NSG 3850 EXAM 4 | PATHOPHYSIOLOGY II ACTUAL
QUESTIONS AND ANSWERS LATEST UPDATED
2026/2027 (GRADED A+)- GALEN COLLEGE OF
NURSING
At Galen College of Nursing
NSG 3850 – Pathophysiology II
Exam 4 Test
Section 1: Hepatobiliary Disorders (50 Questions)
Questions
1.
Which mechanism primarily contributes to ascites in patients with
cirrhosis?
A. Increased plasma oncotic pressure
B. Portal hypertension and decreased albumin production
C. Increased lymphatic drainage
D. Excess insulin secretion
Answer: B
Rationale: Ascites develops mainly due to portal hypertension and
hypoalbuminemia in cirrhosis. Portal hypertension increases hydrostatic
pressure in portal circulation while reduced albumin decreases oncotic
pressure. This causes fluid to leak into the peritoneal cavity.
2.
,Which substance accumulation is primarily responsible for hepatic
encephalopathy?
A. Bilirubin
B. Ammonia
C. Creatinine
D. Lactate
Answer: B
Rationale: Hepatic encephalopathy occurs when the liver cannot detoxify
ammonia produced by intestinal bacteria. Elevated ammonia crosses the
blood-brain barrier and disrupts neurotransmission. This leads to confusion,
asterixis, and altered mental status.
3.
Which clinical finding is most characteristic of obstructive jaundice?
A. Pale stools and dark urine
B. Increased appetite
C. Hypoglycemia
D. Bradycardia
Answer: A
Rationale: Obstructive jaundice prevents bilirubin from entering the
intestine. As a result, stools become pale due to lack of stercobilin while
urine becomes dark due to increased conjugated bilirubin excretion.
4.
Portal hypertension most commonly leads to which complication?
A. Renal calculi
B. Esophageal varices
C. Myocardial infarction
D. Hyperthyroidism
Answer: B
Rationale: Portal hypertension causes increased pressure in the portal
venous system. This pressure leads to collateral vessel formation, especially
,in the esophagus. These dilated veins are called esophageal varices and can
rupture causing life-threatening bleeding.
5.
Which organ enlargement commonly occurs with portal
hypertension?
A. Thyroid
B. Pancreas
C. Spleen
D. Adrenal gland
Answer: C
Rationale: Splenomegaly occurs due to congestion of blood within the
spleen from elevated portal venous pressure. The enlarged spleen may also
lead to hypersplenism, causing decreased blood cell counts.
6.
The most common cause of cirrhosis in the United States is:
A. Chronic alcohol use
B. Viral meningitis
C. Hyperthyroidism
D. Acute pancreatitis
Answer: A
Rationale: Chronic alcohol consumption causes repeated hepatocyte injury
leading to fibrosis and cirrhosis. Over time, normal liver architecture is
replaced by scar tissue and regenerative nodules.
7.
Which laboratory finding suggests impaired liver synthetic function?
A. Elevated hemoglobin
B. Increased albumin
, C. Decreased albumin
D. Decreased bilirubin
Answer: C
Rationale: Albumin is synthesized by the liver. When liver function declines,
albumin production decreases. This contributes to edema and ascites due to
reduced oncotic pressure.
8.
Which hepatitis virus is primarily transmitted via the fecal-oral
route?
A. HBV
B. HCV
C. HAV
D. HDV
Answer: C
Rationale: Hepatitis A virus spreads through contaminated food and water.
It is common in areas with poor sanitation and typically causes acute but
self-limited disease.
9.
Which hepatitis virus is most associated with chronic liver disease?
A. HAV
B. HCV
C. HEV
D. HDV
Answer: B
Rationale: Hepatitis C frequently progresses to chronic infection. Persistent
inflammation leads to fibrosis, cirrhosis, and increased risk of hepatocellular
carcinoma.
10.
QUESTIONS AND ANSWERS LATEST UPDATED
2026/2027 (GRADED A+)- GALEN COLLEGE OF
NURSING
At Galen College of Nursing
NSG 3850 – Pathophysiology II
Exam 4 Test
Section 1: Hepatobiliary Disorders (50 Questions)
Questions
1.
Which mechanism primarily contributes to ascites in patients with
cirrhosis?
A. Increased plasma oncotic pressure
B. Portal hypertension and decreased albumin production
C. Increased lymphatic drainage
D. Excess insulin secretion
Answer: B
Rationale: Ascites develops mainly due to portal hypertension and
hypoalbuminemia in cirrhosis. Portal hypertension increases hydrostatic
pressure in portal circulation while reduced albumin decreases oncotic
pressure. This causes fluid to leak into the peritoneal cavity.
2.
,Which substance accumulation is primarily responsible for hepatic
encephalopathy?
A. Bilirubin
B. Ammonia
C. Creatinine
D. Lactate
Answer: B
Rationale: Hepatic encephalopathy occurs when the liver cannot detoxify
ammonia produced by intestinal bacteria. Elevated ammonia crosses the
blood-brain barrier and disrupts neurotransmission. This leads to confusion,
asterixis, and altered mental status.
3.
Which clinical finding is most characteristic of obstructive jaundice?
A. Pale stools and dark urine
B. Increased appetite
C. Hypoglycemia
D. Bradycardia
Answer: A
Rationale: Obstructive jaundice prevents bilirubin from entering the
intestine. As a result, stools become pale due to lack of stercobilin while
urine becomes dark due to increased conjugated bilirubin excretion.
4.
Portal hypertension most commonly leads to which complication?
A. Renal calculi
B. Esophageal varices
C. Myocardial infarction
D. Hyperthyroidism
Answer: B
Rationale: Portal hypertension causes increased pressure in the portal
venous system. This pressure leads to collateral vessel formation, especially
,in the esophagus. These dilated veins are called esophageal varices and can
rupture causing life-threatening bleeding.
5.
Which organ enlargement commonly occurs with portal
hypertension?
A. Thyroid
B. Pancreas
C. Spleen
D. Adrenal gland
Answer: C
Rationale: Splenomegaly occurs due to congestion of blood within the
spleen from elevated portal venous pressure. The enlarged spleen may also
lead to hypersplenism, causing decreased blood cell counts.
6.
The most common cause of cirrhosis in the United States is:
A. Chronic alcohol use
B. Viral meningitis
C. Hyperthyroidism
D. Acute pancreatitis
Answer: A
Rationale: Chronic alcohol consumption causes repeated hepatocyte injury
leading to fibrosis and cirrhosis. Over time, normal liver architecture is
replaced by scar tissue and regenerative nodules.
7.
Which laboratory finding suggests impaired liver synthetic function?
A. Elevated hemoglobin
B. Increased albumin
, C. Decreased albumin
D. Decreased bilirubin
Answer: C
Rationale: Albumin is synthesized by the liver. When liver function declines,
albumin production decreases. This contributes to edema and ascites due to
reduced oncotic pressure.
8.
Which hepatitis virus is primarily transmitted via the fecal-oral
route?
A. HBV
B. HCV
C. HAV
D. HDV
Answer: C
Rationale: Hepatitis A virus spreads through contaminated food and water.
It is common in areas with poor sanitation and typically causes acute but
self-limited disease.
9.
Which hepatitis virus is most associated with chronic liver disease?
A. HAV
B. HCV
C. HEV
D. HDV
Answer: B
Rationale: Hepatitis C frequently progresses to chronic infection. Persistent
inflammation leads to fibrosis, cirrhosis, and increased risk of hepatocellular
carcinoma.
10.
