NR 545 PHARMACOLOGY, PHYSICAL ASSESSMENT &
PATHOPHYSIOLOGY EXAM 3 (PDF) | 2026 EXAM
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
Section 1: Gastrointestinal Disorders – Peptic Ulcer Disease
1. A peptic ulcer is defined as:
A) Inflammation of the gastric mucosa only
B) Penetration of the submucosa that can cause perforation
C) A bacterial infection of the stomach
D) A cancerous tumor of the stomach
Correct Answer: B) Penetration of the submucosa that can cause perforation
Rationale: A peptic ulcer is a defect in the gastrointestinal mucosa that extends
through the muscularis mucosae into the submucosa or deeper layers, which can
lead to complications such as perforation. Option A describes gastritis, C describes
H. pylori infection (which causes ulcers), and D describes gastric cancer.
2. What are the most common causes of peptic ulcer disease?
A) Stress and spicy foods
B) H. pylori infection and NSAID use
C) Excessive caffeine and alcohol intake
D) Genetic predisposition
Correct Answer: B) H. pylori infection and NSAID use
Rationale: H. pylori infection is the most common cause of peptic ulcer disease,
accounting for approximately 70-90% of duodenal ulcers and 50-80% of gastric
ulcers. NSAID use is the second most common cause. Alcohol, caffeine, and stress
can worsen symptoms but are not primary causes.
3. Which blood type is commonly associated with peptic ulcers?
A) Type A
B) Type B
C) Type AB
D) Type O
Correct Answer: D) Type O
,Rationale: Individuals with blood type O have higher susceptibility to H. pylori
infection and peptic ulcers. This is thought to be related to blood group antigens
that affect bacterial adhesion to the gastric mucosa.
4. A patient reports epigastric pain, belching, and a burning sensation
immediately after eating. Antacids provide minimal relief. This presentation is
most consistent with:
A) Duodenal ulcer
B) Gastric ulcer
C) Gastroenteritis
D) Cholecystitis
Correct Answer: B) Gastric ulcer
Rationale: Gastric ulcers cause pain shortly after eating, often within 30-60
minutes, because food stimulates acid secretion. Antacids provide only minimal
relief. Duodenal ulcers cause pain 2-4 hours after meals and at night, with relief
from food or antacids.
5. A patient reports epigastric burning 3-4 hours after eating that is worse at
night. Antacids relieve the pain. This describes:
A) Gastric ulcer
B) Duodenal ulcer
C) Gastroesophageal reflux disease
D) Pancreatitis
Correct Answer: B) Duodenal ulcer
Rationale: Duodenal ulcers present with pain when the stomach is empty (between
meals, at night) that improves with food or antacids. This pain is often described as
a burning sensation and may awaken the patient from sleep.
6. A patient with peptic ulcer disease presents with sudden, severe abdominal
pain that is board-like, rigid, and accompanied by tachycardia. What
complication should the nurse suspect?
A) Hemorrhage
B) Obstruction
C) Perforation
D) Gastritis
,Correct Answer: C) Perforation
Rationale: Perforation is a life-threatening complication of peptic ulcer disease
characterized by sudden, severe pain and signs of peritonitis (board-like abdomen,
rigidity, tachycardia). This occurs when the ulcer erodes through the entire wall of
the stomach or duodenum, allowing gastric contents to enter the peritoneal cavity.
7. What are the complications of peptic ulcers?
A) Hemorrhage, obstruction, and perforation
B) Hepatitis, cirrhosis, and jaundice
C) Pancreatitis and gallstones
D) Diverticulitis and colitis
Correct Answer: A) Hemorrhage, obstruction, and perforation
Rationale: The three major complications of peptic ulcers are hemorrhage
(bleeding), obstruction (gastric outlet obstruction), and perforation (erosion
through the full thickness of the wall). These are serious complications requiring
surgical intervention.
8. H. pylori secretes which substances that cause damage to the mucosal
defense?
A) Protease, phospholipase, and urease only
B) Lipase and amylase only
C) Collagenase and elastase only
D) Trypsin and chymotrypsin only
Correct Answer: A) Protease, phospholipase, and urease only
Rationale: H. pylori produces cytotoxins and the enzymes protease,
phospholipase, and urease, which damage the gastric mucosal defense. Urease
produces ammonia that neutralizes gastric acid, while protease and phospholipase
break down the protective mucus layer.
