Galen NSG 3280 Exam 4 | Pathophysiology for
Nurses I (2026) Actual Q&A PDF
1. A sexually active young adult presents with dysuria and purulent urethral
discharge. Which pathophysiologic process is most consistent with gonorrhea?
A) Viral latency in sensory ganglia
B) Gram-negative diplococci invading columnar epithelium
C) Fungal overgrowth in vaginal mucosa
D) Spirochete-mediated destruction of large joints
Correct Answer: Gram-negative diplococci invading columnar epithelium
Rationale: Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative
diplococcus that attaches to and penetrates columnar epithelium, triggering an
inflammatory response with neutrophil infiltration. This process results in purulent
exudate, dysuria, and urethritis.
2. Which complication best reflects the long-term pathogenesis of untreated
gonorrhea in females?
A) Bone marrow suppression
B) Scarring of reproductive structures
C) Demyelination of peripheral nerves
D) Loss of lens elasticity
Correct Answer: Scarring of reproductive structures
Rationale: Untreated gonorrhea in females can ascend from the cervix to the upper
genital tract, causing salpingitis and pelvic inflammatory disease. The resulting
,scarring and adhesions of the fallopian tubes can lead to tubal factor infertility and
increased risk of ectopic pregnancy.
3. 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, indurated
ulcerated lesion at the site of inoculation—appearing 10 to 90 days after exposure.
Regional lymphadenopathy is often present. Secondary syphilis involves systemic
rash, latent syphilis has no symptoms, and tertiary syphilis involves gummas and
neurosyphilis.
4. In secondary syphilis, which finding is most characteristic?
A) Gummatus 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 to 10 weeks after the primary chancre, with
systemic dissemination causing a diffuse maculopapular rash often on the palms and
soles, mucous patches, and condylomata lata (moist, wart-like lesions). Gummas and
aortic aneurysms are characteristic of tertiary syphilis.
5. 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 trachomatis ascends from the cervix to the upper genital tract,
causing salpingitis, scarring, and adhesions that lead to tubal factor infertility and
ectopic pregnancy. Bartholin cysts are duct obstructions; fibroids are benign tumors;
ovarian torsion is a surgical emergency unrelated to infection.
6. 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.
7. A patient is diagnosed with gonorrhea and 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.
8. What is the main organism that causes pelvic inflammatory disease?
A) Treponema pallidum
B) Gonorrhea
C) Candida albicans
D) Trichomonas vaginalis
Correct Answer: Gonorrhea
Nurses I (2026) Actual Q&A PDF
1. A sexually active young adult presents with dysuria and purulent urethral
discharge. Which pathophysiologic process is most consistent with gonorrhea?
A) Viral latency in sensory ganglia
B) Gram-negative diplococci invading columnar epithelium
C) Fungal overgrowth in vaginal mucosa
D) Spirochete-mediated destruction of large joints
Correct Answer: Gram-negative diplococci invading columnar epithelium
Rationale: Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative
diplococcus that attaches to and penetrates columnar epithelium, triggering an
inflammatory response with neutrophil infiltration. This process results in purulent
exudate, dysuria, and urethritis.
2. Which complication best reflects the long-term pathogenesis of untreated
gonorrhea in females?
A) Bone marrow suppression
B) Scarring of reproductive structures
C) Demyelination of peripheral nerves
D) Loss of lens elasticity
Correct Answer: Scarring of reproductive structures
Rationale: Untreated gonorrhea in females can ascend from the cervix to the upper
genital tract, causing salpingitis and pelvic inflammatory disease. The resulting
,scarring and adhesions of the fallopian tubes can lead to tubal factor infertility and
increased risk of ectopic pregnancy.
3. 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, indurated
ulcerated lesion at the site of inoculation—appearing 10 to 90 days after exposure.
Regional lymphadenopathy is often present. Secondary syphilis involves systemic
rash, latent syphilis has no symptoms, and tertiary syphilis involves gummas and
neurosyphilis.
4. In secondary syphilis, which finding is most characteristic?
A) Gummatus 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 to 10 weeks after the primary chancre, with
systemic dissemination causing a diffuse maculopapular rash often on the palms and
soles, mucous patches, and condylomata lata (moist, wart-like lesions). Gummas and
aortic aneurysms are characteristic of tertiary syphilis.
5. 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 trachomatis ascends from the cervix to the upper genital tract,
causing salpingitis, scarring, and adhesions that lead to tubal factor infertility and
ectopic pregnancy. Bartholin cysts are duct obstructions; fibroids are benign tumors;
ovarian torsion is a surgical emergency unrelated to infection.
6. 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.
7. A patient is diagnosed with gonorrhea and 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.
8. What is the main organism that causes pelvic inflammatory disease?
A) Treponema pallidum
B) Gonorrhea
C) Candida albicans
D) Trichomonas vaginalis
Correct Answer: Gonorrhea
