,NSG 2600 Exam 2 Adult Health Nursing I Questions And Answers
2026/2027 South College
Q1. A 58-year-old client reports persistent burning discomfort
behind the sternum after meals, sour-tasting regurgitation, and
worsening symptoms when lying down. Cardiac causes of the
discomfort have been appropriately excluded. Which physiological
mechanism most likely explains the symptoms?
A) Excessive pancreatic enzyme secretion
B) Increased small intestinal motility
C) Impaired lower esophageal sphincter function allowing gastric contents to
reflux into the esophagus
D) Complete obstruction of the common bile duct
Correct Answer: C) Impaired lower esophageal sphincter function allowing
gastric contents to reflux into the esophagus
Rationale: Gastroesophageal reflux disease develops when gastric contents
repeatedly enter the esophagus, commonly because of transient lower
esophageal sphincter relaxation or impaired antireflux barrier function. Acid
exposure can cause heartburn, regurgitation, and esophageal inflammation.
Obesity, large meals, and recumbency may worsen symptoms.
Q2. A 64-year-old client with chronic gastroesophageal reflux
disease reports progressive difficulty swallowing solid foods and
unintentional weight loss over three months. Which nursing action
is most appropriate?
A) Recommend increasing meal sizes.
B) Explain that difficulty swallowing is a normal consequence of aging.
C) Encourage the client to use antacids indefinitely without evaluation.
D) Arrange prompt diagnostic evaluation for possible esophageal stricture or
malignancy.
Correct Answer: D) Arrange prompt diagnostic evaluation for possible
esophageal stricture or malignancy.
Rationale: Progressive dysphagia and unexplained weight loss are alarm
symptoms that require investigation. Chronic acid injury may cause
esophageal strictures, while malignancy must also be considered. Upper
,gastrointestinal endoscopy is commonly indicated to evaluate structural
abnormalities and obtain tissue samples when necessary.
Q3. A 55-year-old client with persistent gastroesophageal reflux
disease is prescribed omeprazole. Which explanation best describes
its therapeutic mechanism?
A) It irreversibly inhibits the gastric proton pump, reducing acid secretion.
B) It physically blocks the esophagus to prevent reflux.
C) It directly neutralizes all gastric acid already present.
D) It accelerates gastric emptying by stimulating intestinal smooth muscle.
Correct Answer: A) It irreversibly inhibits the gastric proton pump, reducing
acid secretion.
Rationale: Omeprazole is a proton pump inhibitor that suppresses gastric
acid production through inhibition of the hydrogen-potassium ATPase enzyme
in gastric parietal cells. Reduced acidity promotes healing of reflux-
associated esophagitis and improves acid-related symptoms. Long-term
therapy should be periodically reviewed for continued indication.
Q4. A 72-year-old client has a long history of gastroesophageal
reflux disease. Endoscopic biopsy reveals replacement of normal
squamous epithelium with intestinal-type columnar epithelium in
the distal esophagus. Which condition is present?
A) Achalasia
B) Barrett esophagus
C) Esophageal varices
D) Mallory-Weiss syndrome
Correct Answer: B) Barrett esophagus
Rationale: Barrett esophagus is an acquired metaplastic change associated
with chronic gastroesophageal reflux. Intestinal metaplasia increases the risk
of esophageal adenocarcinoma. Management may involve acid suppression,
surveillance endoscopy, and endoscopic treatment when dysplasia is
identified.
Q5. A 61-year-old client reports progressive difficulty swallowing
both solids and liquids, nighttime regurgitation of undigested food,
, and unintended weight loss. Esophageal manometry reveals absent
normal peristalsis and impaired relaxation of the lower esophageal
sphincter. Which disorder is most likely?
A) Gastroesophageal reflux disease alone
B) Duodenal ulcer disease
C) Achalasia
D) Acute gastritis
Correct Answer: C) Achalasia
Rationale: Achalasia is an esophageal motility disorder characterized by
impaired lower esophageal sphincter relaxation and loss of normal
esophageal peristalsis. Food retention can cause regurgitation, dysphagia,
and aspiration. Treatment may include pneumatic dilation, myotomy, or
other specialist-directed interventions.
Q6. A 69-year-old client develops severe chest pain, fever,
tachycardia, and subcutaneous crepitus shortly after forceful
vomiting. Which complication requires immediate consideration?
A) Uncomplicated gastroesophageal reflux
B) Functional dyspepsia
C) Chronic constipation
D) Esophageal perforation
Correct Answer: D) Esophageal perforation
Rationale: Forceful vomiting can occasionally cause full-thickness esophageal
rupture, also known as Boerhaave syndrome. Leakage of esophageal
contents into the mediastinum may cause mediastinitis, sepsis, and shock.
Immediate imaging, fasting status, broad-spectrum antimicrobial therapy,
and surgical evaluation are essential.
Q7. A 47-year-old client reports recurrent epigastric burning and
nausea. Testing identifies Helicobacter pylori infection. Which
treatment strategy is most appropriate?
