with meals Colitis

Locatio Anywhere in GI Colon & rectum

n tract only

5️⃣ Liver Cirrhosis & Esophageal Varices Sympto RLQ pain, Bloody diarrhea,

📌 Cause: Alcohol, hepatitis​ ms diarrhea, LLQ pain

📌 Symptoms:​ malabsorption

🔹 Jaundice, ascites, confusion Compli Fistulas, weight Toxic

(encephalopathy)​ cations loss megacolon,
🔹 Esophageal varices = bleeding risk!​ colon cancer
📌 Treatment:​
✅ Beta-blockers (propranolol)​ Diet Low-fiber, Low-residue, no

✅ Lactulose (↓ ammonia levels)​ high-protein dairy

✅ Low-sodium diet Treatm Steroids, Aminosalicylates

ent immunosuppressa (5-ASA)
nts
6️⃣ Cholecystitis (Gallbladder Inflammation)

📌 Symptoms: RUQ pain after fatty meals, fever, 🩺 ENDOCRINE DISORDERS FLASHCARDS
nausea​
📌 Treatment:​
✅ NPO, IV fluids, pain control​
9️⃣ Hypopituitarism

✅ Cholecystectomy (surgical removal)​ 📌 Causes: Pituitary tumor, trauma​

✅ Splint incision post-op 📌 Symptoms:​
🔹 Low GH → Growth retardation​
🔹 Low TSH → Hypothyroidism (cold intolerance,
weight gain)​ 🚨 Thyroid storm (severe tachycardia, fever, HTN)
🔹 Low ACTH → Addison’s disease (fatigue, low is a medical emergency!​
BP) 📌 Treatment: Beta-blockers, PTU,
methimazole, radioactive iodine

🔟 Diabetes Insipidus (DI) – LOW ADH

📌 Symptoms:​ 1️⃣4️⃣ Addison’s Disease (Adrenal Insufficiency)

🔹 Polyuria (excess urination), dehydration, 📌 Symptoms:​

thirst​ 🔹 Low cortisol & aldosterone → Hypotension,
🔹 Low urine specific gravity (< 1.005)​ hyperkalemia, hyperpigmentation​
📌 Treatment: Desmopressin (ADH 📌 Treatment: Lifelong steroids
replacement) (hydrocortisone, prednisone)​
✅ Increase salt intake​
✅ Carry emergency steroid injection
1️⃣1️⃣ SIADH – TOO MUCH ADH

📌 Symptoms:​
🔹 Fluid retention, weight gain, confusion​ 1️⃣5️⃣ Cushing’s Syndrome (Excess Cortisol)

🔹 Dilutional hyponatremia (low sodium)​ 📌 Symptoms:​

📌 Treatment: Fluid restriction, hypertonic saline 🔹 Moon face, buffalo hump, purple striae, high
(3% NaCl) BP​
📌 Treatment: Tumor removal, steroid tapering
1️⃣2️⃣ Hypothyroidism (Hashimoto’s Disease)

📌 Symptoms:​ 1️⃣6️⃣ Hypoglycemia vs. Hyperglycemia

🔹 Fatigue, cold intolerance, bradycardia, Featur Hypoglycemia (< Hyperglycemia

weight gain​ e 70 mg/dL) (> 250 mg/dL)
📌 Treatment:​
✅ Levothyroxine (take in AM, empty stomach, Sympt
oms
Sweating, tremors,
tachycardia
Dry skin,
polyuria,
lifelong)
dehydration

Compl Seizures, coma DKA, HHS

ication
1️⃣3️⃣ Hyperthyroidism (Graves' Disease)

📌 Symptoms: Heat intolerance, weight loss, Treat

ment
Fast-acting carbs
(juice, glucose tabs)
Insulin, fluids

tremors, exophthalmos (bulging eyes)​

TEST-TAKING STRATEGIES

✔ Identify Keywords ("most concerning," "first

action," or "priority")​
✔ Prioritize ABCs (Airway, Breathing, Circulation)​
✔ Know Medication Precautions (e.g.,
Levothyroxine → morning, empty stomach)​
✔ Use Elimination – If an option worsens the
condition, rule it out.​
✔ Recognize Emergencies (thyroid storm,
Addisonian crisis, peritonitis, hypoglycemia, DKA).