NUR 5461/NUR5461 Module 5 V3 |
Digestive System Q&A with Rationale |
William Paterson University
1. A patient with Gastroesophageal Reflux Disease (GERD) is prescribed a Proton Pump
Inhibitor (PPI). What is the primary mechanism of action for this drug class?
A. Irreversibly inhibiting the H+/K+ ATPase pump
B. Neutralizing existing stomach acid
C. Blocking H2 receptors on parietal cells
D. Coating the esophageal lining with a protective barrier
Correct Answer: A
Expert Explanation: Proton Pump Inhibitors (PPIs) work by binding to the H+/K+ ATPase
enzyme system at the secretory surface of the gastric parietal cell. This action blocks the
final step of acid production, leading to a significant increase in gastric pH. This mechanism
is more potent and longer-lasting than that of H2 receptor antagonists or antacids.
2. Which clinical manifestation is most characteristic of a patient experiencing a duodenal
ulcer rather than a gastric ulcer?
A. Pain that worsens immediately after eating
B. Weight loss due to fear of eating
C. Pain relief occurring 2 to 3 hours after a meal
,D. Hematemesis is more common than melena
Correct Answer: C
Expert Explanation: Duodenal ulcers are characterized by pain that is often relieved by
food or antacids because the food buffers the acid. The pain typically reappears 2 to 3
hours after a meal when the stomach is empty. In contrast, gastric ulcer pain often occurs
immediately after eating and is not relieved by food.
3. A nurse is caring for a patient with Liver Cirrhosis who presents with significant ascites.
Which laboratory finding is most likely responsible for this fluid shift?
A. Decreased Serum Albumin
B. Elevated Serum Ammonia
C. Elevated Alanine Aminotransferase (ALT)
D. Decreased Platelet Count
Correct Answer: A
Expert Explanation: Albumin is a protein produced by the liver that maintains oncotic
pressure within the vascular system. When the liver is cirrhotic, albumin production
decreases, leading to a drop in oncotic pressure and causing fluid to leak into the peritoneal
cavity. This process, combined with portal hypertension, results in the development of
ascites.
, 4. During an assessment of a patient with suspected Acute Pancreatitis, the nurse notes
bluish discoloration around the umbilicus. How should the nurse document this finding?
A. Cullen’s Sign
B. Grey Turner’s Sign
C. Murphy’s Sign
D. McBurney’s Sign
Correct Answer: A
Expert Explanation: Cullen’s sign is characterized by superficial edema and bruising in the
subcutaneous fatty tissue around the umbilicus. It is a clinical indicator of intraperitoneal
hemorrhage, often associated with severe acute pancreatitis. Grey Turner’s sign, on the
other hand, refers to bruising of the flanks.
5. A patient is diagnosed with Ulcerative Colitis. Which of the following pathological features
is uniquely associated with this condition compared to Crohn’s Disease?
A. Transmural inflammation involving all layers of the bowel
B. Inflammation limited to the mucosa and submucosa of the colon
C. Presence of ‘skip lesions’ throughout the GI tract
D. Formation of fistulas and perianal abscesses
Correct Answer: B
Digestive System Q&A with Rationale |
William Paterson University
1. A patient with Gastroesophageal Reflux Disease (GERD) is prescribed a Proton Pump
Inhibitor (PPI). What is the primary mechanism of action for this drug class?
A. Irreversibly inhibiting the H+/K+ ATPase pump
B. Neutralizing existing stomach acid
C. Blocking H2 receptors on parietal cells
D. Coating the esophageal lining with a protective barrier
Correct Answer: A
Expert Explanation: Proton Pump Inhibitors (PPIs) work by binding to the H+/K+ ATPase
enzyme system at the secretory surface of the gastric parietal cell. This action blocks the
final step of acid production, leading to a significant increase in gastric pH. This mechanism
is more potent and longer-lasting than that of H2 receptor antagonists or antacids.
2. Which clinical manifestation is most characteristic of a patient experiencing a duodenal
ulcer rather than a gastric ulcer?
A. Pain that worsens immediately after eating
B. Weight loss due to fear of eating
C. Pain relief occurring 2 to 3 hours after a meal
,D. Hematemesis is more common than melena
Correct Answer: C
Expert Explanation: Duodenal ulcers are characterized by pain that is often relieved by
food or antacids because the food buffers the acid. The pain typically reappears 2 to 3
hours after a meal when the stomach is empty. In contrast, gastric ulcer pain often occurs
immediately after eating and is not relieved by food.
3. A nurse is caring for a patient with Liver Cirrhosis who presents with significant ascites.
Which laboratory finding is most likely responsible for this fluid shift?
A. Decreased Serum Albumin
B. Elevated Serum Ammonia
C. Elevated Alanine Aminotransferase (ALT)
D. Decreased Platelet Count
Correct Answer: A
Expert Explanation: Albumin is a protein produced by the liver that maintains oncotic
pressure within the vascular system. When the liver is cirrhotic, albumin production
decreases, leading to a drop in oncotic pressure and causing fluid to leak into the peritoneal
cavity. This process, combined with portal hypertension, results in the development of
ascites.
, 4. During an assessment of a patient with suspected Acute Pancreatitis, the nurse notes
bluish discoloration around the umbilicus. How should the nurse document this finding?
A. Cullen’s Sign
B. Grey Turner’s Sign
C. Murphy’s Sign
D. McBurney’s Sign
Correct Answer: A
Expert Explanation: Cullen’s sign is characterized by superficial edema and bruising in the
subcutaneous fatty tissue around the umbilicus. It is a clinical indicator of intraperitoneal
hemorrhage, often associated with severe acute pancreatitis. Grey Turner’s sign, on the
other hand, refers to bruising of the flanks.
5. A patient is diagnosed with Ulcerative Colitis. Which of the following pathological features
is uniquely associated with this condition compared to Crohn’s Disease?
A. Transmural inflammation involving all layers of the bowel
B. Inflammation limited to the mucosa and submucosa of the colon
C. Presence of ‘skip lesions’ throughout the GI tract
D. Formation of fistulas and perianal abscesses
Correct Answer: B