A) A proton pump inhibitor alone for three days
B) An appropriate multidrug eradication regimen selected according to
resistance considerations and treatment history
2026/2027 South College
Q1. A 58-year-old client reports persistent burning discomfort
behind the sternum after meals, sour-tasting regurgitation, and
worsening symptoms when lying down. Cardiac causes of the
discomfort have been appropriately excluded. Which physiological
mechanism most likely explains the symptoms?
A) Excessive pancreatic enzyme secretion
B) Increased small intestinal motility
C) Impaired lower esophageal sphincter function allowing gastric contents to
reflux into the esophagus
D) Complete obstruction of the common bile duct
Correct Answer: C) Impaired lower esophageal sphincter function allowing
gastric contents to reflux into the esophagus
Rationale: Gastroesophageal reflux disease develops when gastric contents
repeatedly enter the esophagus, commonly because of transient lower
esophageal sphincter relaxation or impaired antireflux barrier function. Acid
exposure can cause heartburn, regurgitation, and esophageal inflammation.
Obesity, large meals, and recumbency may worsen symptoms.
Q2. A 64-year-old client with chronic gastroesophageal reflux
disease reports progressive difficulty swallowing solid foods and
unintentional weight loss over three months. Which nursing action
is most appropriate?
A) Recommend increasing meal sizes.
B) Explain that difficulty swallowing is a normal consequence of aging.
C) Encourage the client to use antacids indefinitely without evaluation.
D) Arrange prompt diagnostic evaluation for possible esophageal stricture or
malignancy.
Correct Answer: D) Arrange prompt diagnostic evaluation for possible
esophageal stricture or malignancy.
Rationale: Progressive dysphagia and unexplained weight loss are alarm
symptoms that require investigation. Chronic acid injury may cause
esophageal strictures, while malignancy must also be considered. Upper
,gastrointestinal endoscopy is commonly indicated to evaluate structural
abnormalities and obtain tissue samples when necessary.
Q3. A 55-year-old client with persistent gastroesophageal reflux
disease is prescribed omeprazole. Which explanation best describes
its therapeutic mechanism?
A) It irreversibly inhibits the gastric proton pump, reducing acid secretion.
B) It physically blocks the esophagus to prevent reflux.
C) It directly neutralizes all gastric acid already present.
D) It accelerates gastric emptying by stimulating intestinal smooth muscle.
Correct Answer: A) It irreversibly inhibits the gastric proton pump, reducing
acid secretion.
Rationale: Omeprazole is a proton pump inhibitor that suppresses gastric
acid production through inhibition of the hydrogen-potassium ATPase enzyme
in gastric parietal cells. Reduced acidity promotes healing of reflux-
associated esophagitis and improves acid-related symptoms. Long-term
therapy should be periodically reviewed for continued indication.
Q4. A 72-year-old client has a long history of gastroesophageal
reflux disease. Endoscopic biopsy reveals replacement of normal
squamous epithelium with intestinal-type columnar epithelium in
the distal esophagus. Which condition is present?
A) Achalasia
B) Barrett esophagus
C) Esophageal varices
D) Mallory-Weiss syndrome
Correct Answer: B) Barrett esophagus
Rationale: Barrett esophagus is an acquired metaplastic change associated
with chronic gastroesophageal reflux. Intestinal metaplasia increases the risk
of esophageal adenocarcinoma. Management may involve acid suppression,
surveillance endoscopy, and endoscopic treatment when dysplasia is
identified.
Q5. A 61-year-old client reports progressive difficulty swallowing
both solids and liquids, nighttime regurgitation of undigested food,
, and unintended weight loss. Esophageal manometry reveals absent
normal peristalsis and impaired relaxation of the lower esophageal
sphincter. Which disorder is most likely?
A) Gastroesophageal reflux disease alone
B) Duodenal ulcer disease
C) Achalasia
D) Acute gastritis
Correct Answer: C) Achalasia
Rationale: Achalasia is an esophageal motility disorder characterized by
impaired lower esophageal sphincter relaxation and loss of normal
esophageal peristalsis. Food retention can cause regurgitation, dysphagia,
and aspiration. Treatment may include pneumatic dilation, myotomy, or
other specialist-directed interventions.
Q6. A 69-year-old client develops severe chest pain, fever,
tachycardia, and subcutaneous crepitus shortly after forceful
vomiting. Which complication requires immediate consideration?
A) Uncomplicated gastroesophageal reflux
B) Functional dyspepsia
C) Chronic constipation
D) Esophageal perforation
Correct Answer: D) Esophageal perforation
Rationale: Forceful vomiting can occasionally cause full-thickness esophageal
rupture, also known as Boerhaave syndrome. Leakage of esophageal
contents into the mediastinum may cause mediastinitis, sepsis, and shock.
Immediate imaging, fasting status, broad-spectrum antimicrobial therapy,
and surgical evaluation are essential.
Q7. A 47-year-old client reports recurrent epigastric burning and
nausea. Testing identifies Helicobacter pylori infection. Which
treatment strategy is most appropriate?
A) A proton pump inhibitor alone for three days
B) An appropriate multidrug eradication regimen selected according to
resistance considerations and treatment history
