2026 Nursing NR446 Complete Readiness Practice Test

In upper GI bleeding, the hallmark symptom is hematemesis—vomiting blood. This occurs because the bleeding source is in the esophagus, stomach, or duodenum, so blood is expelled through the mouth. The blood may appear bright red if the bleed is brisk or have a coffee-ground appearance if it has been partially digested. Jaundice points to liver or biliary problems, not an upper GI bleed. Chest pain and shortness of breath can occur for other reasons and are not the typical features used to identify an upper GI bleed. Sometimes melena (black, tarry stools) also indicates an upper GI source, reflecting digested blood.