A 49-year-old man reports epigastric abdominal pain, early satiety, and fullness following a meal. The nurse practitioner suspects peptic ulcer disease (PUD). What is the pathophysiology underlying this disease process?
Colonic wall structure, colonic motility, diet, fiber intake, obesity and physical activity
Defects in the epithelial barrier, immune response, leukocyte recruitment, and microflora of the colon
An imbalance between gastric mucosal protective and destructive factors such as H. pylori infection and NSAID use
Impaired lower esophageal sphincter (LES) function and transient lower esophageal sphincter relaxations (TLESRs)
The Correct Answer is C
Choice A reason: These factors are associated with irritable bowel syndrome and other colonic disorders, not peptic ulcer disease. PUD affects the stomach and duodenum, not the colon.
Choice B reason: This describes the pathophysiology of inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. It does not apply to PUD, which is primarily driven by gastric acid and mucosal injury.
Choice C reason: PUD results from an imbalance between aggressive factors (e.g., gastric acid, pepsin, H. pylori, NSAIDs) and protective mechanisms (e.g., mucus, bicarbonate, mucosal blood flow). H. pylori disrupts mucosal defenses, and NSAIDs inhibit prostaglandin synthesis, both contributing to ulcer formation.
Choice D reason: LES dysfunction and TLESRs are associated with gastroesophageal reflux disease (GERD), not PUD. GERD involves reflux of gastric contents into the esophagus, whereas PUD involves mucosal erosion in the stomach or duodenum.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Metronidazole has shown efficacy in treating perianal Crohn’s disease and mild-to-moderate disease activity, particularly when infection or abscess is suspected. It is often used as adjunct therapy.
Choice B reason: Sulfasalazine is more effective in ulcerative colitis than in Crohn’s disease. Its benefit in Crohn’s is limited and not considered first-line, especially for small bowel involvement. This makes the statement incorrect.
Choice C reason: Thiopurines such as azathioprine and 6-mercaptopurine are immunomodulators used to maintain remission and reduce steroid dependence. They are effective in long-term management of Crohn’s disease.
Choice D reason: NSAIDs can exacerbate Crohn’s disease by increasing intestinal permeability and promoting inflammation. Their use is generally avoided in patients with inflammatory bowel disease.
Correct Answer is A
Explanation
Choice A reason: Primary syphilis typically presents with a single, painless, indurated ulcer known as a chancre at the site of inoculation. This lesion is highly characteristic and usually appears within 2–3 weeks of exposure. It is often unnoticed by patients due to its painless nature and resolves spontaneously, although the infection persists systemically.
Choice B reason: Herpes simplex virus usually causes painful vesicular lesions that may ulcerate. These lesions are often multiple and associated with burning or tingling sensations. The presentation of a painless, indurated lesion does not match HSV.
Choice C reason: Human papillomavirus (HPV) typically causes genital warts—soft, flesh-colored, cauliflower-like lesions. These are not indurated or ulcerative and are usually painless but do not resemble the described chancre.
Choice D reason: Latent syphilis refers to a stage of syphilis where the infection is present but asymptomatic. There are no visible lesions during this phase, making it inconsistent with the current physical findings.
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