NUR 2392: Exam 2 Multidimensional Care II / MDC 2
2026/2027 | Rasmussen College | 100% Correct | Grade A
Verified Questions & Answers with Rationales
Section 1: Gastrointestinal Disorders (Questions 1-20)
Q1: A 45-year-old male presents with epigastric burning pain that worsens 2-3 hours after meals
and is relieved by eating. He reports occasional melena. Which finding is most consistent with
this presentation?
A. Gastric ulcer – pain worsens with food
B. Duodenal ulcer – pain relieved by food, worsens when empty [CORRECT]
C. GERD – retrosternal burning after meals
D. Gastritis – diffuse epigastric discomfort
Correct Answer: B
Rationale: Duodenal ulcers typically present with pain that occurs 2-5 hours after meals (when
stomach is empty) and is relieved by food or antacids; melena indicates upper GI bleeding, a
common complication. Gastric ulcers typically worsen with food. GERD presents with
retrosternal burning, not epigastric pain relieved by eating. Gastritis causes diffuse discomfort
without this classic timing pattern.
Q2: A patient is diagnosed with gastroesophageal reflux disease (GERD). Which instruction
should the nurse include in the discharge teaching?
A. "Eat a large, high-fat meal late at night to keep the stomach full."
B. "Elevate the head of your bed on 6-inch blocks." [CORRECT]
C. "Drink a glass of orange juice each morning to promote digestion."
D. "Lie down flat for 30 minutes after taking your antacid."
Correct Answer: B
,Rationale: Elevating the head of the bed uses gravity to prevent reflux of gastric contents into
the esophagus. Large, late, high-fat meals delay gastric emptying and increase reflux. Citrus
juices (orange juice) are acidic and worsen GERD. Lying flat after eating or taking antacids
removes the protective effect of gravity and is contraindicated.
Q3: A patient with peptic ulcer disease (PUD) is prescribed sucralfate. When should the nurse
instruct the patient to take this medication?
A. With meals to enhance absorption
B. 1 hour before meals and at bedtime on an empty stomach [CORRECT]
C. With an antacid to prevent gastrointestinal upset
D. Immediately after eating to coat the ulcer
Correct Answer: B
Rationale: Sucralfate acts locally to form a protective barrier over the ulcer crater; it requires an
acidic environment to polymerize and must be given on an empty stomach (1 hour before meals
and at bedtime). Taking it with meals or antacids alters stomach pH and prevents the drug from
working properly.
Q4: A patient is admitted with acute gastritis. Which of the following is the most common cause
of acute gastritis?
A. Chronic alcohol use [CORRECT]
B. Chronic use of H2 receptor blockers
C. Spicy food consumption
D. Bacterial overgrowth in the jejunum
Correct Answer: A
Rationale: Acute gastritis is frequently caused by direct mucosal irritation from substances such
as alcohol, NSAIDs, or corrosive agents. H2 blockers and spicy foods can exacerbate symptoms
but are not the most common cause of acute mucosal inflammation. Bacterial overgrowth in the
jejunum is associated with blind loop syndrome.
Q5: A patient is diagnosed with a Helicobacter pylori infection. Which of the following
medications are typically included in a triple therapy regimen? (Select all that apply)
, A. Omeprazole (PPI) [CORRECT]
B. Amoxicillin [CORRECT]
C. Metronidazole [CORRECT]
D. Sulfasalazine
E. Ondansetron
Correct Answer: A, B, C
Rationale: Standard triple therapy for H. pylori consists of a proton pump inhibitor (omeprazole)
combined with two antibiotics (commonly amoxicillin and clarithromycin, or metronidazole if
penicillin allergic) taken for 14 days. Sulfasalazine is used for inflammatory bowel disease.
Ondansetron is an antiemetic.
Q6: The nurse is providing discharge teaching to a patient with Barrett's esophagus. Which
statement by the patient indicates an understanding of the condition?
A. "I will need to have an endoscopy every 6 months to check for cancer."
B. "Because I take a daily PPI, I no longer need to worry about cancer."
C. "This condition means my lower esophageal sphincter is too tight." [CORRECT]
D. " Barrett's esophagus is completely reversible with diet changes."
Correct Answer: C
Rationale: Barrett's esophagus is a complication of chronic GERD where the normal squamous
epithelium of the esophagus is replaced by intestinal metaplasia due to chronic acid exposure
(LES incompetence). It is a premalignant condition requiring periodic (not necessarily every 6
months, guidelines vary) surveillance endoscopy, as PPIs do not eliminate cancer risk. The
cellular changes are generally irreversible.
Q7: A patient with Crohn's disease asks the nurse how it differs from ulcerative colitis (UC).
Which response by the nurse is accurate?
