2026 NUR 5461 Module 5 Quiz –
Advanced Pathophysiology – (2026)
Actual Questions & Answers (William
Paterson University)
Section 1: GI & Digestive Function Alterations (Questions 1-40)
Question 1: A complication of ulcerative colitis not seen with Crohn's disease is:
A. Fistula formation
B. Skip lesions throughout the GI tract
C. Increased risk for adenocarcinoma of the colon
D. Malabsorption of vitamin B₁₂
Correct Answer: C. Increased risk for adenocarcinoma of the colon
Rationale: Ulcerative colitis is confined to the colon and is strongly associated
with an increased risk of colorectal adenocarcinoma, especially with long-standing,
extensive disease. Crohn's disease carries some cancer risk but not to the same
degree or as characteristically as UC .
Question 2: A peptic ulcer may occur in all of the following areas except:
A. Stomach
B. Duodenum
,C. Esophagus
D. Jejunum
Correct Answer: D. Jejunum
Rationale: Classic peptic ulcers arise in areas exposed to gastric acid and pepsin—
primarily the stomach, duodenum, and sometimes the lower esophagus. The
jejunum is not a typical site for primary peptic ulcer disease .
Question 3: What is a role of the normal intestinal bacterial flora?
A. Secretion of intrinsic factor
B. Metabolize bile salts, estrogens, and lipids
C. Synthesize pepsin
D. Produce gastric acid
Correct Answer: B. Metabolize bile salts, estrogens, and lipids
Rationale: Normal gut flora metabolize bile salts, estrogens, and lipids, synthesize
vitamin K and certain B vitamins, and prevent colonization by pathogenic
organisms. They do not secrete intrinsic factor (parietal cells), synthesize pepsin
(chief cells), or produce gastric acid .
Question 4: The products of lipid hydrolysis must be made water soluble if they
are to be absorbed efficiently from the intestinal lumen. Which structure facilitates
this absorption?
,A. Chylomicrons
B. Villi
C. Micelles
D. Brush border enzymes
Correct Answer: C. Micelles
Rationale: Bile salts form micelles—small, water-soluble aggregates that transport
fatty acids and monoglycerides to the intestinal brush border for absorption.
Chylomicrons form later inside enterocytes for lymphatic transport .
Question 5: What is the process of the conjugation of bilirubin by the liver?
A. Conversion of conjugated bilirubin into unconjugated bilirubin
B. Transformation of unconjugated (fat-soluble) bilirubin into conjugated (water-
soluble) bilirubin
C. Excretion of bilirubin directly into urine
D. Oxidation of bilirubin into bile salts
Correct Answer: B. Transformation of unconjugated (fat-soluble) bilirubin
into conjugated (water-soluble) bilirubin
Rationale: Hepatocytes conjugate bilirubin with glucuronic acid, making it water-
soluble so it can be excreted in bile into the intestine. Impaired conjugation leads to
unconjugated hyperbilirubinemia .
Question 6: A hiatal hernia is often associated with which of the following?
, A. Esophageal varices
B. Gastroesophageal reflux
C. Right lower quadrant pain
D. Dysphagia to solids only
Correct Answer: B. Gastroesophageal reflux
Rationale: Hiatal hernia allows part of the stomach to protrude through the
diaphragm, weakening the lower esophageal sphincter and predisposing to reflux
symptoms such as heartburn and regurgitation .
Question 7: Peptic ulcers may be caused by:
A. Psychological stress alone
B. NSAIDs, Helicobacter pylori infection, and habitual alcohol consumption
C. High-fiber diet
D. Low-salt intake
Correct Answer: B. NSAIDs, Helicobacter pylori infection, and habitual
alcohol consumption
Rationale: The major etiologic factors in peptic ulcer disease are H. pylori
infection, NSAID use (which decreases prostaglandins), and mucosal injury from
alcohol. Stress may exacerbate but is not a primary structural cause .
