Wilkes University NSG 530 Advanced Pathophysiology Exam 3 (pdf) |
2026/2027 | Patho Q&A | Pathophysiology
1. Which of the following correctly lists the layers of the gastrointestinal tract
from outermost to innermost?
A) Mucosa, submucosa, muscularis, serosa/adventitia
B) Serosa/adventitia, muscularis, submucosa, mucosa
C) Submucosa, mucosa, serosa/adventitia, muscularis
D) Muscularis, serosa/adventitia, mucosa, submucosa
Correct Answer: Serosa/adventitia, muscularis, submucosa, mucosa
Rationale: The GI tract has four layers: the outermost serosa/adventitia
(connective tissue), muscularis (smooth muscle for motility), submucosa
(blood vessels and nerves), and mucosa (innermost layer for absorption).
This layered structure allows for coordinated movement, secretion, and
absorption of nutrients.
2. What is the primary function of the enteric (intramural) plexus?
A) Digest proteins
B) Control motility, secretion, sensation, and blood flow
C) Absorb nutrients
D) Produce bile
Correct Answer: Control motility, secretion, sensation, and blood flow
Rationale: The enteric plexus, also called the "brain of the gut," is a network
of neurons embedded in the GI tract wall that independently regulates
motility, secretion, sensation, and blood flow to the digestive organs. The
vagus nerve provides extrinsic control.
,3. A patient presents with difficulty swallowing. The nurse recognizes that
this condition involves which phase of swallowing?
A) Oral phase only
B) Pharyngeal phase only
C) Esophageal phase only
D) Any or all phases of swallowing
Correct Answer: Any or all phases of swallowing
Rationale: Dysphagia can occur during the oropharyngeal phase (voluntary,
striated muscle) or the esophageal phase (involuntary, smooth muscle). The
oropharyngeal phase forms a bolus and forces it toward the pharynx, while
the esophageal phase uses peristalsis to move food through the lower
esophageal sphincter.
4. Which of the following best describes the function of saliva?
A) Only lubricates food
B) Lubrication, antibacterial action, pH regulation, thermoregulation, and
enzymatic digestion
C) Only initiates starch digestion
D) Only neutralizes stomach acid
Correct Answer: Lubrication, antibacterial action, pH regulation,
thermoregulation, and enzymatic digestion
Rationale: Saliva has multiple critical functions: lubrication for swallowing,
antibacterial action (lysozyme), pH regulation (neutralizes bacterial acids),
thermoregulation (evaporative cooling), and enzymatic digestion (amylase
begins starch breakdown).
,5. The three pairs of salivary glands are the:
A) Parotid, submandibular, and sublingual
B) Parotid, sublingual, and adrenal
C) Submandibular, sublingual, and thyroid
D) Parotid, submandibular, and pancreatic
Correct Answer: Parotid, submandibular, and sublingual
Rationale: The three pairs of salivary glands are the parotid (largest, located
near the ear), submandibular (under the jaw), and sublingual (under the
tongue). These glands secrete saliva with a pH of approximately 7.4, which
neutralizes bacterial acids and prevents tooth decay.
6. A patient with decreased salivary flow is at risk for which complication?
A) Increased gastric acid production
B) Dental caries and oral infections
C) Enhanced digestion
D) Improved taste sensation
Correct Answer: Dental caries and oral infections
Rationale: Saliva has a pH of about 7.4 and neutralizes bacterial acids to
prevent tooth decay. Decreased salivary flow (xerostomia) increases the risk
of dental caries, oral infections, and difficulty swallowing. Saliva also contains
antibacterial lysozyme and mucin for lubrication.
7. Which structure prevents regurgitation from the stomach into the
esophagus?
A) Upper esophageal sphincter
, B) Lower esophageal sphincter
C) Pyloric sphincter
D) Cardiac orifice
Correct Answer: Lower esophageal sphincter
Rationale: The lower esophageal sphincter (LES) is a ring of smooth muscle
that prevents regurgitation of gastric contents into the esophagus, protecting
it from caustic injury. Failure of the LES leads to gastroesophageal reflux
disease (GERD).
8. A patient with gastroesophageal reflux disease (GERD) is most likely to
have dysfunction of which structure?
A) Upper esophageal sphincter
B) Lower esophageal sphincter
C) Pyloric sphincter
D) Ileocecal valve
Correct Answer: Lower esophageal sphincter
Rationale: GERD is caused by failure of the lower esophageal sphincter,
allowing stomach contents to flow back into the esophagus. This results in
burning and irritation in the chest and throat from gastric acid exposure.
