NSG 3113 Patho for Nurses Exam 2 Review Verified
Q&A Graded A+
Question 1: A patient presents with difficulty swallowing. Which term best describes this condition?
A) Peristalsis
B) Steatorrhea
C) Hematemesis
D) Dysphagia
ANSWER: D
Rationale: Dysphagia is difficulty swallowing; it is associated with lack of gag reflex and is assessed with a
barium swallow test. Peristalsis is the squeezing movement that pushes food through the digestive tract;
steatorrhea is fatty, foul-smelling stools; hematemesis is vomiting blood.
Question 2: A patient with chronic GERD develops Barrett's esophagus. This represents which cellular
adaptation?
A) Dysplasia
B) Hyperplasia
C) Anaplasia
D) Metaplasia
ANSWER: D
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another. In
GERD, chronic acid reflux causes the normal squamous epithelium of the esophagus to be replaced by
columnar epithelium with goblet cells (Barrett's esophagus), which is a precursor to esophageal
,adenocarcinoma. Dysplasia is abnormal cellular growth; hyperplasia is increased cell number; anaplasia
is undifferentiated cells characteristic of malignancy.
Question 3: Which cells secrete hydrochloric acid and intrinsic factor?
A) Gastric goblet cells
B) Gastric parietal cells
C) Chief cells
D) Mucous cells
ANSWER: B
Rationale: Gastric parietal cells secrete hydrochloric acid and intrinsic factor. Gastric goblet cells secrete
mucus and prostaglandin to protect the stomach lining from harsh acid. Chief cells secrete pepsinogen;
mucous cells produce alkaline mucus.
Question 4: What is the primary function of the lower esophageal sphincter (LES)?
A) Prevents backflow of food from esophagus back into mouth
B) Separates gastric contents from the esophagus
C) Secretes digestive enzymes
D) Absorbs nutrients
ANSWER: B
Rationale: The lower esophageal sphincter (LES) separates gastric contents from the esophagus. The
upper esophageal sphincter prevents backflow of food from esophagus back into mouth. The LES does
not secrete enzymes or absorb nutrients.
Question 5: What is GERD and what causes it?
A) Excessive gastric acid production without sphincter involvement
,B) Decreased closure of the lower esophageal sphincter, allowing acidic gastric contents to reflux up into
the esophagus
C) Inflammation of the gastric mucosa
D) Infection with Helicobacter pylori
ANSWER: B
Rationale: GERD (Gastroesophageal Reflux Disease) occurs due to decreased closure of the lower
esophageal sphincter, which allows acidic gastric contents to reflux up into the esophagus. Excessive
acid production alone does not cause GERD without sphincter dysfunction. Gastric inflammation is
gastritis; H. pylori is associated with peptic ulcers.
Question 6: A patient with peptic ulcer disease is prescribed a proton pump inhibitor (PPI). What is the
mechanism of action of this medication?
A) Blocks histamine-2 receptors on parietal cells
B) Neutralizes gastric acid in the stomach lumen
C) Inhibits the hydrogen-potassium ATPase pump on parietal cells
D) Coats the gastric mucosa to protect it from acid
ANSWER: C
Rationale: PPIs inhibit the hydrogen-potassium ATPase (proton pump) on parietal cells, which is the final
common pathway for acid secretion. H2 blockers block histamine receptors; antacids neutralize acid;
sucralfate coats the mucosa.
Question 7: Which of the following is a risk factor for the development of gastric cancer?
A) Low-salt diet
B) Helicobacter pylori infection
C) Frequent use of NSAIDs
D) High-fiber diet
, ANSWER: B
Rationale: H. pylori infection is a major risk factor for gastric cancer, as it causes chronic inflammation
that can progress to malignancy. High-salt diets increase risk; NSAIDs are associated with ulcers but not
directly gastric cancer; high-fiber diets are protective.
Question 8: A patient presents with right upper quadrant pain, nausea, and fever. Ultrasound reveals
gallstones. Which condition is most likely?
A) Cholecystitis
B) Pancreatitis
C) Appendicitis
D) Diverticulitis
ANSWER: A
Rationale: Cholecystitis is inflammation of the gallbladder, often caused by gallstones obstructing the
cystic duct, presenting with right upper quadrant pain, nausea, and fever. Pancreatitis presents with
epigastric pain radiating to back; appendicitis presents with right lower quadrant pain; diverticulitis
presents with left lower quadrant pain.
Question 9: What is the primary cause of acute pancreatitis?
A) Gallstones and alcohol abuse
B) High-fat diet
C) Bacterial infection
D) Autoimmune disease
ANSWER: A
Rationale: Gallstones and alcohol abuse are the two most common causes of acute pancreatitis,
accounting for approximately 80% of cases. High-fat diet may contribute to gallstones but is not a direct
cause; bacterial infection is not a primary cause; autoimmune pancreatitis is rare.
