NSG 3850 EXAM 4 | ACTUAL QUESTIONS
WITH 100% CORRECT AND VERIFIED
ANSWERS LATEST UPDATED 2026/2027
(GRADED A+) GALEN COLLEGE OF
NURSING
2026
,NSG 3850 Exam
Pathophysiology for Nurses II– Multiple Choice with
Rationales
NSG 3850 Exam 4 – Version A
1. The nurse is caring for a client who has developed ascites as a
complication of advanced liver disease. Which of the following is the
primary etiological risk factor behind this complication?
a. Portal hypertension
b. Plasma hypoalbuminemia
c. An impaired absorption of fat-soluble vitamins
d. An accumulation of ammonia in the peritoneal cavity
Answer: b. Plasma hypoalbuminemia
Rationale: Low plasma albumin reduces oncotic pressure, allowing fluid to
accumulate in the peritoneal cavity. While portal hypertension contributes,
hypoalbuminemia directly causes fluid retention. This is the most common
mechanism of ascites in liver disease.
2. The nurse is caring for a client who has acute cholecystitis. Which
factor contributes most to the pathological process of this
condition?
a. Enzymatic activation causing autoimmune gallbladder stones
b. Lecithin production causing cholesterol solidification
c. Vascular insufficiency causing ischemic injury
d. Cystic duct obstruction
Answer: d. Cystic duct obstruction
Rationale: Obstruction of the cystic duct, usually by gallstones, leads to
bile accumulation, inflammation, and infection in the gallbladder. This is the
primary mechanism of acute cholecystitis. Other factors like ischemia or
infection may follow but are secondary.
3. The nurse is caring for a client who has chronic cholelithiasis.
Which symptom should the nurse expect the client to report?
a. Persistent epigastric pain
vendarsol
,b. Functional dyspepsia
c. Gray-blue color at the flank
d. Left upper quadrant pain radiating to the back
Answer: a. Persistent epigastric pain
Rationale: Chronic gallstones commonly cause recurrent or persistent
right upper quadrant or epigastric pain. Pain may radiate to the back but is
usually mild and recurrent. Severe acute symptoms indicate complications
like cholecystitis or pancreatitis.
4. The nurse is discussing the pathogenesis of hepatitis A virus
(HAV) with a client. Which statement is correct?
a. “It is very important to get regular hepatitis titers if you are on dialysis.”
b. “Lack of safe water and poor sanitation are big risk factors.”
c. “This is a chronic illness with no lifelong immunity.”
d. “Do not travel for extended periods overseas.”
Answer: b. “Lack of safe water and poor sanitation are big risk factors.”
Rationale: HAV is transmitted via the fecal-oral route. Contaminated
water and poor sanitation are major risk factors. Most HAV infections are
acute, self-limiting, and provide lifelong immunity after recovery.
5. The nurse is caring for a client with hepatitis C virus (HCV) and a
positive anti-HCV laboratory value. What does this indicate?
a. There are antibodies to the virus present
b. The client is in the early stage of infection
c. The client has immunity to the virus
d. The infection is in remission
Answer: a. There are antibodies to the virus present
Rationale: A positive anti-HCV indicates the presence of antibodies. It
does not confirm active infection or immunity. Further testing with HCV RNA
is needed to determine current infection.
6. The nurse is caring for an older adult client with liver disease.
Which factor should the nurse consider in medication management?
a. Prolonged drug half-life
b. Anasarca
vendarsol
, c. Narrow pulse pressure
d. Hypocholesterolemia
Answer: a. Prolonged drug half-life
Rationale: Liver disease impairs drug metabolism, extending half-life.
Older adults are more vulnerable due to age-related decreases in hepatic
function. Dosage adjustments are often necessary.
7. The nurse is caring for a client with hepatitis D virus (HDV). How
is this virus primarily transmitted?
a. Oral-fecal route with hepatitis E virus (HEV)
b. Parenteral route with hepatitis B virus (HBV)
c. Sexual route with hepatitis C virus (HCV)
d. Blood contamination with hepatitis A virus (HAV)
Answer: b. Parenteral route with hepatitis B virus (HBV)
Rationale: HDV requires co-infection with HBV to replicate. Transmission
occurs through blood or needles. It cannot infect independently via oral-fecal
or sexual routes.
8. The nurse is caring for a client with chronic alcoholism who
developed jaundice. Which pathophysiological process explains the
symptom?
a. Greenish-yellow staining of body tissues by bilirubin
b. Decreased plasma proteins and increased urobilinogen
c. Hepatocytes secrete bile supersaturated with cholesterol
d. Serum IgA is decreased in alcoholism
Answer: a. Greenish-yellow staining of body tissues by bilirubin
Rationale: Jaundice results from bilirubin accumulation in tissues due to
impaired hepatic metabolism or excretion. This leads to the characteristic
yellow skin and sclera discoloration.
