NUR 2063 Essentials of Pathophysiology Exam 2
Multiple Choice Questions (MCQs) with Answers &
Rationales | Rasmussen University
Below is a comprehensive set of MCQs for Exam 2, covering Gastrointestinal
Disorders, Urinary Tract Disorders, and Endocrine Disorders. Each question includes
the correct answer in bold italics and a detailed rationale.
PART 1: GASTROINTESTINAL DISORDERS
1. A patient reports burning chest pain after meals that worsens when lying down. This is
most consistent with:
a) Peptic ulcer disease
b) Gastroesophageal reflux disease (GERD) ✅
c) Pancreatitis
d) Cholecystitis
Rationale: GERD presents with postprandial burning chest pain (heartburn) that worsens
supine due to reflux of gastric acid into the esophagus. Peptic ulcer pain is typically
epigastric and relieved by food. Pancreatitis presents with severe epigastric pain radiating to
the back. Cholecystitis presents with right upper quadrant pain after fatty meals.
2. Which pathophysiological mechanism is the primary cause of GERD?
a) Excessive gastric acid production
b) Incompetent lower esophageal sphincter (LES) ✅
c) H. pylori infection
d) Delayed gastric emptying
,Rationale: GERD is primarily caused by LES incompetence or inappropriate relaxation,
allowing gastric contents to reflux into the esophagus. While excessive acid and delayed
emptying can contribute, LES dysfunction is the primary mechanism. H. pylori causes peptic
ulcers, not GERD.
3. A patient with a hiatal hernia is most likely to experience:
a) Constipation and bloating
b) Heartburn and regurgitation ✅
c) Bloody diarrhea
d) Right lower quadrant pain
Rationale: Hiatal hernia allows stomach portion to protrude through the diaphragm,
disrupting LES function and promoting acid reflux, causing heartburn and regurgitation.
Constipation is colonic; bloody diarrhea suggests infection or IBD; RLQ pain suggests
appendicitis.
4. Which type of gastritis is most commonly associated with chronic alcohol use?
a) Autoimmune gastritis
b) Acute erosive gastritis ✅
c) Atrophic gastritis
d) Infectious gastritis
Rationale: Alcohol directly irritates and erodes the gastric mucosa, causing acute erosive
gastritis. Autoimmune gastritis involves antibodies against parietal cells. Atrophic gastritis is
chronic. Infectious gastritis is usually H. pylori-related.
5. A patient presents with epigastric burning pain that improves with food but returns 2-3
hours after meals. This suggests:
a) Duodenal ulcer ✅
b) Gastric ulcer
, c) GERD
d) Gastric cancer
Rationale: Duodenal ulcers classically cause pain that improves with food (food buffers
acid) but returns hours later when acid reaccumulates. Gastric ulcer pain often worsens with
food. GERD is postprandial burning. Gastric cancer may have vague symptoms.
6. Which complication of peptic ulcer disease requires immediate surgical intervention?
a) Melena
b) Perforation ✅
c) Anemia
d) Epigastric pain
Rationale: Perforation is a medical emergency allowing gastric contents to enter peritoneal
cavity, causing peritonitis and sepsis. Melena and anemia indicate bleeding but may be
managed medically. Pain alone does not require surgery.
7. A patient with Crohn's disease is most likely to have:
a) Continuous colonic inflammation
b) Transmural inflammation with skip lesions ✅
c) Only rectal involvement
d) Pseudomembrane formation
Rationale: Crohn's disease causes transmural (full-thickness), patchy inflammation with
skip lesions anywhere in GI tract. Ulcerative colitis has continuous colonic inflammation
limited to mucosa. Pseudomembranes suggest C. difficile.
8. Ulcerative colitis is limited to which layer of the bowel?
a) Serosa
b) Muscularis propria
Multiple Choice Questions (MCQs) with Answers &
Rationales | Rasmussen University
Below is a comprehensive set of MCQs for Exam 2, covering Gastrointestinal
Disorders, Urinary Tract Disorders, and Endocrine Disorders. Each question includes
the correct answer in bold italics and a detailed rationale.
PART 1: GASTROINTESTINAL DISORDERS
1. A patient reports burning chest pain after meals that worsens when lying down. This is
most consistent with:
a) Peptic ulcer disease
b) Gastroesophageal reflux disease (GERD) ✅
c) Pancreatitis
d) Cholecystitis
Rationale: GERD presents with postprandial burning chest pain (heartburn) that worsens
supine due to reflux of gastric acid into the esophagus. Peptic ulcer pain is typically
epigastric and relieved by food. Pancreatitis presents with severe epigastric pain radiating to
the back. Cholecystitis presents with right upper quadrant pain after fatty meals.
2. Which pathophysiological mechanism is the primary cause of GERD?
a) Excessive gastric acid production
b) Incompetent lower esophageal sphincter (LES) ✅
c) H. pylori infection
d) Delayed gastric emptying
,Rationale: GERD is primarily caused by LES incompetence or inappropriate relaxation,
allowing gastric contents to reflux into the esophagus. While excessive acid and delayed
emptying can contribute, LES dysfunction is the primary mechanism. H. pylori causes peptic
ulcers, not GERD.
3. A patient with a hiatal hernia is most likely to experience:
a) Constipation and bloating
b) Heartburn and regurgitation ✅
c) Bloody diarrhea
d) Right lower quadrant pain
Rationale: Hiatal hernia allows stomach portion to protrude through the diaphragm,
disrupting LES function and promoting acid reflux, causing heartburn and regurgitation.
Constipation is colonic; bloody diarrhea suggests infection or IBD; RLQ pain suggests
appendicitis.
4. Which type of gastritis is most commonly associated with chronic alcohol use?
a) Autoimmune gastritis
b) Acute erosive gastritis ✅
c) Atrophic gastritis
d) Infectious gastritis
Rationale: Alcohol directly irritates and erodes the gastric mucosa, causing acute erosive
gastritis. Autoimmune gastritis involves antibodies against parietal cells. Atrophic gastritis is
chronic. Infectious gastritis is usually H. pylori-related.
5. A patient presents with epigastric burning pain that improves with food but returns 2-3
hours after meals. This suggests:
a) Duodenal ulcer ✅
b) Gastric ulcer
, c) GERD
d) Gastric cancer
Rationale: Duodenal ulcers classically cause pain that improves with food (food buffers
acid) but returns hours later when acid reaccumulates. Gastric ulcer pain often worsens with
food. GERD is postprandial burning. Gastric cancer may have vague symptoms.
6. Which complication of peptic ulcer disease requires immediate surgical intervention?
a) Melena
b) Perforation ✅
c) Anemia
d) Epigastric pain
Rationale: Perforation is a medical emergency allowing gastric contents to enter peritoneal
cavity, causing peritonitis and sepsis. Melena and anemia indicate bleeding but may be
managed medically. Pain alone does not require surgery.
7. A patient with Crohn's disease is most likely to have:
a) Continuous colonic inflammation
b) Transmural inflammation with skip lesions ✅
c) Only rectal involvement
d) Pseudomembrane formation
Rationale: Crohn's disease causes transmural (full-thickness), patchy inflammation with
skip lesions anywhere in GI tract. Ulcerative colitis has continuous colonic inflammation
limited to mucosa. Pseudomembranes suggest C. difficile.
8. Ulcerative colitis is limited to which layer of the bowel?
a) Serosa
b) Muscularis propria
