NUR 376
EXAM 2
(Applied Pathophysiology)
Actual Questions with Correct Answers
Concordia University’s
What’s Included:
• EXAM + STUDY GUIDE
• 50 verified questions with Correct answers with
Rationales.
• Multiple-choice questions
• select-all-that-apply (SATA) questions
• Matching & Sequencing questions
• Ideal for exam preparation and concept reinforcement.
,Table of Contents
NUR 376 EXAM 2 .................................................................. 2
NUR 376 EXAM 2 STUDY GUIDE ......................................... 25
NUR 376 EXAM 2
1. A patient with advanced liver failure has presented with edema. Which of the following
likely played a role in this development?
a. Excess clotting factors
b. Decreased capillary permeability
c. Hypoalbuminemia
d. Hypovolemic hypernatremia
Correct Answer: c. Hypoalbuminemia
Rationale:
The liver synthesizes albumin, the primary plasma protein responsible for maintaining oncotic
pressure. In advanced liver failure, albumin production drops significantly (hypoalbuminemia),
reducing plasma oncotic pressure and allowing fluid to shift into interstitial spaces, resulting in
edema. Excess clotting factors (a) is incorrect because liver failure typically causes decreased
clotting factor synthesis. Decreased capillary permeability (b) would reduce edema formation,
not increase it. Hypovolemic hypernatremia (d) is unrelated to the pathophysiology of liver
failure edema.
2. Which of the following is true regarding pancreatic cancer?
a. Identified with alpha-fetoprotein (AFP) marker
b. High survival rate
c. Jaundice is often the first sign
d. Presents with severe acute symptoms
,Correct Answer: c. Jaundice is often the first sign
Rationale:
Pancreatic cancer, particularly tumors in the head of the pancreas, frequently obstruct the
common bile duct early in the disease course, causing painless jaundice as an initial presenting
symptom. AFP (a) is a marker for hepatocellular carcinoma, not pancreatic cancer (CA 19-9 is
the typical tumor marker). Pancreatic cancer has one of the lowest survival rates among
malignancies (b), and it typically presents with insidious, nonspecific symptoms rather than
severe acute manifestations (d).
3. A nurse is explaining how problems in the liver can result in vomiting of blood. Please place
the following in the proper sequence.
a. Portal hypertension
b. Blood backs up in esophageal vein
c. Esophageal varices rupture
d. Blood appears in vomitus
e. Cirrhosis of the liver
Correct Answer:
1. e. Cirrhosis of the liver
2. a. Portal hypertension
3. b. Blood backs up in esophageal vein
4. c. Esophageal varices rupture
5. d. Blood appears in vomitus
Rationale:
Cirrhosis causes structural distortion of the liver architecture, increasing resistance to portal
blood flow (portal hypertension). This pressure forces blood to seek collateral pathways,
including the esophageal veins, which dilate and become tortuous (varices). These thin-walled
varices are prone to rupture from increased pressure or mechanical irritation, resulting in
hematemesis (vomiting blood). This sequence illustrates the classic portal hypertensive bleeding
pathway.
4. A clinician is asking a patient with severe liver disease about bruising and other signs of
bleeding. Which of the following explains why the clinician is concerned?
a. All medications for liver failure work on thinning the blood to reduce portal pressure
b. The liver synthesizes clotting factors, which may be affected by the patient's liver disease
, c. The patient has likely developed an autoimmune response to clotting factors
d. Liver diseases disrupt portal circulation that may appear as bruising on the extremities
Correct Answer: b. The liver synthesizes clotting factors, which may be affected by the
patient's liver disease
Rationale:
The liver produces the majority of coagulation factors (I, II, V, VII, IX, X, XI, XII) and regulatory
proteins such as antithrombin and protein C. In severe liver disease, impaired synthesis leads to
coagulopathy, manifesting as easy bruising, petechiae, and bleeding tendencies. Option (a) is
incorrect because not all liver medications are anticoagulants. Autoimmune responses to
clotting factors (c) are not characteristic of liver disease. Portal circulation disruption (d) causes
ascites and varices, not bruising.
5. A nurse educator is outlining the progression of a hepatitis B infection. Please place the
following steps in the correct order.
a. Reduction in hepatitis B virus (HBV) viral load due to immune response
b. Inflammatory reaction of the hepatocytes
c. Inoculation with HBV
d. No viral levels detected, high level of HBV antibodies
e. No signs of symptoms, although virus can be passed to others
Correct Answer:
1. c. Inoculation with HBV
2. e. No signs of symptoms, although virus can be passed to others
3. b. Inflammatory reaction of the hepatocytes
4. a. Reduction in hepatitis B virus (HBV) viral load due to immune response
5. d. No viral levels detected, high level of HBV antibodies
Rationale:
Following HBV inoculation, there is an incubation period where the patient is asymptomatic but
infectious (e). The immune system then recognizes infected hepatocytes, triggering an
inflammatory response (b) that causes hepatocellular damage. As the immune response
mounts, viral replication is suppressed (a). In resolved infection, seroconversion occurs with
undetectable viral DNA and elevated protective antibodies (anti-HBs), indicating immunity (d).
6. A patient states that he has been diagnosed with diverticulitis. Which of the following
statements by the patient indicates that he best understands this disorder?