9. The stomach is impermeable to water but can absorb which substances?
A) Proteins and carbohydrates
B) Alcohol and aspirin
C) Vitamins and minerals
D) Electrolytes only
2026/2027 | Patho Q&A | Pathophysiology
1. Which of the following correctly lists the layers of the gastrointestinal tract
from outermost to innermost?
A) Mucosa, submucosa, muscularis, serosa/adventitia
B) Serosa/adventitia, muscularis, submucosa, mucosa
C) Submucosa, mucosa, serosa/adventitia, muscularis
D) Muscularis, serosa/adventitia, mucosa, submucosa
Correct Answer: Serosa/adventitia, muscularis, submucosa, mucosa
Rationale: The GI tract has four layers: the outermost serosa/adventitia
(connective tissue), muscularis (smooth muscle for motility), submucosa
(blood vessels and nerves), and mucosa (innermost layer for absorption).
This layered structure allows for coordinated movement, secretion, and
absorption of nutrients.
2. What is the primary function of the enteric (intramural) plexus?
A) Digest proteins
B) Control motility, secretion, sensation, and blood flow
C) Absorb nutrients
D) Produce bile
Correct Answer: Control motility, secretion, sensation, and blood flow
Rationale: The enteric plexus, also called the "brain of the gut," is a network
of neurons embedded in the GI tract wall that independently regulates
motility, secretion, sensation, and blood flow to the digestive organs. The
vagus nerve provides extrinsic control.
,3. A patient presents with difficulty swallowing. The nurse recognizes that
this condition involves which phase of swallowing?
A) Oral phase only
B) Pharyngeal phase only
C) Esophageal phase only
D) Any or all phases of swallowing
Correct Answer: Any or all phases of swallowing
Rationale: Dysphagia can occur during the oropharyngeal phase (voluntary,
striated muscle) or the esophageal phase (involuntary, smooth muscle). The
oropharyngeal phase forms a bolus and forces it toward the pharynx, while
the esophageal phase uses peristalsis to move food through the lower
esophageal sphincter.
4. Which of the following best describes the function of saliva?
A) Only lubricates food
B) Lubrication, antibacterial action, pH regulation, thermoregulation, and
enzymatic digestion
C) Only initiates starch digestion
D) Only neutralizes stomach acid
Correct Answer: Lubrication, antibacterial action, pH regulation,
thermoregulation, and enzymatic digestion
Rationale: Saliva has multiple critical functions: lubrication for swallowing,
antibacterial action (lysozyme), pH regulation (neutralizes bacterial acids),
thermoregulation (evaporative cooling), and enzymatic digestion (amylase
begins starch breakdown).
,5. The three pairs of salivary glands are the:
A) Parotid, submandibular, and sublingual
B) Parotid, sublingual, and adrenal
C) Submandibular, sublingual, and thyroid
D) Parotid, submandibular, and pancreatic
Correct Answer: Parotid, submandibular, and sublingual
Rationale: The three pairs of salivary glands are the parotid (largest, located
near the ear), submandibular (under the jaw), and sublingual (under the
tongue). These glands secrete saliva with a pH of approximately 7.4, which
neutralizes bacterial acids and prevents tooth decay.
6. A patient with decreased salivary flow is at risk for which complication?
A) Increased gastric acid production
B) Dental caries and oral infections
C) Enhanced digestion
D) Improved taste sensation
Correct Answer: Dental caries and oral infections
Rationale: Saliva has a pH of about 7.4 and neutralizes bacterial acids to
prevent tooth decay. Decreased salivary flow (xerostomia) increases the risk
of dental caries, oral infections, and difficulty swallowing. Saliva also contains
antibacterial lysozyme and mucin for lubrication.
7. Which structure prevents regurgitation from the stomach into the
esophagus?
A) Upper esophageal sphincter
, B) Lower esophageal sphincter
C) Pyloric sphincter
D) Cardiac orifice
Correct Answer: Lower esophageal sphincter
Rationale: The lower esophageal sphincter (LES) is a ring of smooth muscle
that prevents regurgitation of gastric contents into the esophagus, protecting
it from caustic injury. Failure of the LES leads to gastroesophageal reflux
disease (GERD).
8. A patient with gastroesophageal reflux disease (GERD) is most likely to
have dysfunction of which structure?
A) Upper esophageal sphincter
B) Lower esophageal sphincter
C) Pyloric sphincter
D) Ileocecal valve
Correct Answer: Lower esophageal sphincter
Rationale: GERD is caused by failure of the lower esophageal sphincter,
allowing stomach contents to flow back into the esophagus. This results in
burning and irritation in the chest and throat from gastric acid exposure.
9. The stomach is impermeable to water but can absorb which substances?
A) Proteins and carbohydrates
B) Alcohol and aspirin
C) Vitamins and minerals
D) Electrolytes only
