NSG 3850 Patho Exam 3 Review Questions and Answers | 2026 Update | 100% Correct
Liver and Biliary Pathophysiology Review
1. In the pathophysiology of cirrhosis, which cell type is primarily responsible for the excessive
production of collagen and the resulting fibrosis?
A) Kupffer cells
B) Hepatocytes
C) Ito (Stellate) cells
D) Sinusoidal endothelial cells
Correct Answer: C
2. Acetaminophen toxicity typically causes necrosis in Zone 3 (centrilobular) of the liver lobule. Why is
this area most susceptible to damage?
A) It has the highest concentration of oxygenated blood.
B) It contains the highest concentration of CYP450 enzymes and is furthest from oxygen supply .
C) It is the first area to receive blood from the hepatic artery.
D) It is protected by the highest concentration of glutathione.
Correct Answer: B
3. Which of the following best describes the mechanism of Portal Hypertension in a patient with
advanced cirrhosis?
A) Decreased systemic vascular resistance leading to hypotension.
B) Sluggish blood flow through fibrotic sinusoids increasing resistance in the portal vein.
C) Increased albumin production causing osmotic pressure changes.
D) Obstruction of the common bile duct by cholesterol stones.
Correct Answer: B
, 4. According to Starling forces, which physiological change is the primary driver of Ascites formation in
liver failure?
A) Increased plasma oncotic pressure and decreased capillary hydrostatic pressure.
B) Decreased plasma oncotic pressure (hypoalbuminemia) and increased capillary hydrostatic pressure.
C) Increased lymphatic drainage and decreased sodium retention.
D) Decreased portal vein pressure and increased systemic protein levels.
Correct Answer: B
5. A patient's serology shows HBsAg (+) and IgM anti-HBc (+). How should the nurse interpret these
results?
A) The patient has chronic Hepatitis B.
B) The patient has acute Hepatitis B.
C) The patient is immune due to vaccination.
D) The patient has recovered from a past infection.
Correct Answer: B
6. Which serologic marker is the first to appear in the blood during an acute Hepatitis B infection, often
before symptoms begin?
A) Anti-HBs
B) HBsAg
C) Anti-HBe
D) HBeAg
Correct Answer: B
7. What is the primary difference between Cholelithiasis and Cholecystitis?
A) Cholelithiasis is inflammation; Cholecystitis is the presence of stones.
B) Cholelithiasis is the presence of stones; Cholecystitis is inflammation of the gallbladder wall.
C) Cholelithiasis only occurs in the liver; Cholecystitis only occurs in the bile duct.
D) Cholelithiasis is always bacterial; Cholecystitis is always chemical.
Correct Answer: B
Liver and Biliary Pathophysiology Review
1. In the pathophysiology of cirrhosis, which cell type is primarily responsible for the excessive
production of collagen and the resulting fibrosis?
A) Kupffer cells
B) Hepatocytes
C) Ito (Stellate) cells
D) Sinusoidal endothelial cells
Correct Answer: C
2. Acetaminophen toxicity typically causes necrosis in Zone 3 (centrilobular) of the liver lobule. Why is
this area most susceptible to damage?
A) It has the highest concentration of oxygenated blood.
B) It contains the highest concentration of CYP450 enzymes and is furthest from oxygen supply .
C) It is the first area to receive blood from the hepatic artery.
D) It is protected by the highest concentration of glutathione.
Correct Answer: B
3. Which of the following best describes the mechanism of Portal Hypertension in a patient with
advanced cirrhosis?
A) Decreased systemic vascular resistance leading to hypotension.
B) Sluggish blood flow through fibrotic sinusoids increasing resistance in the portal vein.
C) Increased albumin production causing osmotic pressure changes.
D) Obstruction of the common bile duct by cholesterol stones.
Correct Answer: B
, 4. According to Starling forces, which physiological change is the primary driver of Ascites formation in
liver failure?
A) Increased plasma oncotic pressure and decreased capillary hydrostatic pressure.
B) Decreased plasma oncotic pressure (hypoalbuminemia) and increased capillary hydrostatic pressure.
C) Increased lymphatic drainage and decreased sodium retention.
D) Decreased portal vein pressure and increased systemic protein levels.
Correct Answer: B
5. A patient's serology shows HBsAg (+) and IgM anti-HBc (+). How should the nurse interpret these
results?
A) The patient has chronic Hepatitis B.
B) The patient has acute Hepatitis B.
C) The patient is immune due to vaccination.
D) The patient has recovered from a past infection.
Correct Answer: B
6. Which serologic marker is the first to appear in the blood during an acute Hepatitis B infection, often
before symptoms begin?
A) Anti-HBs
B) HBsAg
C) Anti-HBe
D) HBeAg
Correct Answer: B
7. What is the primary difference between Cholelithiasis and Cholecystitis?
A) Cholelithiasis is inflammation; Cholecystitis is the presence of stones.
B) Cholelithiasis is the presence of stones; Cholecystitis is inflammation of the gallbladder wall.
C) Cholelithiasis only occurs in the liver; Cholecystitis only occurs in the bile duct.
D) Cholelithiasis is always bacterial; Cholecystitis is always chemical.
Correct Answer: B
