NSG 3850 Exam 4 (2026/2027) – Pathophysiology for
Nurses II – Actual Exam Questions, Verified
Answers & Detailed Rationales | Galen, Walden,
Chamberlain – Graded A+
,1. The nurse is caring for a client who has developed ascites as a complication of advanced
liver disease. The nurse recognizes which of the following as the etiological risk factors
behind the complication?
a. Portal hypertension.
b. Plasma hypoalbuminemia.
c. An impaired absorption of fat-soluble vitamins.
d. An accumulation of ammonia in the peritoneal cavity.
Rationale: Ascites in advanced liver disease is primarily caused by portal hypertension
and decreased colloidal oncotic pressure due to hypoalbuminemia, leading to fluid
shifting into the peritoneal cavity.
2. The nurse is caring for a client who has acute cholecystitis. The nurse recognizes which
of the following as the contributing factor to the pathological process of this condition?
a. Enzymatic activation causes an autoimmune response in the gallbladder causes
stones.
b. Lecithin production by the gallbladder causes the solidification of cholesterol into
stones.
c. Vascular insufficiency to the gallbladder causes ischemic injury and hardened cystic
ducts.
d. Cystic duct obstruction causes pathological processes within the gallbladder.
Rationale: Acute cholecystitis is most commonly caused by obstruction of the cystic duct
by gallstones, leading to inflammation, ischemia, and potential infection of the
gallbladder wall.
3. The nurse is caring for a client who has chronic cholelithiasis. Which of the following
should the nurse expect the client to report?
a. Persistent epigastric pain.
b. Functional dyspepsia.
c. A gray-blue color at the flank.
d. Right upper quadrant (RUQ) pain that radiates to the back.
Rationale: Chronic cholelithiasis typically presents with biliary colic, which is
, characterized by severe, steady pain in the right upper quadrant or epigastric region that
often radiates to the right scapula or back.
4. The nurse is discussing the pathogenesis of hepatitis virus A (HVA) with a client who is at
increased risk. Which of the following statements should the nurse include in the
discussion?
a. It is very important to get regular hepatitis titers if you are on dialysis.
b. Lack of safe water and poor sanitation are big risk factors.
c. This is a chronic illness with no lifelong immunity.
d. Do not travel for extended periods overseas.
Rationale: Hepatitis A is transmitted via the fecal-oral route, primarily through
contaminated food and water. Poor sanitation and lack of safe water are major risk
factors for HAV infection.
5. The nurse is caring for a client who has hepatitis virus C (HVC) and a positive anti-HVC
laboratory value. Which of the following conclusions should the nurse make?
a. There are antibodies to the virus present.
b. The client is in the early stage of infection.
c. The client has immunity to the virus.
d. The infection is in remission.
Rationale: A positive anti-HCV test indicates the presence of antibodies to the hepatitis C
virus, which means the client has been exposed to the virus. It does not distinguish
between acute, chronic, or resolved infection.
6. The nurse is caring for an older adult client who has liver disease. Which of the following
should the nurse consider when caring for this client?
a. Prolonged drug half-life.
b. Anasarca.
c. Narrow pulse pressure.
d. Hypocholesterolemia.
Rationale: Older adults often have decreased hepatic blood flow and reduced liver mass,
, which can impair drug metabolism and prolong the half-life of medications metabolized
by the liver.
7. The nurse is caring for a client who has hepatitis virus D (HVD). The nurse is aware that
this is primarily transmitted by
a. the oral-fecal route and occurs with hepatitis virus E (HVE) infection.
b. the parenteral route and occurs with hepatitis virus B (HVB) infection.
c. the sexual route and occurs with hepatitis virus C (HVC) infection.
d. blood contamination and occurs with hepatitis virus A (HVA) infection.
Rationale: Hepatitis D is an incomplete RNA virus that requires the hepatitis B virus to
replicate. It is transmitted primarily through the parenteral route (blood and bodily
fluids), similar to HBV.
8. The nurse is caring for a client who has chronic alcoholism and has developed jaundice.
The nurse is aware that the pathogenetic processes of this condition result in
a. greenish-yellow staining of body tissues by bilirubin.
b. decreased plasma proteins and increased urobilinogen.
c. hepatocytes secrete bile that is supersaturated with cholesterol.
d. serum IgA is often decreased in clients who have alcoholism.
Rationale: Jaundice is caused by hyperbilirubinemia. When bilirubin accumulates in the
blood and tissues, it causes a greenish-yellow staining of the skin, mucous membranes,
and sclera.
9. The nurse is caring for a client who has a viral hepatitis screen with a positive hepatitis B
surface antigen (HBsAg). The nurse should interpret these results to indicate that the
client
a. has chronic inflammation.
b. is recovering from acute disease.
c. has an active infection.
d. has a positive titer.
