Miami Dade College
2 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 2
G I D I S O R D E RS · AC I D - B A S E B A L A N C E · P R O C E D U R E S & N U RS I N G P R I O R I T I E S
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Examination 2 — COURSE TITLE Med-Surg Nursing II
Comprehensive
TOTAL QUESTIONS 30 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers PUD, GERD, dumping syndrome, ostomy care, GI procedures, acid-base balance, and GI
emergencies.
▸ Normal lab values and ABG interpretation are integrated throughout rationales.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 30
1. What is Peptic Ulcer Disease (PUD)?
A. Inflammation of the peritoneum caused by bacterial infection
B. Erosion of the GI mucosa caused by H. pylori, NSAID use, and stress
C. Functional bowel disorder without structural inflammation
D. Autoimmune destruction of intestinal villi from gluten intolerance
CORRECT ANSWER B — Erosion of the GI mucosa caused by H. pylori, NSAID use, and stress.
RATIONALE PUD is an erosion in the GI lining resulting from an imbalance between aggressive
factors (H. pylori bacteria, NSAIDs inhibiting protective prostaglandins, and
physiological stress increasing acid secretion) and defensive factors (mucus,
bicarbonate, mucosal blood flow). H. pylori is the most common cause. NSAIDs
are the second most common cause — they decrease prostaglandins that
normally protect the gastric mucosal barrier. Stress ulcers occur in critically ill
patients from decreased mucosal perfusion.
, 2. A patient with a known peptic ulcer suddenly develops low blood pressure, high heart
rate, burning epigastric pain, and nausea with vomiting. What complication should the
nurse suspect?
A. Dumping syndrome
B. PUD perforation with risk for peritonitis — notify the provider immediately
C. Hiatal hernia
D. Small bowel obstruction
CORRECT ANSWER B — PUD perforation with risk for peritonitis — notify the provider
immediately.
RATIONALE PUD perforation is a surgical emergency. When an ulcer erodes completely
through the gastric or duodenal wall, gastric contents spill into the sterile
peritoneal cavity. Classic signs: sudden severe burning epigastric pain,
hypotension (hypovolemic/septic shock), tachycardia, nausea/vomiting, and a
rigid board-like abdomen. Without immediate intervention, chemical peritonitis
progresses to bacterial peritonitis and sepsis. The nurse must notify the provider
immediately, keep the patient NPO, start IV fluids, and prepare for emergency
surgery.
3. A patient describes epigastric pain that occurs 2–3 hours after meals and is relieved by
eating or taking antacids. What type of ulcer is most likely?
A. Gastric ulcer
B. Duodenal ulcer
C. Esophageal ulcer
D. Stress ulcer
CORRECT ANSWER B — Duodenal ulcer.
RATIONALE Duodenal ulcers are the most common type of PUD. Classic symptom pattern:
pain 2–3 hours after meals (when gastric acid enters the duodenum without food
buffer) and at night, RELIEVED by eating or antacids (food buffers acid). Duodenal
ulcers are most often caused by H. pylori. In contrast, gastric ulcer pain WORSENS
with eating because food stimulates acid secretion directly onto the ulcerated
gastric mucosa. This clinical distinction helps differentiate ulcer location.
2 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 2
G I D I S O R D E RS · AC I D - B A S E B A L A N C E · P R O C E D U R E S & N U RS I N G P R I O R I T I E S
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Examination 2 — COURSE TITLE Med-Surg Nursing II
Comprehensive
TOTAL QUESTIONS 30 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers PUD, GERD, dumping syndrome, ostomy care, GI procedures, acid-base balance, and GI
emergencies.
▸ Normal lab values and ABG interpretation are integrated throughout rationales.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 30
1. What is Peptic Ulcer Disease (PUD)?
A. Inflammation of the peritoneum caused by bacterial infection
B. Erosion of the GI mucosa caused by H. pylori, NSAID use, and stress
C. Functional bowel disorder without structural inflammation
D. Autoimmune destruction of intestinal villi from gluten intolerance
CORRECT ANSWER B — Erosion of the GI mucosa caused by H. pylori, NSAID use, and stress.
RATIONALE PUD is an erosion in the GI lining resulting from an imbalance between aggressive
factors (H. pylori bacteria, NSAIDs inhibiting protective prostaglandins, and
physiological stress increasing acid secretion) and defensive factors (mucus,
bicarbonate, mucosal blood flow). H. pylori is the most common cause. NSAIDs
are the second most common cause — they decrease prostaglandins that
normally protect the gastric mucosal barrier. Stress ulcers occur in critically ill
patients from decreased mucosal perfusion.
, 2. A patient with a known peptic ulcer suddenly develops low blood pressure, high heart
rate, burning epigastric pain, and nausea with vomiting. What complication should the
nurse suspect?
A. Dumping syndrome
B. PUD perforation with risk for peritonitis — notify the provider immediately
C. Hiatal hernia
D. Small bowel obstruction
CORRECT ANSWER B — PUD perforation with risk for peritonitis — notify the provider
immediately.
RATIONALE PUD perforation is a surgical emergency. When an ulcer erodes completely
through the gastric or duodenal wall, gastric contents spill into the sterile
peritoneal cavity. Classic signs: sudden severe burning epigastric pain,
hypotension (hypovolemic/septic shock), tachycardia, nausea/vomiting, and a
rigid board-like abdomen. Without immediate intervention, chemical peritonitis
progresses to bacterial peritonitis and sepsis. The nurse must notify the provider
immediately, keep the patient NPO, start IV fluids, and prepare for emergency
surgery.
3. A patient describes epigastric pain that occurs 2–3 hours after meals and is relieved by
eating or taking antacids. What type of ulcer is most likely?
A. Gastric ulcer
B. Duodenal ulcer
C. Esophageal ulcer
D. Stress ulcer
CORRECT ANSWER B — Duodenal ulcer.
RATIONALE Duodenal ulcers are the most common type of PUD. Classic symptom pattern:
pain 2–3 hours after meals (when gastric acid enters the duodenum without food
buffer) and at night, RELIEVED by eating or antacids (food buffers acid). Duodenal
ulcers are most often caused by H. pylori. In contrast, gastric ulcer pain WORSENS
with eating because food stimulates acid secretion directly onto the ulcerated
gastric mucosa. This clinical distinction helps differentiate ulcer location.
