,NSG 123 Exam 2 | Medical-Surgical Nursing I (2026)
Q&A | Herzing University
1. Which statement best describes the pathophysiology of gastroesophageal reflux
disease (GERD)?
A) Weakening of the lower esophageal sphincter allows gastric contents to reflux
into the esophagus
B) Excessive production of intrinsic factor leads to mucosal irritation
C) Rapid gastric emptying causes duodenal ulcers
D) Decreased gastric acid secretion leads to esophageal inflammation
Correct Answer: Weakening of the lower esophageal sphincter allows gastric
contents to reflux into the esophagus
Rationale: GERD occurs when the lower esophageal sphincter (LES) is
incompetent or relaxes transiently, allowing acidic gastric contents to flow
backward into the esophagus. This reflux irritates the esophageal mucosa and
causes the classic symptom of heartburn.
2. A client with peptic ulcer disease reports a burning epigastric pain that occurs 2
to 3 hours after meals and is relieved by eating. Which type of ulcer is most
consistent with this presentation?
A) Gastric ulcer
B) Duodenal ulcer
C) Esophageal ulcer
D) Stress ulcer
,Correct Answer: Duodenal ulcer
Rationale: Duodenal ulcer pain typically occurs 2 to 3 hours after a meal when
the stomach is empty, and it is often relieved by food or antacids. Gastric ulcer
pain is often worsened by eating.
3. Which finding is most concerning for a client with acute appendicitis?
A) Periumbilical pain that migrates to the right lower quadrant
B) Sudden relief of pain followed by rigid abdomen
C) Low-grade fever and anorexia
D) Pain that worsens with coughing
Correct Answer: Sudden relief of pain followed by rigid abdomen
Rationale: Sudden relief of pain in appendicitis may indicate rupture of the
appendix, which can lead to peritonitis and shock. A rigid abdomen is a sign of
peritonitis. This is a surgical emergency.
4. A nurse is caring for a client with ulcerative colitis. Which statement about this
condition is accurate?
A) It typically involves skip lesions throughout the GI tract
B) It is characterized by continuous inflammation starting in the rectum
C) It most commonly affects the small intestine
D) It is caused by a bacterial infection
Correct Answer: It is characterized by continuous inflammation starting in the
rectum
, Rationale: Ulcerative colitis involves continuous, diffuse mucosal inflammation
that begins in the rectum and extends proximally. Crohn disease, in contrast,
involves skip lesions and can affect any part of the GI tract.
5. Which client is at highest risk for developing cholelithiasis?
A) A 25-year-old male athlete with a low body mass index
B) A 45-year-old female with obesity and a history of rapid weight loss
C) A 60-year-old male with a history of high-fiber diet
D) A 30-year-old female with regular menstrual cycles
Correct Answer: A 45-year-old female with obesity and a history of rapid
weight loss
Rationale: Risk factors for gallstones include female sex, age over 40, obesity,
rapid weight loss, pregnancy, and a diet high in fat and cholesterol. This client has
multiple significant risk factors.
6. A client with diverticulitis is admitted to the unit. Which dietary instruction is
most appropriate during the acute phase?
A) High-fiber diet
B) Clear liquid diet
C) Low-residue diet
D) Regular diet as tolerated
Correct Answer: Clear liquid diet
Q&A | Herzing University
1. Which statement best describes the pathophysiology of gastroesophageal reflux
disease (GERD)?
A) Weakening of the lower esophageal sphincter allows gastric contents to reflux
into the esophagus
B) Excessive production of intrinsic factor leads to mucosal irritation
C) Rapid gastric emptying causes duodenal ulcers
D) Decreased gastric acid secretion leads to esophageal inflammation
Correct Answer: Weakening of the lower esophageal sphincter allows gastric
contents to reflux into the esophagus
Rationale: GERD occurs when the lower esophageal sphincter (LES) is
incompetent or relaxes transiently, allowing acidic gastric contents to flow
backward into the esophagus. This reflux irritates the esophageal mucosa and
causes the classic symptom of heartburn.
2. A client with peptic ulcer disease reports a burning epigastric pain that occurs 2
to 3 hours after meals and is relieved by eating. Which type of ulcer is most
consistent with this presentation?
A) Gastric ulcer
B) Duodenal ulcer
C) Esophageal ulcer
D) Stress ulcer
,Correct Answer: Duodenal ulcer
Rationale: Duodenal ulcer pain typically occurs 2 to 3 hours after a meal when
the stomach is empty, and it is often relieved by food or antacids. Gastric ulcer
pain is often worsened by eating.
3. Which finding is most concerning for a client with acute appendicitis?
A) Periumbilical pain that migrates to the right lower quadrant
B) Sudden relief of pain followed by rigid abdomen
C) Low-grade fever and anorexia
D) Pain that worsens with coughing
Correct Answer: Sudden relief of pain followed by rigid abdomen
Rationale: Sudden relief of pain in appendicitis may indicate rupture of the
appendix, which can lead to peritonitis and shock. A rigid abdomen is a sign of
peritonitis. This is a surgical emergency.
4. A nurse is caring for a client with ulcerative colitis. Which statement about this
condition is accurate?
A) It typically involves skip lesions throughout the GI tract
B) It is characterized by continuous inflammation starting in the rectum
C) It most commonly affects the small intestine
D) It is caused by a bacterial infection
Correct Answer: It is characterized by continuous inflammation starting in the
rectum
, Rationale: Ulcerative colitis involves continuous, diffuse mucosal inflammation
that begins in the rectum and extends proximally. Crohn disease, in contrast,
involves skip lesions and can affect any part of the GI tract.
5. Which client is at highest risk for developing cholelithiasis?
A) A 25-year-old male athlete with a low body mass index
B) A 45-year-old female with obesity and a history of rapid weight loss
C) A 60-year-old male with a history of high-fiber diet
D) A 30-year-old female with regular menstrual cycles
Correct Answer: A 45-year-old female with obesity and a history of rapid
weight loss
Rationale: Risk factors for gallstones include female sex, age over 40, obesity,
rapid weight loss, pregnancy, and a diet high in fat and cholesterol. This client has
multiple significant risk factors.
6. A client with diverticulitis is admitted to the unit. Which dietary instruction is
most appropriate during the acute phase?
A) High-fiber diet
B) Clear liquid diet
C) Low-residue diet
D) Regular diet as tolerated
Correct Answer: Clear liquid diet