Nurses II – Actual Exam Questions, Verified
Answers & Detailed Rationales | Galen, Walden,
Chamberlain – Graded A+
,1. The nurse is caring for a client who has developed ascites as a complication of advanced
liver disease. The nurse recognizes which of the following as the etiological risk factors
behind the complication?
a. Portal hypertension.
b. Plasma hypoalbuminemia.
c. An impaired absorption of fat-soluble vitamins.
d. An accumulation of ammonia in the peritoneal cavity.
Rationale: Ascites in advanced liver disease is primarily caused by portal hypertension
and decreased colloidal oncotic pressure due to hypoalbuminemia, leading to fluid
shifting into the peritoneal cavity.
2. The nurse is caring for a client who has acute cholecystitis. The nurse recognizes which
of the following as the contributing factor to the pathological process of this condition?
a. Enzymatic activation causes an autoimmune response in the gallbladder causes
stones.
b. Lecithin production by the gallbladder causes the solidification of cholesterol into
stones.
c. Vascular insufficiency to the gallbladder causes ischemic injury and hardened cystic
ducts.
d. Cystic duct obstruction causes pathological processes within the gallbladder.
Rationale: Acute cholecystitis is most commonly caused by obstruction of the cystic duct
by gallstones, leading to inflammation, ischemia, and potential infection of the
gallbladder wall.
3. The nurse is caring for a client who has chronic cholelithiasis. Which of the following
should the nurse expect the client to report?
a. Persistent epigastric pain.
b. Functional dyspepsia.
c. A gray-blue color at the flank.
d. Right upper quadrant (RUQ) pain that radiates to the back.
Rationale: Chronic cholelithiasis typically presents with biliary colic, which is
, characterized by severe, steady pain in the right upper quadrant or epigastric region that
often radiates to the right scapula or back.
4. The nurse is discussing the pathogenesis of hepatitis virus A (HVA) with a client who is at
increased risk. Which of the following statements should the nurse include in the
discussion?
a. It is very important to get regular hepatitis titers if you are on dialysis.
b. Lack of safe water and poor sanitation are big risk factors.
c. This is a chronic illness with no lifelong immunity.
d. Do not travel for extended periods overseas.
Rationale: Hepatitis A is transmitted via the fecal-oral route, primarily through
contaminated food and water. Poor sanitation and lack of safe water are major risk
factors for HAV infection.
5. The nurse is caring for a client who has hepatitis virus C (HVC) and a positive anti-HVC
laboratory value. Which of the following conclusions should the nurse make?
a. There are antibodies to the virus present.
b. The client is in the early stage of infection.
c. The client has immunity to the virus.
d. The infection is in remission.
Rationale: A positive anti-HCV test indicates the presence of antibodies to the hepatitis C
virus, which means the client has been exposed to the virus. It does not distinguish
between acute, chronic, or resolved infection.
6. The nurse is caring for an older adult client who has liver disease. Which of the following
should the nurse consider when caring for this client?
a. Prolonged drug half-life.
b. Anasarca.
c. Narrow pulse pressure.
d. Hypocholesterolemia.
Rationale: Older adults often have decreased hepatic blood flow and reduced liver mass,
, which can impair drug metabolism and prolong the half-life of medications metabolized
by the liver.
7. The nurse is caring for a client who has hepatitis virus D (HVD). The nurse is aware that
this is primarily transmitted by
a. the oral-fecal route and occurs with hepatitis virus E (HVE) infection.
b. the parenteral route and occurs with hepatitis virus B (HVB) infection.
c. the sexual route and occurs with hepatitis virus C (HVC) infection.
d. blood contamination and occurs with hepatitis virus A (HVA) infection.
Rationale: Hepatitis D is an incomplete RNA virus that requires the hepatitis B virus to
replicate. It is transmitted primarily through the parenteral route (blood and bodily
fluids), similar to HBV.
8. The nurse is caring for a client who has chronic alcoholism and has developed jaundice.
The nurse is aware that the pathogenetic processes of this condition result in
a. greenish-yellow staining of body tissues by bilirubin.
b. decreased plasma proteins and increased urobilinogen.
c. hepatocytes secrete bile that is supersaturated with cholesterol.
d. serum IgA is often decreased in clients who have alcoholism.
Rationale: Jaundice is caused by hyperbilirubinemia. When bilirubin accumulates in the
blood and tissues, it causes a greenish-yellow staining of the skin, mucous membranes,
and sclera.
9. The nurse is caring for a client who has a viral hepatitis screen with a positive hepatitis B
surface antigen (HBsAg). The nurse should interpret these results to indicate that the
client
a. has chronic inflammation.
b. is recovering from acute disease.
c. has an active infection.
d. has a positive titer.
