NSG 3850 Exam 4 Review: Patho IV -
Gallbladder and Liver Disorders 2026
actual,ALREADY GRADED A+!!!
SECTION A: GALLBLADDER DISORDERS
1. A client presents with sudden onset of right upper quadrant pain, fever, and leukocytosis.
The nurse suspects acute cholecystitis. Which pathophysiological process is most likely
occurring?
A) Chronic bile stasis leading to stone formation
B) Supersaturation of cholesterol in the bile causing acute inflammation
C) Decreased somatostatin production leading to bile overproduction D) Viral infection of the
gallbladder mucosa
ANSWER: B
Rationale:
Option A: Incorrect. Chronic bile stasis is associated with chronic cholecystitis, not the acute
form.
Option B: Correct. Acute cholecystitis involves rapid onset inflammation of the gallbladder wall
due to supersaturation of cholesterol in the bile, leading to gallstone formation and
obstruction.
,Option C: Incorrect. Somatostatin decreases gallbladder function; excessive somatostatin
increases gallstone formation, but this is not the primary acute process.
Option D: Incorrect. Viral infection is not the primary cause of acute cholecystitis; it is typically
related to gallstone obstruction.
2. A client with chronic cholecystitis asks the nurse why gallstones develop over time. Which
response is most accurate regarding the pathophysiology of chronic cholecystitis?
A) "The gallbladder becomes infected with bacteria causing rapid stone formation."
B) "Bile becomes supersaturated with cholesterol, leading to immediate stone formation."
C) "Bile does not flow normally and remains in the gallbladder, allowing stones to form slowly."
D) "The liver produces excess bile that overwhelms the gallbladder's storage capacity."
ANSWER: C
Rationale:
Option A: Incorrect. Bacterial infection is not the primary mechanism; it's a complication.
Option B: Incorrect. Supersaturation of cholesterol is more characteristic of acute cholecystitis.
Option C: Correct. Chronic cholecystitis involves slow development where bile flow is impaired,
bile stays in the gallbladder, leading to gradual stone formation.
Option D: Incorrect. The issue is bile stasis and concentration, not overproduction by the liver.
3. The nurse is caring for a client who is 32 weeks pregnant and complaining of right upper
quadrant pain. Which risk factor for cholesterol gallstones is most relevant to this client?
,A) Advanced age
B) Pregnancy
C) Male gender
D) Low BMI
ANSWER: B
Rationale:
Option A: Incorrect. While age is a risk factor, pregnancy is more directly relevant to this client's
presentation.
Option B: Correct. Pregnancy is a significant risk factor for cholesterol gallstone formation due
to hormonal changes and decreased gallbladder motility.
Option C: Incorrect. Women are at higher risk than men for cholesterol gallstones.
Option D: Incorrect. Obesity with BMI >30 is a risk factor; low BMI is not associated with
increased risk.
4. Which client population is at highest risk for developing cholesterol gallstones?
A) Young adult males with normal BMI
B) Postmenopausal women with a history of diabetes
C) Adolescent females with low-fat diets
D) Elderly males with hypertension
, ANSWER: B
Rationale:
Option A: Incorrect. Young adult males have lower risk; females and those with higher BMI are
at greater risk.
Option B: Correct. Risk factors include women, obesity, diabetes (Type I and II), and high
cholesterol levels.
Option C: Incorrect. High-fat diets increase risk; low-fat diets do not promote stone formation.
Option D: Incorrect. Elderly males have lower risk compared to females with metabolic risk
factors.
5. The nurse is reviewing risk factors for gallstone formation with a client. Which statement by
the client indicates a need for further teaching?
A) "Rapid weight loss can increase my risk for gallstones."
B) "Being a woman puts me at higher risk for gallstones."
C) "A low-fat, high-protein diet will help prevent gallstones."
D) "Having a spinal cord injury increases my risk."
ANSWER: C
Rationale:
Option A: Correct. Rapid weight loss is a risk factor; no further teaching needed.