Question 8: Gastric ulcers:
Advanced Pathophysiology – (2026)
Actual Questions & Answers (William
Paterson University)
Section 1: GI & Digestive Function Alterations (Questions 1-40)
Question 1: A complication of ulcerative colitis not seen with Crohn's disease is:
A. Fistula formation
B. Skip lesions throughout the GI tract
C. Increased risk for adenocarcinoma of the colon
D. Malabsorption of vitamin B₁₂
Correct Answer: C. Increased risk for adenocarcinoma of the colon
Rationale: Ulcerative colitis is confined to the colon and is strongly associated
with an increased risk of colorectal adenocarcinoma, especially with long-standing,
extensive disease. Crohn's disease carries some cancer risk but not to the same
degree or as characteristically as UC .
Question 2: A peptic ulcer may occur in all of the following areas except:
A. Stomach
B. Duodenum
,C. Esophagus
D. Jejunum
Correct Answer: D. Jejunum
Rationale: Classic peptic ulcers arise in areas exposed to gastric acid and pepsin—
primarily the stomach, duodenum, and sometimes the lower esophagus. The
jejunum is not a typical site for primary peptic ulcer disease .
Question 3: What is a role of the normal intestinal bacterial flora?
A. Secretion of intrinsic factor
B. Metabolize bile salts, estrogens, and lipids
C. Synthesize pepsin
D. Produce gastric acid
Correct Answer: B. Metabolize bile salts, estrogens, and lipids
Rationale: Normal gut flora metabolize bile salts, estrogens, and lipids, synthesize
vitamin K and certain B vitamins, and prevent colonization by pathogenic
organisms. They do not secrete intrinsic factor (parietal cells), synthesize pepsin
(chief cells), or produce gastric acid .
Question 4: The products of lipid hydrolysis must be made water soluble if they
are to be absorbed efficiently from the intestinal lumen. Which structure facilitates
this absorption?
,A. Chylomicrons
B. Villi
C. Micelles
D. Brush border enzymes
Correct Answer: C. Micelles
Rationale: Bile salts form micelles—small, water-soluble aggregates that transport
fatty acids and monoglycerides to the intestinal brush border for absorption.
Chylomicrons form later inside enterocytes for lymphatic transport .
Question 5: What is the process of the conjugation of bilirubin by the liver?
A. Conversion of conjugated bilirubin into unconjugated bilirubin
B. Transformation of unconjugated (fat-soluble) bilirubin into conjugated (water-
soluble) bilirubin
C. Excretion of bilirubin directly into urine
D. Oxidation of bilirubin into bile salts
Correct Answer: B. Transformation of unconjugated (fat-soluble) bilirubin
into conjugated (water-soluble) bilirubin
Rationale: Hepatocytes conjugate bilirubin with glucuronic acid, making it water-
soluble so it can be excreted in bile into the intestine. Impaired conjugation leads to
unconjugated hyperbilirubinemia .
Question 6: A hiatal hernia is often associated with which of the following?
, A. Esophageal varices
B. Gastroesophageal reflux
C. Right lower quadrant pain
D. Dysphagia to solids only
Correct Answer: B. Gastroesophageal reflux
Rationale: Hiatal hernia allows part of the stomach to protrude through the
diaphragm, weakening the lower esophageal sphincter and predisposing to reflux
symptoms such as heartburn and regurgitation .
Question 7: Peptic ulcers may be caused by:
A. Psychological stress alone
B. NSAIDs, Helicobacter pylori infection, and habitual alcohol consumption
C. High-fiber diet
D. Low-salt intake
Correct Answer: B. NSAIDs, Helicobacter pylori infection, and habitual
alcohol consumption
Rationale: The major etiologic factors in peptic ulcer disease are H. pylori
infection, NSAID use (which decreases prostaglandins), and mucosal injury from
alcohol. Stress may exacerbate but is not a primary structural cause .
Question 8: Gastric ulcers:
