NSG 430 FINAL EXAM REVIEW TOPICS 2026/2027 ACCURATE REAL
EXAM QUESTIONS AND VERIFIED ANSWERS WITH DETAILED
RATIONALES EACH | CURRENTLY TESTING AND FREQUENTLY TESTED
QUESTIONS | GRADED A+
SECTION 1: LIVER DISEASE & CIRRHOSIS (Questions 1–30)
Q1. What is a major complication from Cirrhosis of the liver?
A) Portal Hypertension
B) Jaundice
C) Edema in the hands and feet
D) Cardiomegaly
Correct Answer: A
Rationale: Portal hypertension occurs when sclerotic vessels impair blood flow,
causing increased pressure in the portal vein. This leads to backup of blood,
resulting in engorged/enlarged vessels and complications like varices and
ascites.
Q2. Where can spider-like angiomas be seen in a patient with liver disease?
A) Lower extremities and abdomen
B) Cheeks, upper neck, and shoulders
C) Palms of the hands and soles of the feet
D) Back and buttocks
Correct Answer: B
Rationale: Spider angiomas are a cutaneous manifestation of liver disease and
are commonly found on the cheeks, upper neck, and shoulders due to increased
estrogen levels from impaired liver metabolism.
Q3. What are the complications of liver cirrhosis? (Select all that apply)
A) Esophageal varices
B) Ascites
C) Hepatic encephalopathy
1
,D) Hepatorenal syndrome
Correct Answer: A, B, C, D
Rationale: All four are serious complications of cirrhosis. Esophageal varices
result from portal hypertension; ascites from decreased albumin and increased
portal pressure; hepatic encephalopathy from ammonia accumulation; and
hepatorenal syndrome from renal vasoconstriction.
Q4. What are esophageal varices?
A) Enlarged arteries in the stomach
B) Enlarged veins at the lower end of the esophagus
C) Small capillaries in the intestines
D) Dilated lymph nodes in the chest
Correct Answer: B
Rationale: Esophageal varices are abnormally dilated veins in the lower
esophagus caused by increased pressure in the portal venous system. They are
prone to rupture and can cause life-threatening hemorrhage.
Q5. What is ascites?
A) Accumulation of fluid in the lungs
B) Accumulation of fluid in the abdominal cavity
C) Accumulation of fluid in the pericardial sac
D) Accumulation of fluid in the joints
Correct Answer: B
Rationale: Ascites is the pathologic accumulation of serous fluid in the
peritoneal cavity. It results from portal hypertension and decreased plasma
albumin, leading to fluid shifting into the abdominal space.
Q6. What is the priority nursing intervention for a patient with ascites?
A) Strict intake and output monitoring
2
,B) Daily weight measurements
C) Low-sodium diet
D) Respiratory assessment and positioning
Correct Answer: D
Rationale: Respiratory assessment is the priority because massive ascites can
push the diaphragm upward, impairing lung expansion and causing respiratory
distress. Airway and breathing always take precedence.
Q7. What is hepatic encephalopathy?
A) Liver failure causing kidney damage
B) Neurologic syndrome caused by accumulation of ammonia
C) Inflammation of the liver tissue
D) Obstruction of bile flow from the liver
Correct Answer: B
Rationale: Hepatic encephalopathy is a neuropsychiatric syndrome resulting from
liver failure. The failing liver cannot convert ammonia to urea, causing
ammonia to accumulate in the blood and cross the blood-brain barrier, leading to
altered mental status.
Q8. What is the most effective treatment for portal hypertension?
A) Diuretics
B) Liver transplantation
C) Low-protein diet
D) Paracentesis
Correct Answer: B
Rationale: Liver transplantation is the definitive treatment for portal
hypertension and end-stage liver disease. Other treatments like diuretics,
paracentesis, and TIPS provide symptomatic relief but do not cure the
underlying condition.
3
, Q9. What is the classic presentation of ascites? (Select all that apply)
A) Weight gain
B) Distended abdomen
C) Shortness of breath
D) Decreased urine output
Correct Answer: A, B, C
Rationale: Ascites presents with progressive weight gain, abdominal distension
with visible venous patterns, and shortness of breath from diaphragmatic
splinting. Decreased urine output is a later finding indicating hepatorenal
syndrome.
Q10. What is the most common cause of cirrhosis?
A) Biliary obstruction
B) Alcohol abuse
C) Hepatitis C infection
D) Nonalcoholic fatty liver disease (NAFLD)
Correct Answer: B
Rationale: Chronic alcohol abuse is the leading cause of cirrhosis in the
United States. Hepatitis C and NAFLD are also significant causes, but alcohol
remains the most common single etiology.
Q11. What is lactulose used for in liver disease?
A) To decrease portal pressure
B) To reduce serum ammonia levels
C) To promote bile flow
D) To treat ascites
Correct Answer: B
Rationale: Lactulose is a synthetic disaccharide that acidifies the intestinal
contents, converting ammonia (NH3) to ammonium (NH4+), which is not
absorbed.
