NUR 376 Exam 3 Study Guide (2026/2027)
Applied Pathophysiology | Concordia St. Paul –
Practice Questions & Rationales
1. A patient is diagnosed with gastroesophageal reflux disease
(GERD). Which pathophysiological mechanism is the primary
cause of the acid reflux?
A) Excessive production of gastric acid
B) Esophageal dysmotility
C) Incompetence of the lower esophageal sphincter (LES)
D) Delayed gastric emptying
Answer: C) Incompetence of the lower esophageal sphincter
(LES)
Rationale: GERD is primarily caused by a weakened or relaxed
lower esophageal sphincter. When the LES fails to close tightly
after food enters the stomach, gastric contents and acid flow
backward into the esophagus.
2. A client presents with a perforated peptic ulcer. The nurse
knows this is a life-threatening emergency because it results in:
A) Severe gastrointestinal bleeding
,B) Peritonitis due to leakage of gastric contents
C) Bowel obstruction
D) Pyloric stenosis
Answer: B) Peritonitis due to leakage of gastric contents
Rationale: A perforated ulcer creates a hole in the stomach or
duodenal wall, allowing gastric acid, bile, and bacteria to leak
into the normally sterile peritoneal cavity. This causes severe,
life-threatening chemical and bacterial peritonitis.
3. Which pathophysiological finding distinguishes Crohn’s
disease from ulcerative colitis?
A) Crohn’s disease affects only the rectum.
B) Crohn’s disease causes continuous mucosal inflammation
starting at the rectum.
C) Crohn’s disease can involve any part of the gastrointestinal
tract from mouth to anus and has "skip lesions."
D) Crohn’s disease increases the risk of colon cancer more than
ulcerative colitis.
Answer: C) Crohn’s disease can involve any part of the
gastrointestinal tract from mouth to anus and has "skip lesions."
,Rationale: Crohn’s disease is characterized by transmural
inflammation (affecting all layers of the bowel wall) and skip
lesions (healthy tissue alternating with inflamed tissue)
anywhere from the mouth to the anus. Ulcerative colitis is
limited to the colon and rectum, involves only the mucosa, and
is continuous.
4. A patient with celiac disease experiences severe diarrhea and
weight loss after eating wheat products. The pathophysiology of
this response is:
A) An autoimmune reaction to gluten causing villous atrophy in
the small intestine
B) A bacterial infection of the large intestine
C) An enzyme deficiency leading to lactose intolerance
D) Hypersecretion of gastric acid
Answer: A) An autoimmune reaction to gluten causing villous
atrophy in the small intestine
Rationale: Celiac disease is an autoimmune disorder triggered
by gluten (a protein in wheat, barley, rye). Ingestion causes an
immune response that damages the intestinal villi, leading to
malabsorption.
, 5. A client is diagnosed with acute appendicitis. Which
pathophysiological event initiates the condition?
A) Ischemia of the appendix
B) Obstruction of the appendiceal lumen by a fecalith
C) Viral infection of the bowel
D) Peptic ulcer perforation
Answer: B) Obstruction of the appendiceal lumen by a fecalith
Rationale: Appendicitis usually begins when the lumen of the
appendix becomes obstructed (often by a fecalith, tumor, or
lymphoid hyperplasia). This obstruction leads to mucus
accumulation, bacterial overgrowth, increased intraluminal
pressure, ischemia, and eventual rupture.
6. A patient has a mechanical small bowel obstruction. Which
pathophysiological consequence poses the most immediate life-
threatening risk?
A) Metabolic alkalosis
B) Hypovolemic shock and electrolyte imbalance
C) Liver failure
D) Malabsorption of nutrients
Answer: B) Hypovolemic shock and electrolyte imbalance
Applied Pathophysiology | Concordia St. Paul –
Practice Questions & Rationales
1. A patient is diagnosed with gastroesophageal reflux disease
(GERD). Which pathophysiological mechanism is the primary
cause of the acid reflux?
A) Excessive production of gastric acid
B) Esophageal dysmotility
C) Incompetence of the lower esophageal sphincter (LES)
D) Delayed gastric emptying
Answer: C) Incompetence of the lower esophageal sphincter
(LES)
Rationale: GERD is primarily caused by a weakened or relaxed
lower esophageal sphincter. When the LES fails to close tightly
after food enters the stomach, gastric contents and acid flow
backward into the esophagus.
2. A client presents with a perforated peptic ulcer. The nurse
knows this is a life-threatening emergency because it results in:
A) Severe gastrointestinal bleeding
,B) Peritonitis due to leakage of gastric contents
C) Bowel obstruction
D) Pyloric stenosis
Answer: B) Peritonitis due to leakage of gastric contents
Rationale: A perforated ulcer creates a hole in the stomach or
duodenal wall, allowing gastric acid, bile, and bacteria to leak
into the normally sterile peritoneal cavity. This causes severe,
life-threatening chemical and bacterial peritonitis.
3. Which pathophysiological finding distinguishes Crohn’s
disease from ulcerative colitis?
A) Crohn’s disease affects only the rectum.
B) Crohn’s disease causes continuous mucosal inflammation
starting at the rectum.
C) Crohn’s disease can involve any part of the gastrointestinal
tract from mouth to anus and has "skip lesions."
D) Crohn’s disease increases the risk of colon cancer more than
ulcerative colitis.
Answer: C) Crohn’s disease can involve any part of the
gastrointestinal tract from mouth to anus and has "skip lesions."
,Rationale: Crohn’s disease is characterized by transmural
inflammation (affecting all layers of the bowel wall) and skip
lesions (healthy tissue alternating with inflamed tissue)
anywhere from the mouth to the anus. Ulcerative colitis is
limited to the colon and rectum, involves only the mucosa, and
is continuous.
4. A patient with celiac disease experiences severe diarrhea and
weight loss after eating wheat products. The pathophysiology of
this response is:
A) An autoimmune reaction to gluten causing villous atrophy in
the small intestine
B) A bacterial infection of the large intestine
C) An enzyme deficiency leading to lactose intolerance
D) Hypersecretion of gastric acid
Answer: A) An autoimmune reaction to gluten causing villous
atrophy in the small intestine
Rationale: Celiac disease is an autoimmune disorder triggered
by gluten (a protein in wheat, barley, rye). Ingestion causes an
immune response that damages the intestinal villi, leading to
malabsorption.
, 5. A client is diagnosed with acute appendicitis. Which
pathophysiological event initiates the condition?
A) Ischemia of the appendix
B) Obstruction of the appendiceal lumen by a fecalith
C) Viral infection of the bowel
D) Peptic ulcer perforation
Answer: B) Obstruction of the appendiceal lumen by a fecalith
Rationale: Appendicitis usually begins when the lumen of the
appendix becomes obstructed (often by a fecalith, tumor, or
lymphoid hyperplasia). This obstruction leads to mucus
accumulation, bacterial overgrowth, increased intraluminal
pressure, ischemia, and eventual rupture.
6. A patient has a mechanical small bowel obstruction. Which
pathophysiological consequence poses the most immediate life-
threatening risk?
A) Metabolic alkalosis
B) Hypovolemic shock and electrolyte imbalance
C) Liver failure
D) Malabsorption of nutrients
Answer: B) Hypovolemic shock and electrolyte imbalance
