NSG 3280 Exam 4 with 50 Questions and
100% Correct Answers with Rationales
Latest Fall 2025/2026 Update – Galen.
1. A sexually active young adult presents with dysuria and purulent urethral
discharge. Which pathophysiologic process is most consistent with gonorrhea?
A. Fungal overgrowth in the vaginal mucosa
B. Gram-negative diplococci invading columnar epithelium
C. Spirochete-mediated destruction of large joints
D. Viral latency in sensory ganglia
Correct Answer: B. Gram-negative diplococci invading columnar epithelium
Rationale: Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative
diplococcus that attaches to and invades columnar epithelial cells of the urethra,
cervix, and rectum, triggering an intense inflammatory response with purulent
discharge.
2. Which complication best reflects the long-term pathogenesis of untreated
gonorrhea?
A. Bone marrow suppression
B. Scarring of reproductive structures
C. Demyelination of peripheral nerves
D. Loss of lens elasticity
Correct Answer: B. Scarring of reproductive structures
Rationale: Untreated gonorrhea can ascend and cause pelvic inflammatory disease
(PID) in females or epididymitis in males. The resulting inflammation and fibrosis
can scar the fallopian tubes or epididymis, leading to infertility.
,3. Which condition may result from either gonorrhea or chlamydia?
A. Erectile dysfunction
B. Epididymitis
C. Endometriosis
D. Urinary incontinence
Correct Answer: B. Epididymitis
Rationale: Both N. gonorrhoeae and C. trachomatis can infect the epididymis via
ascending spread from the urethra, causing painful epididymitis.
4. The organism most commonly associated with pelvic inflammatory disease
(PID) is:
A. Neisseria gonorrhoeae
B. Treponema pallidum
C. Escherichia coli
D. Pseudomonas
Correct Answer: A. Neisseria gonorrhoeae
Rationale: PID is most commonly caused by ascending infection from the lower
genital tract, with Neisseria gonorrhoeae and Chlamydia trachomatis being the
primary pathogens.
5. A painless ulceration called a chancre is a lesion associated with infection
by:
A. Human papillomavirus
B. N. gonorrhoeae
C. C. trachomatis
D. T. pallidum
Correct Answer: D. T. pallidum
Rationale: Treponema pallidum, the spirochete that causes syphilis, produces a
primary chancre at the inoculation site. This lesion is characteristically painless
and indurated, healing spontaneously within weeks.
,6. A long asymptomatic latent phase is characteristic of which sexually
transmitted infection?
A. Gonorrhea
B. Syphilis
C. Chlamydia
D. Hepatitis B
Correct Answer: B. Syphilis
Rationale: After the secondary stage resolves, untreated syphilis enters a latent
phase that can last for years without clinical signs or symptoms, yet the infection
remains detectable by serologic testing.
7. Which infection can be a risk factor for cervical cancer?
A. Human papillomavirus (HPV)
B. Molluscum contagiosum
C. Granuloma inguinale
D. Chancroid
Correct Answer: A. Human papillomavirus (HPV)
Rationale: Persistent infection with high-risk HPV types (e.g., HPV-16, HPV-18)
leads to integration of viral oncogenes E6 and E7 into host DNA, promoting
cellular transformation and progression to cervical dysplasia and carcinoma.
8. Which of the following infections is asymptomatic and self-limited and does
not require therapy?
A. Syphilis
B. Nongonococcal cervicitis
C. Gonorrhea
D. Molluscum contagiosum
Correct Answer: D. Molluscum contagiosum
Rationale: Caused by the poxvirus, molluscum contagiosum produces benign,
, self-limited skin papules that typically resolve over months to years without
treatment in immunocompetent individuals.
9. The first choice of treatment for the management of syphilis is:
A. Penicillin G
B. Doxycycline
C. Antiviral agents
D. Antimicrobial agents
Correct Answer: A. Penicillin G
Rationale: Treponema pallidum remains exquisitely sensitive to penicillin, which
disrupts bacterial cell wall synthesis; parenteral penicillin G (benzathine or
aqueous) is the preferred therapy for all stages of syphilis.
10. Transmission of Chlamydia during birth may result in
_________________, or infection of the eyes in the newborn.
A. Neonatal jaundice
B. Ophthalmia neonatorum
C. Neonatal conjunctivitis
D. Erythema neonatorum
Correct Answer: B. Ophthalmia neonatorum
Rationale: Intrapartum exposure to Chlamydia trachomatis can cause neonatal
conjunctivitis (ophthalmia neonatorum), typically presenting 5–14 days after birth,
and can also lead to chlamydial pneumonia.
11. Central nervous system degeneration, blindness, and paresis are
associated with untreated:
A. HSV
B. LGV
C. Syphilis
D. Gonorrhea
100% Correct Answers with Rationales
Latest Fall 2025/2026 Update – Galen.