Q&A Graded A+
Question 1: A patient presents with difficulty swallowing. Which term best describes this condition?
A) Peristalsis
B) Steatorrhea
C) Hematemesis
D) Dysphagia
ANSWER: D
Rationale: Dysphagia is difficulty swallowing; it is associated with lack of gag reflex and is assessed with a
barium swallow test. Peristalsis is the squeezing movement that pushes food through the digestive tract;
steatorrhea is fatty, foul-smelling stools; hematemesis is vomiting blood.
Question 2: A patient with chronic GERD develops Barrett's esophagus. This represents which cellular
adaptation?
A) Dysplasia
B) Hyperplasia
C) Anaplasia
D) Metaplasia
ANSWER: D
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another. In
GERD, chronic acid reflux causes the normal squamous epithelium of the esophagus to be replaced by
columnar epithelium with goblet cells (Barrett's esophagus), which is a precursor to esophageal
,adenocarcinoma. Dysplasia is abnormal cellular growth; hyperplasia is increased cell number; anaplasia
is undifferentiated cells characteristic of malignancy.
Question 3: Which cells secrete hydrochloric acid and intrinsic factor?
A) Gastric goblet cells
B) Gastric parietal cells
C) Chief cells
D) Mucous cells
ANSWER: B
Rationale: Gastric parietal cells secrete hydrochloric acid and intrinsic factor. Gastric goblet cells secrete
mucus and prostaglandin to protect the stomach lining from harsh acid. Chief cells secrete pepsinogen;
mucous cells produce alkaline mucus.
Question 4: What is the primary function of the lower esophageal sphincter (LES)?
A) Prevents backflow of food from esophagus back into mouth
B) Separates gastric contents from the esophagus
C) Secretes digestive enzymes
D) Absorbs nutrients
ANSWER: B
Rationale: The lower esophageal sphincter (LES) separates gastric contents from the esophagus. The
upper esophageal sphincter prevents backflow of food from esophagus back into mouth. The LES does
not secrete enzymes or absorb nutrients.
Question 5: What is GERD and what causes it?
A) Excessive gastric acid production without sphincter involvement
,B) Decreased closure of the lower esophageal sphincter, allowing acidic gastric contents to reflux up into
the esophagus
C) Inflammation of the gastric mucosa
D) Infection with Helicobacter pylori
ANSWER: B
Rationale: GERD (Gastroesophageal Reflux Disease) occurs due to decreased closure of the lower
esophageal sphincter, which allows acidic gastric contents to reflux up into the esophagus. Excessive
acid production alone does not cause GERD without sphincter dysfunction. Gastric inflammation is
gastritis; H. pylori is associated with peptic ulcers.
Question 6: A patient with peptic ulcer disease is prescribed a proton pump inhibitor (PPI). What is the
mechanism of action of this medication?
A) Blocks histamine-2 receptors on parietal cells
B) Neutralizes gastric acid in the stomach lumen
C) Inhibits the hydrogen-potassium ATPase pump on parietal cells
D) Coats the gastric mucosa to protect it from acid
ANSWER: C
Rationale: PPIs inhibit the hydrogen-potassium ATPase (proton pump) on parietal cells, which is the final
common pathway for acid secretion. H2 blockers block histamine receptors; antacids neutralize acid;
sucralfate coats the mucosa.
Question 7: Which of the following is a risk factor for the development of gastric cancer?
A) Low-salt diet
B) Helicobacter pylori infection
C) Frequent use of NSAIDs
D) High-fiber diet
, ANSWER: B
Rationale: H. pylori infection is a major risk factor for gastric cancer, as it causes chronic inflammation
that can progress to malignancy. High-salt diets increase risk; NSAIDs are associated with ulcers but not
directly gastric cancer; high-fiber diets are protective.
Question 8: A patient presents with right upper quadrant pain, nausea, and fever. Ultrasound reveals
gallstones. Which condition is most likely?
A) Cholecystitis
B) Pancreatitis
C) Appendicitis
D) Diverticulitis
ANSWER: A
Rationale: Cholecystitis is inflammation of the gallbladder, often caused by gallstones obstructing the
cystic duct, presenting with right upper quadrant pain, nausea, and fever. Pancreatitis presents with
epigastric pain radiating to back; appendicitis presents with right lower quadrant pain; diverticulitis
presents with left lower quadrant pain.
Question 9: What is the primary cause of acute pancreatitis?
A) Gallstones and alcohol abuse
B) High-fat diet
C) Bacterial infection
D) Autoimmune disease
ANSWER: A
Rationale: Gallstones and alcohol abuse are the two most common causes of acute pancreatitis,
accounting for approximately 80% of cases. High-fat diet may contribute to gallstones but is not a direct
cause; bacterial infection is not a primary cause; autoimmune pancreatitis is rare.