9. The nurse is caring for a client with a positive hepatitis B surface
antigen (HBsAg) test. What does this indicate?
a. Chronic inflammation
b. Recovering from acute disease
c. Active infection
d. Positive titer
vendarsol
WITH 100% CORRECT AND VERIFIED
ANSWERS LATEST UPDATED 2026/2027
(GRADED A+) GALEN COLLEGE OF
NURSING
2026
,NSG 3850 Exam
Pathophysiology for Nurses II– Multiple Choice with
Rationales
NSG 3850 Exam 4 – Version A
1. The nurse is caring for a client who has developed ascites as a
complication of advanced liver disease. Which of the following is the
primary etiological risk factor behind this complication?
a. Portal hypertension
b. Plasma hypoalbuminemia
c. An impaired absorption of fat-soluble vitamins
d. An accumulation of ammonia in the peritoneal cavity
Answer: b. Plasma hypoalbuminemia
Rationale: Low plasma albumin reduces oncotic pressure, allowing fluid to
accumulate in the peritoneal cavity. While portal hypertension contributes,
hypoalbuminemia directly causes fluid retention. This is the most common
mechanism of ascites in liver disease.
2. The nurse is caring for a client who has acute cholecystitis. Which
factor contributes most to the pathological process of this
condition?
a. Enzymatic activation causing autoimmune gallbladder stones
b. Lecithin production causing cholesterol solidification
c. Vascular insufficiency causing ischemic injury
d. Cystic duct obstruction
Answer: d. Cystic duct obstruction
Rationale: Obstruction of the cystic duct, usually by gallstones, leads to
bile accumulation, inflammation, and infection in the gallbladder. This is the
primary mechanism of acute cholecystitis. Other factors like ischemia or
infection may follow but are secondary.
3. The nurse is caring for a client who has chronic cholelithiasis.
Which symptom should the nurse expect the client to report?
a. Persistent epigastric pain
vendarsol
,b. Functional dyspepsia
c. Gray-blue color at the flank
d. Left upper quadrant pain radiating to the back
Answer: a. Persistent epigastric pain
Rationale: Chronic gallstones commonly cause recurrent or persistent
right upper quadrant or epigastric pain. Pain may radiate to the back but is
usually mild and recurrent. Severe acute symptoms indicate complications
like cholecystitis or pancreatitis.
4. The nurse is discussing the pathogenesis of hepatitis A virus
(HAV) with a client. Which statement is correct?
a. “It is very important to get regular hepatitis titers if you are on dialysis.”
b. “Lack of safe water and poor sanitation are big risk factors.”
c. “This is a chronic illness with no lifelong immunity.”
d. “Do not travel for extended periods overseas.”
Answer: b. “Lack of safe water and poor sanitation are big risk factors.”
Rationale: HAV is transmitted via the fecal-oral route. Contaminated
water and poor sanitation are major risk factors. Most HAV infections are
acute, self-limiting, and provide lifelong immunity after recovery.
5. The nurse is caring for a client with hepatitis C virus (HCV) and a
positive anti-HCV laboratory value. What does this indicate?
a. There are antibodies to the virus present
b. The client is in the early stage of infection
c. The client has immunity to the virus
d. The infection is in remission
Answer: a. There are antibodies to the virus present
Rationale: A positive anti-HCV indicates the presence of antibodies. It
does not confirm active infection or immunity. Further testing with HCV RNA
is needed to determine current infection.
6. The nurse is caring for an older adult client with liver disease.
Which factor should the nurse consider in medication management?
a. Prolonged drug half-life
b. Anasarca
vendarsol
, c. Narrow pulse pressure
d. Hypocholesterolemia
Answer: a. Prolonged drug half-life
Rationale: Liver disease impairs drug metabolism, extending half-life.
Older adults are more vulnerable due to age-related decreases in hepatic
function. Dosage adjustments are often necessary.
7. The nurse is caring for a client with hepatitis D virus (HDV). How
is this virus primarily transmitted?
a. Oral-fecal route with hepatitis E virus (HEV)
b. Parenteral route with hepatitis B virus (HBV)
c. Sexual route with hepatitis C virus (HCV)
d. Blood contamination with hepatitis A virus (HAV)
Answer: b. Parenteral route with hepatitis B virus (HBV)
Rationale: HDV requires co-infection with HBV to replicate. Transmission
occurs through blood or needles. It cannot infect independently via oral-fecal
or sexual routes.
8. The nurse is caring for a client with chronic alcoholism who
developed jaundice. Which pathophysiological process explains the
symptom?
a. Greenish-yellow staining of body tissues by bilirubin
b. Decreased plasma proteins and increased urobilinogen
c. Hepatocytes secrete bile supersaturated with cholesterol
d. Serum IgA is decreased in alcoholism
Answer: a. Greenish-yellow staining of body tissues by bilirubin
Rationale: Jaundice results from bilirubin accumulation in tissues due to
impaired hepatic metabolism or excretion. This leads to the characteristic
yellow skin and sclera discoloration.
9. The nurse is caring for a client with a positive hepatitis B surface
antigen (HBsAg) test. What does this indicate?
a. Chronic inflammation
b. Recovering from acute disease
c. Active infection
d. Positive titer
vendarsol