9. What is the recommended treatment for H. pylori-associated peptic ulcer?
A) PPI alone
B) Antibiotics alone
C) PPI + Amoxicillin + Clarithromycin (triple therapy)
D) Antacids only
, Correct Answer: C) PPI + Amoxicillin + Clarithromycin (triple therapy)
Rationale: Triple therapy with a PPI and two antibiotics (e.g., PPI, amoxicillin,
clarithromycin) is standard for H. pylori eradication. Alternative regimens include
PPI + Clarithromycin + Metronidazole, or PPI + Bismuth + Tetracycline +
Metronidazole.
10. What is the mechanism of action of proton pump inhibitors?
A) They neutralize stomach acid
B) They reduce the amount of stomach acid produced in the lining of the stomach
C) They aid in the healing of erosive esophagitis and reduce gastric acid
production
D) They kill H. pylori bacteria
Correct Answer: C) They aid in the healing of erosive esophagitis and reduce
gastric acid production
Rationale: Proton pump inhibitors (e.g., omeprazole, pantoprazole, esomeprazole)
reduce gastric acid production by inhibiting the H+/K+ ATPase enzyme system
(the proton pump) of the gastric parietal cells. This promotes healing of ulcers and
erosive esophagitis.
Section 2: Gastrointestinal Disorders – Gastritis
11. Acute gastritis is defined as:
A) Chronic atrophy of stomach mucosa
B) Inflammation of the stomach
C) Ulceration of the duodenum
D) Inflammation of the pancreas
Correct Answer: B) Inflammation of the stomach
Rationale: Acute gastritis is temporary inflammation of the gastric mucosa caused
by irritants such as NSAIDs, excessive alcohol, or ingestion of spicy foods.
Chronic gastritis involves progressive atrophy of the gastric mucosa.
12. What are the signs and symptoms of acute gastritis?
A) Nausea, vomiting, anorexia, and epigastric pain or cramps
B) Watery diarrhea with blood and mucous
PATHOPHYSIOLOGY EXAM 3 (PDF) | 2026 EXAM
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
Section 1: Gastrointestinal Disorders – Peptic Ulcer Disease
1. A peptic ulcer is defined as:
A) Inflammation of the gastric mucosa only
B) Penetration of the submucosa that can cause perforation
C) A bacterial infection of the stomach
D) A cancerous tumor of the stomach
Correct Answer: B) Penetration of the submucosa that can cause perforation
Rationale: A peptic ulcer is a defect in the gastrointestinal mucosa that extends
through the muscularis mucosae into the submucosa or deeper layers, which can
lead to complications such as perforation. Option A describes gastritis, C describes
H. pylori infection (which causes ulcers), and D describes gastric cancer.
2. What are the most common causes of peptic ulcer disease?
A) Stress and spicy foods
B) H. pylori infection and NSAID use
C) Excessive caffeine and alcohol intake
D) Genetic predisposition
Correct Answer: B) H. pylori infection and NSAID use
Rationale: H. pylori infection is the most common cause of peptic ulcer disease,
accounting for approximately 70-90% of duodenal ulcers and 50-80% of gastric
ulcers. NSAID use is the second most common cause. Alcohol, caffeine, and stress
can worsen symptoms but are not primary causes.
3. Which blood type is commonly associated with peptic ulcers?
A) Type A
B) Type B
C) Type AB
D) Type O
Correct Answer: D) Type O
,Rationale: Individuals with blood type O have higher susceptibility to H. pylori
infection and peptic ulcers. This is thought to be related to blood group antigens
that affect bacterial adhesion to the gastric mucosa.
4. A patient reports epigastric pain, belching, and a burning sensation
immediately after eating. Antacids provide minimal relief. This presentation is
most consistent with:
A) Duodenal ulcer
B) Gastric ulcer
C) Gastroenteritis
D) Cholecystitis
Correct Answer: B) Gastric ulcer
Rationale: Gastric ulcers cause pain shortly after eating, often within 30-60
minutes, because food stimulates acid secretion. Antacids provide only minimal
relief. Duodenal ulcers cause pain 2-4 hours after meals and at night, with relief
from food or antacids.