1. A sexually active young adult presents with dysuria and purulent urethral
discharge. Which pathophysiologic process is most consistent with gonorrhea?
A. Fungal overgrowth in the vaginal mucosa
B. Gram-negative diplococci invading columnar epithelium
C. Spirochete-mediated destruction of large joints
D. Viral latency in sensory ganglia
Correct Answer: B. Gram-negative diplococci invading columnar epithelium
Rationale: Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative
diplococcus that attaches to and invades columnar epithelial cells of the urethra,
cervix, and rectum, triggering an intense inflammatory response with purulent
discharge.
2. Which complication best reflects the long-term pathogenesis of untreated
gonorrhea?
A. Bone marrow suppression
B. Scarring of reproductive structures
C. Demyelination of peripheral nerves
D. Loss of lens elasticity
Correct Answer: B. Scarring of reproductive structures
Rationale: Untreated gonorrhea can ascend and cause pelvic inflammatory disease
(PID) in females or epididymitis in males. The resulting inflammation and fibrosis
can scar the fallopian tubes or epididymis, leading to infertility.
,3. Which condition may result from either gonorrhea or chlamydia?
A. Erectile dysfunction
B. Epididymitis
C. Endometriosis
D. Urinary incontinence
Correct Answer: B. Epididymitis
Rationale: Both N. gonorrhoeae and C. trachomatis can infect the epididymis via
ascending spread from the urethra, causing painful epididymitis.
4. The organism most commonly associated with pelvic inflammatory disease
(PID) is:
A. Neisseria gonorrhoeae
B. Treponema pallidum
C. Escherichia coli
D. Pseudomonas
Correct Answer: A. Neisseria gonorrhoeae
Rationale: PID is most commonly caused by ascending infection from the lower
genital tract, with Neisseria gonorrhoeae and Chlamydia trachomatis being the
primary pathogens.
5. A painless ulceration called a chancre is a lesion associated with infection
by:
A. Human papillomavirus
B. N. gonorrhoeae
C. C. trachomatis
D. T. pallidum
Correct Answer: D. T. pallidum
Rationale: Treponema pallidum, the spirochete that causes syphilis, produces a
primary chancre at the inoculation site. This lesion is characteristically painless
and indurated, healing spontaneously within weeks.
,6. A long asymptomatic latent phase is characteristic of which sexually
transmitted infection?
A. Gonorrhea
B. Syphilis
C. Chlamydia
D. Hepatitis B
Correct Answer: B. Syphilis
Rationale: After the secondary stage resolves, untreated syphilis enters a latent
phase that can last for years without clinical signs or symptoms, yet the infection
remains detectable by serologic testing.
7. Which infection can be a risk factor for cervical cancer?
A. Human papillomavirus (HPV)
B. Molluscum contagiosum
C. Granuloma inguinale
D. Chancroid
Correct Answer: A. Human papillomavirus (HPV)
Rationale: Persistent infection with high-risk HPV types (e.g., HPV-16, HPV-18)
leads to integration of viral oncogenes E6 and E7 into host DNA, promoting
cellular transformation and progression to cervical dysplasia and carcinoma.
8. Which of the following infections is asymptomatic and self-limited and does
not require therapy?
A. Syphilis
B. Nongonococcal cervicitis
C. Gonorrhea
D. Molluscum contagiosum
Correct Answer: D. Molluscum contagiosum
Rationale: Caused by the poxvirus, molluscum contagiosum produces benign,
, self-limited skin papules that typically resolve over months to years without
treatment in immunocompetent individuals.
9. The first choice of treatment for the management of syphilis is:
A. Penicillin G
B. Doxycycline
C. Antiviral agents
D. Antimicrobial agents
Correct Answer: A. Penicillin G
Rationale: Treponema pallidum remains exquisitely sensitive to penicillin, which
disrupts bacterial cell wall synthesis; parenteral penicillin G (benzathine or
aqueous) is the preferred therapy for all stages of syphilis.
10. Transmission of Chlamydia during birth may result in
_________________, or infection of the eyes in the newborn.
A. Neonatal jaundice
B. Ophthalmia neonatorum
C. Neonatal conjunctivitis
D. Erythema neonatorum
Correct Answer: B. Ophthalmia neonatorum
Rationale: Intrapartum exposure to Chlamydia trachomatis can cause neonatal
conjunctivitis (ophthalmia neonatorum), typically presenting 5–14 days after birth,
and can also lead to chlamydial pneumonia.
11. Central nervous system degeneration, blindness, and paresis are
associated with untreated:
A. HSV
B. LGV
C. Syphilis
D. Gonorrhea
