NSG 3800 EXAM 4 ACTUAL EXAM NEWEST COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS| ALREADY GRADED A+
Question 1
A nurse is providing community education about Hepatitis A. Which primary transmission route
should the nurse emphasize to prevent the spread of this virus?
A) Contaminated blood and blood products
B) Unprotected sexual contact
C) Fecal-oral route through contaminated food or water
D) Needle-sharing among intravenous drug users
E) Maternal-fetal transmission during birth
Correct Answer: C) Fecal-oral route through contaminated food or water
Rationale: Hepatitis A is primarily transmitted via the fecal-oral route. This occurs when an
uninfected person ingests food or water that has been contaminated with the feces of an
infected person. Common scenarios include poor hand hygiene after using the restroom or
consuming shellfish from contaminated water. Unlike Hepatitis B and C, it is not typically
spread through blood or bodily fluids.
Question 2
Which types of viral Hepatitis currently have a preventative vaccine available for the general
public in the United States?
A) Hepatitis A and C
B) Hepatitis B and C
C) Hepatitis A and B
D) Hepatitis B and D
E) Hepatitis C and E
Correct Answer: C) Hepatitis A and B
Rationale: Vaccines are available for Hepatitis A and Hepatitis B to provide long-term
immunity. There is currently no vaccine for Hepatitis C. Protection against Hepatitis B also
provides a level of protection against Hepatitis D, as Hepatitis D requires the presence of
Hepatitis B to replicate, but A and B are the standard vaccinations.
Question 3
A client with end-stage cirrhosis presents with significant ascites. Which laboratory finding does
the nurse expect to see as a direct contributor to this fluid accumulation?
A) Elevated serum creatinine
B) Decreased serum albumin
C) Decreased serum potassium
D) Elevated hemoglobin
E) Decreased serum ammonia
Correct Answer: B) Decreased serum albumin
Rationale: The liver is responsible for synthesizing albumin, the primary protein that
maintains oncotic pressure within the vascular space. In cirrhosis, the liver's biosynthetic
, Page 2
function is impaired, leading to hypoalbuminemia. This decrease in oncotic pressure allows
fluid to leak from the intravascular space into the peritoneal cavity, resulting in ascites.
Question 4
A client is diagnosed with Addison’s disease. Which electrolyte profile should the nurse monitor
for most closely?
A) Hypernatremia and hypokalemia
B) Hyponatremia and hyperkalemia
C) Hypocalcemia and hypermagnesemia
D) Hypernatremia and hyperkalemia
E) Hyponatremia and hypokalemia
Correct Answer: B) Hyponatremia and hyperkalemia
Rationale: Addison’s disease involves the destruction of the adrenal cortex, leading to a
deficiency in mineralocorticoids (aldosterone). Aldosterone normally functions to retain
sodium and excrete potassium. Without it, the patient wastes sodium (hyponatremia) and
retains potassium (hyperkalemia).
Question 5
When reviewing the laboratory results for a patient with suspected hypothyroidism, which
hormone levels would the nurse expect to find?
A) Elevated T3 and T4
B) Low Thyroid Stimulating Hormone (TSH) only
C) Low T3 and T4
D) Elevated Cortisol
E) Low Parathyroid Hormone (PTH)
Correct Answer: C) Low T3 and T4
Rationale: Hypothyroidism is characterized by an underactive thyroid gland that fails to
produce adequate amounts of triiodothyronine (T3) and thyroxine (T4). In primary
hypothyroidism, the TSH is typically elevated as the pituitary tries to stimulate the failing
gland, but the hallmark deficiency is in the T3 and T4 levels themselves.
Question 6
Which laboratory test is most commonly used as a highly sensitive screening tool for Systemic
Lupus Erythematosus (SLE)?
A) Reed-Sternberg cell analysis
B) Bence-Jones protein
C) Antinuclear Antibody (ANA)
D) CD4 count
E) Serum Ammonia
Correct Answer: C) Positive ANA (antinuclear antibody)
Rationale: The ANA test is positive in more than 95% of patients with SLE, making it the
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most important screening tool for the disease. While a positive ANA can occur in other
autoimmune conditions, a negative ANA makes a diagnosis of SLE highly unlikely.