5. A patient reports epigastric burning 3-4 hours after eating that is worse at
night. Antacids relieve the pain. This describes:
A) Gastric ulcer
B) Duodenal ulcer
C) Gastroesophageal reflux disease
D) Pancreatitis
Correct Answer: B) Duodenal ulcer
Rationale: Duodenal ulcers present with pain when the stomach is empty (between
meals, at night) that improves with food or antacids. This pain is often described as
a burning sensation and may awaken the patient from sleep.
6. A patient with peptic ulcer disease presents with sudden, severe abdominal
pain that is board-like, rigid, and accompanied by tachycardia. What
complication should the nurse suspect?
A) Hemorrhage
B) Obstruction
C) Perforation
D) Gastritis
,Correct Answer: C) Perforation
Rationale: Perforation is a life-threatening complication of peptic ulcer disease
characterized by sudden, severe pain and signs of peritonitis (board-like abdomen,
rigidity, tachycardia). This occurs when the ulcer erodes through the entire wall of
the stomach or duodenum, allowing gastric contents to enter the peritoneal cavity.
7. What are the complications of peptic ulcers?
A) Hemorrhage, obstruction, and perforation
B) Hepatitis, cirrhosis, and jaundice
C) Pancreatitis and gallstones
D) Diverticulitis and colitis
Correct Answer: A) Hemorrhage, obstruction, and perforation
Rationale: The three major complications of peptic ulcers are hemorrhage
(bleeding), obstruction (gastric outlet obstruction), and perforation (erosion
through the full thickness of the wall). These are serious complications requiring
surgical intervention.
8. H. pylori secretes which substances that cause damage to the mucosal
defense?
A) Protease, phospholipase, and urease only
B) Lipase and amylase only
C) Collagenase and elastase only
D) Trypsin and chymotrypsin only
Correct Answer: A) Protease, phospholipase, and urease only
Rationale: H. pylori produces cytotoxins and the enzymes protease,
phospholipase, and urease, which damage the gastric mucosal defense. Urease
produces ammonia that neutralizes gastric acid, while protease and phospholipase
break down the protective mucus layer.
9. What is the recommended treatment for H. pylori-associated peptic ulcer?
A) PPI alone
B) Antibiotics alone
C) PPI + Amoxicillin + Clarithromycin (triple therapy)
D) Antacids only
, Correct Answer: C) PPI + Amoxicillin + Clarithromycin (triple therapy)
Rationale: Triple therapy with a PPI and two antibiotics (e.g., PPI, amoxicillin,
clarithromycin) is standard for H. pylori eradication. Alternative regimens include
PPI + Clarithromycin + Metronidazole, or PPI + Bismuth + Tetracycline +
Metronidazole.
10. What is the mechanism of action of proton pump inhibitors?
A) They neutralize stomach acid
B) They reduce the amount of stomach acid produced in the lining of the stomach
C) They aid in the healing of erosive esophagitis and reduce gastric acid
production
D) They kill H. pylori bacteria
Correct Answer: C) They aid in the healing of erosive esophagitis and reduce
gastric acid production
Rationale: Proton pump inhibitors (e.g., omeprazole, pantoprazole, esomeprazole)
reduce gastric acid production by inhibiting the H+/K+ ATPase enzyme system
(the proton pump) of the gastric parietal cells. This promotes healing of ulcers and
erosive esophagitis.
Section 2: Gastrointestinal Disorders – Gastritis
11. Acute gastritis is defined as:
A) Chronic atrophy of stomach mucosa
B) Inflammation of the stomach
C) Ulceration of the duodenum
D) Inflammation of the pancreas
Correct Answer: B) Inflammation of the stomach
Rationale: Acute gastritis is temporary inflammation of the gastric mucosa caused
by irritants such as NSAIDs, excessive alcohol, or ingestion of spicy foods.
Chronic gastritis involves progressive atrophy of the gastric mucosa.
12. What are the signs and symptoms of acute gastritis?
A) Nausea, vomiting, anorexia, and epigastric pain or cramps
B) Watery diarrhea with blood and mucous
