NCLEX RN Practice Question # 902

NCLEX Examination.

Practice Question # 902.


nclex examination.


Gastrointestinal (GI) bleeding


  • Bleeding that occurs at some area in the GI tract; classified into upper GI bleeding or lower GI bleeding.
  • Causes of upper GI bleeding include peptic ulcer disease, stress-related erosive syndrome, esophageal or gastric varices, tearing of the GI tract, esophagitis, neoplasm, aortoenteric fistula, and angiodysplasia.
  • Causes of lower GI bleeding include diverticulosis, angiodysplasia, neoplasm, inflammatory bowel disease, trauma, infectious colitis, radiation colitis, ischemia, aortoenteric fistula, and hemorrhoids.
  • GI bleeding, or hemorrhage, is a potentially lifethreatening emergency condition.


  • Hematemesis
  • Hematochezia
  • Melena
  • Decreased hemoglobin and hematocrit levels (may take 24 to 72 hours for the change to occur in acute blood loss)


  • Endoscopy once the client is hemodynamically stabilized
  • Tagged red blood cell scanning, angiography, or both may be used to locate the source of bleeding.

Nursing Interventions

  1. The goal is to stop the bleeding and determine the cause of bleeding.
  2. Fluid resuscitation to achieve hemodynamic stability is necessary.
  3. Correction of hypercoagulability if indicated
  4. Therapeutic procedures to control or stop the bleeding
  5. Medications to suppress or neutralize gastric acids, including histamine-2 antagonists and proton pump inhibitors
  6. Note that these medications may place the client at risk for bacterial colonization and associated infections.
  7. Surgery may be used for a client who continues to be hemodynamically stable despite fluid resuscitation.

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