,Galen NSG 3280 Exam 4 | Pathophysiology for
Nurses I (2026) Actual Q&A PDF
1. A 25-year-old male presents with a painless, indurated ulcer on the shaft of
his penis and nontender inguinal lymphadenopathy. Which stage of syphilis is
the patient most likely experiencing?
A) Secondary syphilis
B) Latent syphilis
C) Primary syphilis
D) Tertiary syphilis
Correct Answer: Primary syphilis
Rationale: Primary syphilis is characterized by a chancre—a painless ulcerated
lesion at the site of inoculation—appearing 10–90 days after exposure.
Lymphadenopathy may be present. Secondary syphilis involves a systemic rash
and mucous membrane lesions; tertiary syphilis involves gummas and
neurosyphilis.
2. A patient diagnosed with gonorrhea develops a purulent urethral discharge
and dysuria. The pathophysiology of these symptoms is primarily due to:
A) Immune complex deposition in the urethral epithelium
B) Treponema pallidum destruction of terminal arterioles
C) Neisseria gonorrhoeae invasion of columnar epithelium and release of
inflammatory mediators
D) Chlamydia trachomatis intracellular replication in the prostate
,Correct Answer: Neisseria gonorrhoeae invasion of columnar epithelium and
release of inflammatory mediators
Rationale: Gonococci attach to and invade mucosal epithelial cells, triggering a
robust inflammatory response with neutrophil infiltration, resulting in purulent
exudate, dysuria, and discharge. Syphilis is caused by Treponema pallidum;
chlamydia is primarily intracellular but gonorrhea directly invades.
3. A 22-year-old female with chlamydia trachomatis cervicitis is at greatest risk
for which complication?
A) Bartholin cyst
B) Pelvic inflammatory disease and subsequent tubal factor infertility
C) Uterine fibroids
D) Ovarian torsion
Correct Answer: Pelvic inflammatory disease and subsequent tubal factor
infertility
Rationale: Chlamydia ascends from the cervix to the upper genital tract, causing
salpingitis, scarring, and adhesions leading to infertility and ectopic pregnancy.
Bartholin cyst is a duct obstruction; fibroids are benign tumors; ovarian torsion
is a surgical emergency unrelated to infection.
4. A mother asks the nurse how her newborn contracted ophthalmia
neonatorum. The nurse responds that the most likely causative organisms
transmitted during birth are:
A) Treponema pallidum or HPV
B) Neisseria gonorrhoeae or Chlamydia trachomatis
, C) Herpes simplex virus or Candida albicans
D) Group B streptococcus or Escherichia coli
Correct Answer: Neisseria gonorrhoeae or Chlamydia trachomatis
Rationale: Both gonorrhea and chlamydia can be vertically transmitted during
delivery, causing neonatal conjunctivitis (ophthalmia neonatorum). Prophylactic
erythromycin eye ointment is given to all newborns. Other organisms listed are
less common causes of this specific infection.
5. A patient is diagnosed with secondary syphilis. Which finding is most
characteristic of this stage?
A) Gummatous lesions of the skin and bone
B) Generalized maculopapular rash, including palms and soles, and condylomata
lata
C) Painless chancre at the site of inoculation
D) Aortic aneurysm and tabes dorsalis
Correct Answer: Generalized maculopapular rash, including palms and soles,
and condylomata lata
Rationale: Secondary syphilis occurs 4–10 weeks after the chancre, with
systemic dissemination causing a diffuse rash often on palms/soles, mucous
patches, and condylomata lata. Primary is the chancre; tertiary involves
gummas and cardiovascular/neurologic complications.
Nurses I (2026) Actual Q&A PDF
1. A 25-year-old male presents with a painless, indurated ulcer on the shaft of
his penis and nontender inguinal lymphadenopathy. Which stage of syphilis is
the patient most likely experiencing?
A) Secondary syphilis
B) Latent syphilis
C) Primary syphilis
D) Tertiary syphilis
Correct Answer: Primary syphilis
Rationale: Primary syphilis is characterized by a chancre—a painless ulcerated
lesion at the site of inoculation—appearing 10–90 days after exposure.
Lymphadenopathy may be present. Secondary syphilis involves a systemic rash
and mucous membrane lesions; tertiary syphilis involves gummas and
neurosyphilis.
2. A patient diagnosed with gonorrhea develops a purulent urethral discharge
and dysuria. The pathophysiology of these symptoms is primarily due to:
A) Immune complex deposition in the urethral epithelium
B) Treponema pallidum destruction of terminal arterioles
C) Neisseria gonorrhoeae invasion of columnar epithelium and release of
inflammatory mediators
D) Chlamydia trachomatis intracellular replication in the prostate
,Correct Answer: Neisseria gonorrhoeae invasion of columnar epithelium and
release of inflammatory mediators
Rationale: Gonococci attach to and invade mucosal epithelial cells, triggering a
robust inflammatory response with neutrophil infiltration, resulting in purulent
exudate, dysuria, and discharge. Syphilis is caused by Treponema pallidum;
chlamydia is primarily intracellular but gonorrhea directly invades.
3. A 22-year-old female with chlamydia trachomatis cervicitis is at greatest risk
for which complication?
A) Bartholin cyst
B) Pelvic inflammatory disease and subsequent tubal factor infertility
C) Uterine fibroids
D) Ovarian torsion
Correct Answer: Pelvic inflammatory disease and subsequent tubal factor
infertility
Rationale: Chlamydia ascends from the cervix to the upper genital tract, causing
salpingitis, scarring, and adhesions leading to infertility and ectopic pregnancy.
Bartholin cyst is a duct obstruction; fibroids are benign tumors; ovarian torsion
is a surgical emergency unrelated to infection.
4. A mother asks the nurse how her newborn contracted ophthalmia
neonatorum. The nurse responds that the most likely causative organisms
transmitted during birth are:
A) Treponema pallidum or HPV
B) Neisseria gonorrhoeae or Chlamydia trachomatis
, C) Herpes simplex virus or Candida albicans
D) Group B streptococcus or Escherichia coli
Correct Answer: Neisseria gonorrhoeae or Chlamydia trachomatis
Rationale: Both gonorrhea and chlamydia can be vertically transmitted during
delivery, causing neonatal conjunctivitis (ophthalmia neonatorum). Prophylactic
erythromycin eye ointment is given to all newborns. Other organisms listed are
less common causes of this specific infection.
5. A patient is diagnosed with secondary syphilis. Which finding is most
characteristic of this stage?
A) Gummatous lesions of the skin and bone
B) Generalized maculopapular rash, including palms and soles, and condylomata
lata
C) Painless chancre at the site of inoculation
D) Aortic aneurysm and tabes dorsalis
Correct Answer: Generalized maculopapular rash, including palms and soles,
and condylomata lata
Rationale: Secondary syphilis occurs 4–10 weeks after the chancre, with
systemic dissemination causing a diffuse rash often on palms/soles, mucous
patches, and condylomata lata. Primary is the chancre; tertiary involves
gummas and cardiovascular/neurologic complications.
