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NR 507 Advanced Pathophysiology Final Exam Practice Questions – Weeks 5–8
High-Yield Blueprint Questions with Rationales
WEEK 5: GASTROINTESTINAL & NEUROBIOLOGICAL
Question 1
Which of the following best describes the primary
pathophysiologic mechanism of gastroesophageal reflux disease
(GERD)?
A. Excessive gastric acid production only
B. Transient lower esophageal sphincter relaxation with acid
reflux into the esophagus
C. Delayed gastric emptying only
D. Esophageal stricture
Answer: B
Rationale: GERD is primarily caused by transient relaxation or
decreased tone of the lower esophageal sphincter, allowing
gastric acid to reflux into the esophagus. Excessive acid may
contribute but is not the primary mechanism.
Question 2
A patient with a gastric ulcer typically reports:
A. Pain that occurs 2–3 hours after meals and is relieved by food
B. Pain that worsens with eating
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C. Painless gastrointestinal bleeding
D. Right upper quadrant pain radiating to the shoulder
Answer: B
Rationale: Gastric ulcer pain often worsens with eating because
food stimulates acid secretion and irritates the ulcer. Duodenal
ulcer pain is classically relieved by food and occurs 2–3 hours
after meals.
Question 3
Which of the following is characteristic of duodenal ulcer pain?
A. Occurs immediately after eating
B. Occurs 2–3 hours after meals and often wakes the patient at
night
C. Is relieved by food only temporarily then worsens
D. Is located in the left lower quadrant
Answer: B
Rationale: Duodenal ulcers cause epigastric pain that occurs 2–
3 hours after meals and may awaken the patient at night; food
or antacids often relieve it.
Question 4
A patient with appendicitis initially presents with periumbilical
pain. This early pain is caused by:
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A. Parietal peritoneal irritation
B. Visceral nerve stimulation from distention/inflammation of
the appendix
C. Diaphragmatic irritation
D. Retroperitoneal involvement
Answer: B
Rationale: Early appendicitis pain is dull and periumbilical
because the inflamed appendix distends and stimulates visceral
afferent nerves. When inflammation reaches the parietal
peritoneum, the pain localizes to the right lower quadrant.
Question 5
The classic progression of appendicitis pain is:
A. Right lower quadrant pain that moves to periumbilical
B. Periumbilical pain that migrates to the right lower quadrant
C. Epigastric pain radiating to the back
D. Diffuse abdominal pain without localization
Answer: B
Rationale: Appendicitis classically begins with periumbilical
pain, then migrates to the right lower quadrant at McBurney's
point as parietal peritoneum becomes inflamed.
Question 6
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Portal hypertension in cirrhosis leads to which of the following
complications?
A. Decreased splenic size
B. Esophageal varices, ascites, and splenomegaly
C. Increased hepatic blood flow
D. Decreased ammonia levels
Answer: B
Rationale: Portal hypertension increases portal system
pressure, causing portosystemic shunts (esophageal varices),
splenomegaly, and ascites. Ammonia levels increase due to
shunting.
Question 7
Which neurotransmitter imbalance is most associated with
positive symptoms of schizophrenia (hallucinations, delusions)?
A. Decreased dopamine
B. Excess dopamine in the mesolimbic pathway
C. Excess serotonin
D. Decreased glutamate only
Answer: B
Rationale: Positive symptoms of schizophrenia are linked to
excessive dopamine activity in the mesolimbic pathway.
Negative symptoms may involve decreased dopamine in the
mesocortical pathway and altered glutamate.
NR 507 Advanced Pathophysiology Final Exam Practice Questions – Weeks 5–8
High-Yield Blueprint Questions with Rationales
WEEK 5: GASTROINTESTINAL & NEUROBIOLOGICAL
Question 1
Which of the following best describes the primary
pathophysiologic mechanism of gastroesophageal reflux disease
(GERD)?
A. Excessive gastric acid production only
B. Transient lower esophageal sphincter relaxation with acid
reflux into the esophagus
C. Delayed gastric emptying only
D. Esophageal stricture
Answer: B
Rationale: GERD is primarily caused by transient relaxation or
decreased tone of the lower esophageal sphincter, allowing
gastric acid to reflux into the esophagus. Excessive acid may
contribute but is not the primary mechanism.
Question 2
A patient with a gastric ulcer typically reports:
A. Pain that occurs 2–3 hours after meals and is relieved by food
B. Pain that worsens with eating
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C. Painless gastrointestinal bleeding
D. Right upper quadrant pain radiating to the shoulder
Answer: B
Rationale: Gastric ulcer pain often worsens with eating because
food stimulates acid secretion and irritates the ulcer. Duodenal
ulcer pain is classically relieved by food and occurs 2–3 hours
after meals.
Question 3
Which of the following is characteristic of duodenal ulcer pain?
A. Occurs immediately after eating
B. Occurs 2–3 hours after meals and often wakes the patient at
night
C. Is relieved by food only temporarily then worsens
D. Is located in the left lower quadrant
Answer: B
Rationale: Duodenal ulcers cause epigastric pain that occurs 2–
3 hours after meals and may awaken the patient at night; food
or antacids often relieve it.
Question 4
A patient with appendicitis initially presents with periumbilical
pain. This early pain is caused by:
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A. Parietal peritoneal irritation
B. Visceral nerve stimulation from distention/inflammation of
the appendix
C. Diaphragmatic irritation
D. Retroperitoneal involvement
Answer: B
Rationale: Early appendicitis pain is dull and periumbilical
because the inflamed appendix distends and stimulates visceral
afferent nerves. When inflammation reaches the parietal
peritoneum, the pain localizes to the right lower quadrant.
Question 5
The classic progression of appendicitis pain is:
A. Right lower quadrant pain that moves to periumbilical
B. Periumbilical pain that migrates to the right lower quadrant
C. Epigastric pain radiating to the back
D. Diffuse abdominal pain without localization
Answer: B
Rationale: Appendicitis classically begins with periumbilical
pain, then migrates to the right lower quadrant at McBurney's
point as parietal peritoneum becomes inflamed.
Question 6
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Portal hypertension in cirrhosis leads to which of the following
complications?
A. Decreased splenic size
B. Esophageal varices, ascites, and splenomegaly
C. Increased hepatic blood flow
D. Decreased ammonia levels
Answer: B
Rationale: Portal hypertension increases portal system
pressure, causing portosystemic shunts (esophageal varices),
splenomegaly, and ascites. Ammonia levels increase due to
shunting.
Question 7
Which neurotransmitter imbalance is most associated with
positive symptoms of schizophrenia (hallucinations, delusions)?
A. Decreased dopamine
B. Excess dopamine in the mesolimbic pathway
C. Excess serotonin
D. Decreased glutamate only
Answer: B
Rationale: Positive symptoms of schizophrenia are linked to
excessive dopamine activity in the mesolimbic pathway.
Negative symptoms may involve decreased dopamine in the
mesocortical pathway and altered glutamate.