Question 7
A nurse is reviewing a pathology report for a client with suspected Hodgkin Lymphoma. The
presence of which specific cell type would confirm this diagnosis?
A) Bence-Jones cells
B) T-helper cells
C) Reed-Sternberg cells
D) Myeloblasts
E) Erythrocytes
Correct Answer: C) Presence of Reed-Sternberg cells
Rationale: The definitive diagnostic marker for Hodgkin Lymphoma is the Reed-Sternberg
cell, which is a giant, multinucleated B-lymphocyte. Non-Hodgkin lymphomas lack these
specific cells. Identification of Reed-Sternberg cells via lymph node biopsy is the hallmark
of Hodgkin’s disease.
Question 8
A client with Multiple Myeloma is undergoing a 24-hour urine collection. Which specific protein
finding is characteristic of this malignancy?
A) Albumin
B) Reed-Sternberg protein
C) Bence-Jones protein
D) Hemoglobin
E) Bilirubin
Correct Answer: C) Bence-Jones protein
Rationale: Multiple Myeloma is a cancer of the plasma cells. These malignant cells produce
abnormal immunoglobulin light chains known as Bence-Jones proteins. These small
proteins are filtered by the kidneys and appear in the urine, often causing renal damage.
Question 9
According to the Centers for Disease Control and Prevention (CDC), at what specific CD4+ T-
cell count does a client’s HIV infection transition into the diagnosis of AIDS?
A) <500 cells/μL
B) <1000 cells/μL
C) <200 cells/μL
D) >200 cells/μL
E) <800 cells/μL
Correct Answer: C) CD4 count <200 cells/μL
Rationale: The clinical definition of AIDS includes being HIV positive and having a CD4+
T-lymphocyte count of less than 200 cells/μL (or a CD4+ percentage of total lymphocytes of
ANSWERS| ALREADY GRADED A+
Question 1
A nurse is providing community education about Hepatitis A. Which primary transmission route
should the nurse emphasize to prevent the spread of this virus?
A) Contaminated blood and blood products
B) Unprotected sexual contact
C) Fecal-oral route through contaminated food or water
D) Needle-sharing among intravenous drug users
E) Maternal-fetal transmission during birth
Correct Answer: C) Fecal-oral route through contaminated food or water
Rationale: Hepatitis A is primarily transmitted via the fecal-oral route. This occurs when an
uninfected person ingests food or water that has been contaminated with the feces of an
infected person. Common scenarios include poor hand hygiene after using the restroom or
consuming shellfish from contaminated water. Unlike Hepatitis B and C, it is not typically
spread through blood or bodily fluids.
Question 2
Which types of viral Hepatitis currently have a preventative vaccine available for the general
public in the United States?
A) Hepatitis A and C
B) Hepatitis B and C
C) Hepatitis A and B
D) Hepatitis B and D
E) Hepatitis C and E
Correct Answer: C) Hepatitis A and B
Rationale: Vaccines are available for Hepatitis A and Hepatitis B to provide long-term
immunity. There is currently no vaccine for Hepatitis C. Protection against Hepatitis B also
provides a level of protection against Hepatitis D, as Hepatitis D requires the presence of
Hepatitis B to replicate, but A and B are the standard vaccinations.
Question 3
A client with end-stage cirrhosis presents with significant ascites. Which laboratory finding does
the nurse expect to see as a direct contributor to this fluid accumulation?
A) Elevated serum creatinine
B) Decreased serum albumin
C) Decreased serum potassium
D) Elevated hemoglobin
E) Decreased serum ammonia
Correct Answer: B) Decreased serum albumin
Rationale: The liver is responsible for synthesizing albumin, the primary protein that
maintains oncotic pressure within the vascular space. In cirrhosis, the liver's biosynthetic
, Page 2
function is impaired, leading to hypoalbuminemia. This decrease in oncotic pressure allows
fluid to leak from the intravascular space into the peritoneal cavity, resulting in ascites.