A. "Crohn's disease causes continuous inflammation only in the rectum and colon."
B. "Crohn's disease involves transmural inflammation and can affect any part of the GI
tract from mouth to anus." [CORRECT]
C. "Ulcerative colitis causes fistulas and skip lesions, while Crohn's does not."
2026/2027 | Rasmussen College | 100% Correct | Grade A
Verified Questions & Answers with Rationales
Section 1: Gastrointestinal Disorders (Questions 1-20)
Q1: A 45-year-old male presents with epigastric burning pain that worsens 2-3 hours after meals
and is relieved by eating. He reports occasional melena. Which finding is most consistent with
this presentation?
A. Gastric ulcer – pain worsens with food
B. Duodenal ulcer – pain relieved by food, worsens when empty [CORRECT]
C. GERD – retrosternal burning after meals
D. Gastritis – diffuse epigastric discomfort
Correct Answer: B
Rationale: Duodenal ulcers typically present with pain that occurs 2-5 hours after meals (when
stomach is empty) and is relieved by food or antacids; melena indicates upper GI bleeding, a
common complication. Gastric ulcers typically worsen with food. GERD presents with
retrosternal burning, not epigastric pain relieved by eating. Gastritis causes diffuse discomfort
without this classic timing pattern.
Q2: A patient is diagnosed with gastroesophageal reflux disease (GERD). Which instruction
should the nurse include in the discharge teaching?
A. "Eat a large, high-fat meal late at night to keep the stomach full."
B. "Elevate the head of your bed on 6-inch blocks." [CORRECT]
C. "Drink a glass of orange juice each morning to promote digestion."
D. "Lie down flat for 30 minutes after taking your antacid."
Correct Answer: B
,Rationale: Elevating the head of the bed uses gravity to prevent reflux of gastric contents into
the esophagus. Large, late, high-fat meals delay gastric emptying and increase reflux. Citrus
juices (orange juice) are acidic and worsen GERD. Lying flat after eating or taking antacids
removes the protective effect of gravity and is contraindicated.
Q3: A patient with peptic ulcer disease (PUD) is prescribed sucralfate. When should the nurse
instruct the patient to take this medication?
A. With meals to enhance absorption
B. 1 hour before meals and at bedtime on an empty stomach [CORRECT]
C. With an antacid to prevent gastrointestinal upset
D. Immediately after eating to coat the ulcer
Correct Answer: B
Rationale: Sucralfate acts locally to form a protective barrier over the ulcer crater; it requires an
acidic environment to polymerize and must be given on an empty stomach (1 hour before meals
and at bedtime). Taking it with meals or antacids alters stomach pH and prevents the drug from
working properly.
Q4: A patient is admitted with acute gastritis. Which of the following is the most common cause
of acute gastritis?
A. Chronic alcohol use [CORRECT]
B. Chronic use of H2 receptor blockers
C. Spicy food consumption
D. Bacterial overgrowth in the jejunum
Correct Answer: A
Rationale: Acute gastritis is frequently caused by direct mucosal irritation from substances such
as alcohol, NSAIDs, or corrosive agents. H2 blockers and spicy foods can exacerbate symptoms
but are not the most common cause of acute mucosal inflammation. Bacterial overgrowth in the
jejunum is associated with blind loop syndrome.
Q5: A patient is diagnosed with a Helicobacter pylori infection. Which of the following
medications are typically included in a triple therapy regimen? (Select all that apply)
, A. Omeprazole (PPI) [CORRECT]
B. Amoxicillin [CORRECT]
C. Metronidazole [CORRECT]
D. Sulfasalazine
E. Ondansetron
Correct Answer: A, B, C
Rationale: Standard triple therapy for H. pylori consists of a proton pump inhibitor (omeprazole)
combined with two antibiotics (commonly amoxicillin and clarithromycin, or metronidazole if
penicillin allergic) taken for 14 days. Sulfasalazine is used for inflammatory bowel disease.
Ondansetron is an antiemetic.
Q6: The nurse is providing discharge teaching to a patient with Barrett's esophagus. Which
statement by the patient indicates an understanding of the condition?
A. "I will need to have an endoscopy every 6 months to check for cancer."
B. "Because I take a daily PPI, I no longer need to worry about cancer."
C. "This condition means my lower esophageal sphincter is too tight." [CORRECT]
D. " Barrett's esophagus is completely reversible with diet changes."
Correct Answer: C
Rationale: Barrett's esophagus is a complication of chronic GERD where the normal squamous
epithelium of the esophagus is replaced by intestinal metaplasia due to chronic acid exposure
(LES incompetence). It is a premalignant condition requiring periodic (not necessarily every 6
months, guidelines vary) surveillance endoscopy, as PPIs do not eliminate cancer risk. The
cellular changes are generally irreversible.
Q7: A patient with Crohn's disease asks the nurse how it differs from ulcerative colitis (UC).
Which response by the nurse is accurate?
A. "Crohn's disease causes continuous inflammation only in the rectum and colon."
B. "Crohn's disease involves transmural inflammation and can affect any part of the GI
tract from mouth to anus." [CORRECT]
C. "Ulcerative colitis causes fistulas and skip lesions, while Crohn's does not."