4
EXAM QUESTIONS AND VERIFIED ANSWERS WITH DETAILED
RATIONALES EACH | CURRENTLY TESTING AND FREQUENTLY TESTED
QUESTIONS | GRADED A+
SECTION 1: LIVER DISEASE & CIRRHOSIS (Questions 1–30)
Q1. What is a major complication from Cirrhosis of the liver?
A) Portal Hypertension
B) Jaundice
C) Edema in the hands and feet
D) Cardiomegaly
Correct Answer: A
Rationale: Portal hypertension occurs when sclerotic vessels impair blood flow,
causing increased pressure in the portal vein. This leads to backup of blood,
resulting in engorged/enlarged vessels and complications like varices and
ascites.
Q2. Where can spider-like angiomas be seen in a patient with liver disease?
A) Lower extremities and abdomen
B) Cheeks, upper neck, and shoulders
C) Palms of the hands and soles of the feet
D) Back and buttocks
Correct Answer: B
Rationale: Spider angiomas are a cutaneous manifestation of liver disease and
are commonly found on the cheeks, upper neck, and shoulders due to increased
estrogen levels from impaired liver metabolism.
Q3. What are the complications of liver cirrhosis? (Select all that apply)
A) Esophageal varices
B) Ascites
C) Hepatic encephalopathy
1
,D) Hepatorenal syndrome
Correct Answer: A, B, C, D
Rationale: All four are serious complications of cirrhosis. Esophageal varices
result from portal hypertension; ascites from decreased albumin and increased
portal pressure; hepatic encephalopathy from ammonia accumulation; and
hepatorenal syndrome from renal vasoconstriction.
Q4. What are esophageal varices?
A) Enlarged arteries in the stomach
B) Enlarged veins at the lower end of the esophagus
C) Small capillaries in the intestines
D) Dilated lymph nodes in the chest
Correct Answer: B
Rationale: Esophageal varices are abnormally dilated veins in the lower
esophagus caused by increased pressure in the portal venous system. They are
prone to rupture and can cause life-threatening hemorrhage.
Q5. What is ascites?
A) Accumulation of fluid in the lungs
B) Accumulation of fluid in the abdominal cavity
C) Accumulation of fluid in the pericardial sac
D) Accumulation of fluid in the joints
Correct Answer: B
Rationale: Ascites is the pathologic accumulation of serous fluid in the
peritoneal cavity. It results from portal hypertension and decreased plasma
albumin, leading to fluid shifting into the abdominal space.
Q6. What is the priority nursing intervention for a patient with ascites?
A) Strict intake and output monitoring
2
,B) Daily weight measurements
C) Low-sodium diet
D) Respiratory assessment and positioning
Correct Answer: D
Rationale: Respiratory assessment is the priority because massive ascites can
push the diaphragm upward, impairing lung expansion and causing respiratory
distress. Airway and breathing always take precedence.
Q7. What is hepatic encephalopathy?
A) Liver failure causing kidney damage
B) Neurologic syndrome caused by accumulation of ammonia
C) Inflammation of the liver tissue
D) Obstruction of bile flow from the liver
Correct Answer: B
Rationale: Hepatic encephalopathy is a neuropsychiatric syndrome resulting from
liver failure. The failing liver cannot convert ammonia to urea, causing
ammonia to accumulate in the blood and cross the blood-brain barrier, leading to
altered mental status.
Q8. What is the most effective treatment for portal hypertension?
A) Diuretics
B) Liver transplantation
C) Low-protein diet
D) Paracentesis
Correct Answer: B
Rationale: Liver transplantation is the definitive treatment for portal
hypertension and end-stage liver disease. Other treatments like diuretics,
paracentesis, and TIPS provide symptomatic relief but do not cure the
underlying condition.
3
, Q9. What is the classic presentation of ascites? (Select all that apply)
A) Weight gain
B) Distended abdomen
C) Shortness of breath
D) Decreased urine output
Correct Answer: A, B, C
Rationale: Ascites presents with progressive weight gain, abdominal distension
with visible venous patterns, and shortness of breath from diaphragmatic
splinting. Decreased urine output is a later finding indicating hepatorenal
syndrome.
Q10. What is the most common cause of cirrhosis?
A) Biliary obstruction
B) Alcohol abuse
C) Hepatitis C infection
D) Nonalcoholic fatty liver disease (NAFLD)
Correct Answer: B
Rationale: Chronic alcohol abuse is the leading cause of cirrhosis in the
United States. Hepatitis C and NAFLD are also significant causes, but alcohol
remains the most common single etiology.
Q11. What is lactulose used for in liver disease?
A) To decrease portal pressure
B) To reduce serum ammonia levels
C) To promote bile flow
D) To treat ascites
Correct Answer: B
Rationale: Lactulose is a synthetic disaccharide that acidifies the intestinal
contents, converting ammonia (NH3) to ammonium (NH4+), which is not
absorbed.
4