Question 4
A client is diagnosed with Addison’s disease. Which electrolyte profile should the nurse monitor
for most closely?
A) Hypernatremia and hypokalemia
B) Hyponatremia and hyperkalemia
C) Hypocalcemia and hypermagnesemia
D) Hypernatremia and hyperkalemia
E) Hyponatremia and hypokalemia
Correct Answer: B) Hyponatremia and hyperkalemia
Rationale: Addison’s disease involves the destruction of the adrenal cortex, leading to a
deficiency in mineralocorticoids (aldosterone). Aldosterone normally functions to retain
sodium and excrete potassium. Without it, the patient wastes sodium (hyponatremia) and
retains potassium (hyperkalemia).
Question 5
When reviewing the laboratory results for a patient with suspected hypothyroidism, which
hormone levels would the nurse expect to find?
A) Elevated T3 and T4
B) Low Thyroid Stimulating Hormone (TSH) only
C) Low T3 and T4
D) Elevated Cortisol
E) Low Parathyroid Hormone (PTH)
Correct Answer: C) Low T3 and T4
Rationale: Hypothyroidism is characterized by an underactive thyroid gland that fails to
produce adequate amounts of triiodothyronine (T3) and thyroxine (T4). In primary
hypothyroidism, the TSH is typically elevated as the pituitary tries to stimulate the failing
gland, but the hallmark deficiency is in the T3 and T4 levels themselves.
Question 6
Which laboratory test is most commonly used as a highly sensitive screening tool for Systemic
Lupus Erythematosus (SLE)?
A) Reed-Sternberg cell analysis
B) Bence-Jones protein
C) Antinuclear Antibody (ANA)
D) CD4 count
E) Serum Ammonia
Correct Answer: C) Positive ANA (antinuclear antibody)
Rationale: The ANA test is positive in more than 95% of patients with SLE, making it the
, Page 3
most important screening tool for the disease. While a positive ANA can occur in other
autoimmune conditions, a negative ANA makes a diagnosis of SLE highly unlikely.
Question 7
A nurse is reviewing a pathology report for a client with suspected Hodgkin Lymphoma. The
presence of which specific cell type would confirm this diagnosis?
A) Bence-Jones cells
B) T-helper cells
C) Reed-Sternberg cells
D) Myeloblasts
E) Erythrocytes
Correct Answer: C) Presence of Reed-Sternberg cells
Rationale: The definitive diagnostic marker for Hodgkin Lymphoma is the Reed-Sternberg
cell, which is a giant, multinucleated B-lymphocyte. Non-Hodgkin lymphomas lack these
specific cells. Identification of Reed-Sternberg cells via lymph node biopsy is the hallmark
of Hodgkin’s disease.
Question 8
A client with Multiple Myeloma is undergoing a 24-hour urine collection. Which specific protein
finding is characteristic of this malignancy?
A) Albumin
B) Reed-Sternberg protein
C) Bence-Jones protein
D) Hemoglobin
E) Bilirubin
Correct Answer: C) Bence-Jones protein
Rationale: Multiple Myeloma is a cancer of the plasma cells. These malignant cells produce
abnormal immunoglobulin light chains known as Bence-Jones proteins. These small
proteins are filtered by the kidneys and appear in the urine, often causing renal damage.
Question 9
According to the Centers for Disease Control and Prevention (CDC), at what specific CD4+ T-
cell count does a client’s HIV infection transition into the diagnosis of AIDS?
A) <500 cells/μL
B) <1000 cells/μL
C) <200 cells/μL
D) >200 cells/μL
E) <800 cells/μL
Correct Answer: C) CD4 count <200 cells/μL
Rationale: The clinical definition of AIDS includes being HIV positive and having a CD4+
T-lymphocyte count of less than 200 cells/μL (or a CD4+ percentage of total lymphocytes of