EXAM 2
(Applied Pathophysiology)
Actual Questions with Correct Answers
Concordia University’s
What’s Included:
• EXAM + STUDY GUIDE
• 50 verified questions with Correct answers with
Rationales.
• Multiple-choice questions
• select-all-that-apply (SATA) questions
• Matching & Sequencing questions
• Ideal for exam preparation and concept reinforcement.
,Table of Contents
NUR 376 EXAM 2 .................................................................. 2
NUR 376 EXAM 2 STUDY GUIDE ......................................... 25
NUR 376 EXAM 2
1. A patient with advanced liver failure has presented with edema. Which of the following
likely played a role in this development?
a. Excess clotting factors
b. Decreased capillary permeability
c. Hypoalbuminemia
d. Hypovolemic hypernatremia
Correct Answer: c. Hypoalbuminemia
Rationale:
The liver synthesizes albumin, the primary plasma protein responsible for maintaining oncotic
pressure. In advanced liver failure, albumin production drops significantly (hypoalbuminemia),
reducing plasma oncotic pressure and allowing fluid to shift into interstitial spaces, resulting in
edema. Excess clotting factors (a) is incorrect because liver failure typically causes decreased
clotting factor synthesis. Decreased capillary permeability (b) would reduce edema formation,
not increase it. Hypovolemic hypernatremia (d) is unrelated to the pathophysiology of liver
failure edema.
2. Which of the following is true regarding pancreatic cancer?
a. Identified with alpha-fetoprotein (AFP) marker
b. High survival rate
c. Jaundice is often the first sign
d. Presents with severe acute symptoms
,Correct Answer: c. Jaundice is often the first sign
Rationale:
Pancreatic cancer, particularly tumors in the head of the pancreas, frequently obstruct the
common bile duct early in the disease course, causing painless jaundice as an initial presenting
symptom. AFP (a) is a marker for hepatocellular carcinoma, not pancreatic cancer (CA 19-9 is
the typical tumor marker). Pancreatic cancer has one of the lowest survival rates among
malignancies (b), and it typically presents with insidious, nonspecific symptoms rather than
severe acute manifestations (d).
3. A nurse is explaining how problems in the liver can result in vomiting of blood. Please place
the following in the proper sequence.
a. Portal hypertension
b. Blood backs up in esophageal vein
c. Esophageal varices rupture
d. Blood appears in vomitus
e. Cirrhosis of the liver
Correct Answer:
1. e. Cirrhosis of the liver
2. a. Portal hypertension
3. b. Blood backs up in esophageal vein
4. c. Esophageal varices rupture
5. d. Blood appears in vomitus
Rationale:
Cirrhosis causes structural distortion of the liver architecture, increasing resistance to portal
blood flow (portal hypertension). This pressure forces blood to seek collateral pathways,
including the esophageal veins, which dilate and become tortuous (varices). These thin-walled
varices are prone to rupture from increased pressure or mechanical irritation, resulting in
hematemesis (vomiting blood). This sequence illustrates the classic portal hypertensive bleeding
pathway.
4. A clinician is asking a patient with severe liver disease about bruising and other signs of
bleeding. Which of the following explains why the clinician is concerned?
a. All medications for liver failure work on thinning the blood to reduce portal pressure
b. The liver synthesizes clotting factors, which may be affected by the patient's liver disease
, c. The patient has likely developed an autoimmune response to clotting factors
d. Liver diseases disrupt portal circulation that may appear as bruising on the extremities
Correct Answer: b. The liver synthesizes clotting factors, which may be affected by the
patient's liver disease
Rationale:
The liver produces the majority of coagulation factors (I, II, V, VII, IX, X, XI, XII) and regulatory
proteins such as antithrombin and protein C. In severe liver disease, impaired synthesis leads to
coagulopathy, manifesting as easy bruising, petechiae, and bleeding tendencies. Option (a) is
incorrect because not all liver medications are anticoagulants. Autoimmune responses to
clotting factors (c) are not characteristic of liver disease. Portal circulation disruption (d) causes
ascites and varices, not bruising.
5. A nurse educator is outlining the progression of a hepatitis B infection. Please place the
following steps in the correct order.
a. Reduction in hepatitis B virus (HBV) viral load due to immune response
b. Inflammatory reaction of the hepatocytes
c. Inoculation with HBV
d. No viral levels detected, high level of HBV antibodies
e. No signs of symptoms, although virus can be passed to others
Correct Answer:
1. c. Inoculation with HBV
2. e. No signs of symptoms, although virus can be passed to others
3. b. Inflammatory reaction of the hepatocytes
4. a. Reduction in hepatitis B virus (HBV) viral load due to immune response
5. d. No viral levels detected, high level of HBV antibodies
Rationale:
Following HBV inoculation, there is an incubation period where the patient is asymptomatic but
infectious (e). The immune system then recognizes infected hepatocytes, triggering an
inflammatory response (b) that causes hepatocellular damage. As the immune response
mounts, viral replication is suppressed (a). In resolved infection, seroconversion occurs with
undetectable viral DNA and elevated protective antibodies (anti-HBs), indicating immunity (d).
6. A patient states that he has been diagnosed with diverticulitis. Which of the following
statements by the patient indicates that he best understands this disorder?
