,NR 545 Final Exam – Pharm, Phys Assess &
Pathophys – Q&A (2026) PDF | Chamberlain
1. A patient presents with epigastric pain that worsens immediately after meals
and is only partially relieved by antacids. The nurse practitioner suspects a
gastric ulcer. What is the most common cause of this condition?
A) Stress and spicy foods
B) Helicobacter pylori infection and NSAID use
C) Excessive caffeine intake
D) Genetic predisposition alone
Correct Answer: B) Helicobacter pylori infection and NSAID use
Rationale: H. pylori and NSAIDs are the primary etiologies of peptic ulcer
disease. H. pylori disrupts the mucosal barrier, and NSAIDs inhibit prostaglandin
synthesis. Stress and diet may exacerbate but are not primary causes.
2. A patient with ulcerative colitis reports frequent watery stools containing
blood and mucus, along with a persistent urge to defecate. This urge is known
as:
A) Hematochezia
B) Steatorrhea
C) Tenesmus
D) Obstipation
Correct Answer: C) Tenesmus
,Rationale: Tenesmus is a spasmodic sensation of needing to defecate even
when the bowel is empty, characteristic of rectal inflammation in ulcerative
colitis. Hematochezia is bright red blood, steatorrhea is fatty stools.
3. The nurse practitioner is evaluating a patient with right lower quadrant pain
that began at the umbilicus. Which physical exam finding best supports a
diagnosis of appendicitis?
A) Murphy's sign
B) Rovsing's sign
C) McBurney's point tenderness
D) Cullen's sign
Correct Answer: C) McBurney's point tenderness
Rationale: McBurney's point, located one-third the distance from the anterior
superior iliac spine to the umbilicus, is the classic location of maximal
tenderness in appendicitis. Murphy's sign indicates cholecystitis.
4. A patient with Crohn's disease asks how it differs from ulcerative colitis. The
nurse practitioner explains that Crohn's disease:
A) Is limited to the rectum and colon
B) Causes continuous mucosal inflammation
C) Can affect any part of the GI tract and causes transmural skip lesions
D) Always spares the small intestine
Correct Answer: C) Can affect any part of the GI tract and causes transmural skip
lesions
, Rationale: Crohn's disease is characterized by transmural inflammation and skip
lesions anywhere from mouth to anus. Ulcerative colitis is limited to the colon
and rectum, with continuous mucosal involvement.
5. The nurse practitioner is teaching a patient with a new diagnosis of peptic
ulcer disease about triple therapy. Which combination is standard first-line
treatment for H. pylori?
A) PPI, amoxicillin, and clarithromycin
B) H2 blocker, bismuth, and metronidazole
C) Sucralfate, tetracycline, and levofloxacin
D) Antacid, clarithromycin, and tinidazole
Correct Answer: A) PPI, amoxicillin, and clarithromycin
Rationale: A proton pump inhibitor combined with amoxicillin and
clarithromycin for 14 days is recommended first-line to eradicate H. pylori, heal
the ulcer, and prevent recurrence.
6. A patient with a duodenal ulcer reports that the burning epigastric pain
typically occurs:
A) Immediately after eating and is unrelieved by antacids
B) Two to three hours after meals and at night, relieved by food or antacids
C) Only with consumption of spicy foods
D) In the left lower quadrant, radiating to the groin
Pathophys – Q&A (2026) PDF | Chamberlain
1. A patient presents with epigastric pain that worsens immediately after meals
and is only partially relieved by antacids. The nurse practitioner suspects a
gastric ulcer. What is the most common cause of this condition?
A) Stress and spicy foods
B) Helicobacter pylori infection and NSAID use
C) Excessive caffeine intake
D) Genetic predisposition alone
Correct Answer: B) Helicobacter pylori infection and NSAID use
Rationale: H. pylori and NSAIDs are the primary etiologies of peptic ulcer
disease. H. pylori disrupts the mucosal barrier, and NSAIDs inhibit prostaglandin
synthesis. Stress and diet may exacerbate but are not primary causes.
2. A patient with ulcerative colitis reports frequent watery stools containing
blood and mucus, along with a persistent urge to defecate. This urge is known
as:
A) Hematochezia
B) Steatorrhea
C) Tenesmus
D) Obstipation
Correct Answer: C) Tenesmus
,Rationale: Tenesmus is a spasmodic sensation of needing to defecate even
when the bowel is empty, characteristic of rectal inflammation in ulcerative
colitis. Hematochezia is bright red blood, steatorrhea is fatty stools.
3. The nurse practitioner is evaluating a patient with right lower quadrant pain
that began at the umbilicus. Which physical exam finding best supports a
diagnosis of appendicitis?
A) Murphy's sign
B) Rovsing's sign
C) McBurney's point tenderness
D) Cullen's sign
Correct Answer: C) McBurney's point tenderness
Rationale: McBurney's point, located one-third the distance from the anterior
superior iliac spine to the umbilicus, is the classic location of maximal
tenderness in appendicitis. Murphy's sign indicates cholecystitis.
4. A patient with Crohn's disease asks how it differs from ulcerative colitis. The
nurse practitioner explains that Crohn's disease:
A) Is limited to the rectum and colon
B) Causes continuous mucosal inflammation
C) Can affect any part of the GI tract and causes transmural skip lesions
D) Always spares the small intestine
Correct Answer: C) Can affect any part of the GI tract and causes transmural skip
lesions
, Rationale: Crohn's disease is characterized by transmural inflammation and skip
lesions anywhere from mouth to anus. Ulcerative colitis is limited to the colon
and rectum, with continuous mucosal involvement.
5. The nurse practitioner is teaching a patient with a new diagnosis of peptic
ulcer disease about triple therapy. Which combination is standard first-line
treatment for H. pylori?
A) PPI, amoxicillin, and clarithromycin
B) H2 blocker, bismuth, and metronidazole
C) Sucralfate, tetracycline, and levofloxacin
D) Antacid, clarithromycin, and tinidazole
Correct Answer: A) PPI, amoxicillin, and clarithromycin
Rationale: A proton pump inhibitor combined with amoxicillin and
clarithromycin for 14 days is recommended first-line to eradicate H. pylori, heal
the ulcer, and prevent recurrence.
6. A patient with a duodenal ulcer reports that the burning epigastric pain
typically occurs:
A) Immediately after eating and is unrelieved by antacids
B) Two to three hours after meals and at night, relieved by food or antacids
C) Only with consumption of spicy foods
D) In the left lower quadrant, radiating to the groin