Gallbladder and Liver Disorders 2026
actual,ALREADY GRADED A+!!!
SECTION A: GALLBLADDER DISORDERS
1. A client presents with sudden onset of right upper quadrant pain, fever, and leukocytosis.
The nurse suspects acute cholecystitis. Which pathophysiological process is most likely
occurring?
A) Chronic bile stasis leading to stone formation
B) Supersaturation of cholesterol in the bile causing acute inflammation
C) Decreased somatostatin production leading to bile overproduction D) Viral infection of the
gallbladder mucosa
ANSWER: B
Rationale:
Option A: Incorrect. Chronic bile stasis is associated with chronic cholecystitis, not the acute
form.
Option B: Correct. Acute cholecystitis involves rapid onset inflammation of the gallbladder wall
due to supersaturation of cholesterol in the bile, leading to gallstone formation and
obstruction.
,Option C: Incorrect. Somatostatin decreases gallbladder function; excessive somatostatin
increases gallstone formation, but this is not the primary acute process.
Option D: Incorrect. Viral infection is not the primary cause of acute cholecystitis; it is typically
related to gallstone obstruction.
2. A client with chronic cholecystitis asks the nurse why gallstones develop over time. Which
response is most accurate regarding the pathophysiology of chronic cholecystitis?
A) "The gallbladder becomes infected with bacteria causing rapid stone formation."
B) "Bile becomes supersaturated with cholesterol, leading to immediate stone formation."
C) "Bile does not flow normally and remains in the gallbladder, allowing stones to form slowly."
D) "The liver produces excess bile that overwhelms the gallbladder's storage capacity."
ANSWER: C
Rationale:
Option A: Incorrect. Bacterial infection is not the primary mechanism; it's a complication.
Option B: Incorrect. Supersaturation of cholesterol is more characteristic of acute cholecystitis.
Option C: Correct. Chronic cholecystitis involves slow development where bile flow is impaired,
bile stays in the gallbladder, leading to gradual stone formation.
Option D: Incorrect. The issue is bile stasis and concentration, not overproduction by the liver.
3. The nurse is caring for a client who is 32 weeks pregnant and complaining of right upper
quadrant pain. Which risk factor for cholesterol gallstones is most relevant to this client?
,A) Advanced age
B) Pregnancy
C) Male gender
D) Low BMI
ANSWER: B
Rationale:
Option A: Incorrect. While age is a risk factor, pregnancy is more directly relevant to this client's
presentation.
Option B: Correct. Pregnancy is a significant risk factor for cholesterol gallstone formation due
to hormonal changes and decreased gallbladder motility.
Option C: Incorrect. Women are at higher risk than men for cholesterol gallstones.
Option D: Incorrect. Obesity with BMI >30 is a risk factor; low BMI is not associated with
increased risk.
4. Which client population is at highest risk for developing cholesterol gallstones?
A) Young adult males with normal BMI
B) Postmenopausal women with a history of diabetes
C) Adolescent females with low-fat diets
D) Elderly males with hypertension
, ANSWER: B
Rationale:
Option A: Incorrect. Young adult males have lower risk; females and those with higher BMI are
at greater risk.
Option B: Correct. Risk factors include women, obesity, diabetes (Type I and II), and high
cholesterol levels.
Option C: Incorrect. High-fat diets increase risk; low-fat diets do not promote stone formation.
Option D: Incorrect. Elderly males have lower risk compared to females with metabolic risk
factors.
5. The nurse is reviewing risk factors for gallstone formation with a client. Which statement by
the client indicates a need for further teaching?
A) "Rapid weight loss can increase my risk for gallstones."
B) "Being a woman puts me at higher risk for gallstones."
C) "A low-fat, high-protein diet will help prevent gallstones."
D) "Having a spinal cord injury increases my risk."
ANSWER: C
Rationale:
Option A: Correct. Rapid weight loss is a risk factor; no further teaching needed.
