NURS 316B EXAM 3 QUESTIONS WITH
100% CORRECT ANSWERS | LATEST
VERSION 2025/2026.
Where is the liver located? - ANS Right upper quadrant of abdomen
List the 2 main blood vessels supplying the liver - ANS (1) Hepatic artery
(2) Portal vein
What are the 3 main etiologies/causes of liver disease? - ANS (1) Hepatocellular injury
(2) Obstructive injury (i.e. Cholelithiasis)
(3) Both: Combination of hepatocellular injury and obstructive injury
Explain how RBC is broken down into unconjugated bilirubin - ANS Hemoglobin (Hgb) broken
down to heme + globin → Heme broken down to iron + porphyrin → Porphyrin converted to
biliverdin → Biliverdin converted to free OR unconjugated bilirubin
What is the difference between unconjugated and conjugated bilirubin? - ANS Unconjugated
bilirubin = In bloodstream, Conjugated bilirubin = Performed by liver
Explain how unconjugated bilirubin eventually gets excreted in the urine - ANS In liver,
unconjugated bilirubin converted to water-soluble conjugated form → Conjugated bilirubin
excreted in bile → Bile is later excrete in urine = Yellow color
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,Why is some bilirubin excreted in bowel? - ANS Some conjugated bilirubin in colon is
converted to urobilinogen by bacteria and excreted in bowel
In a lab test, what is conjugated bilirubin called? - ANS Direct bilirubin
When the function of the liver is altered and there is a decrease in clotting factor synthesis,
what problem(s) can you expect? - ANS Problem with coagulation
When the function of the liver is altered and there is a decrease in albumin, what problem(s)
and resulting signs/symptoms can you expect? - ANS ↓ Albumin (problems with protein) →
Third spacing → Edema, ascites
When the function of the liver is altered and there is a decrease in detoxification activity, what
problem(s) can you expect? - ANS ↓ Detoxification activity → Excess accumulation of drugs,
hormones & metabolites
When the function of the liver is altered and there is a decrease in the storage of nutrients,
what problem(s) can you expect? - ANS Muscle wasting
When the function of the liver is altered and there is a decrease in bilirubin conjugation, what
signs/symptoms can you expect? - ANS Discoloration
I.e. jaundice overall, sclera icterus = jaundice/yellow sclera, jaundice of oral cavity
When the function of the liver is altered and there is a decrease in deamination activity, what 3
signs/symptoms can you expect? - ANS (1) Dark-colored urine
(2) Gray-colored stool
(3) Steatorrhea (loss of fat digestion)
List 3 things that cause liver inflammation - ANS (1) Viruses
(2) Drugs
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,(3) Toxic substances (i.e. alcohol)
Summarize what happens with acute liver inflammation/infection? - ANS WBCs, ↑
Permeability of cell membranes of hepatocytes → Swelling liver → Beginning hepatomegaly
signs
What does chronic viral liver infection increase the risk for? - ANS Liver cancer
List 3 viruses that can cause liver inflammation - ANS (1) Hepatitis viruses: A, B, C, D or G
(2) Cytomegalovirus (CMV) (Can cause chickenpox, herpes simplex and mononucleosis)
(3) Epstein-Barr virus (Causes infectious mononucleosis [mono])
Which drug, taken in excess, can cause liver inflammation? - ANS Acetaminophen
Explain how enzymes can cause liver inflammation - ANS Enzymes can be activated by
medications → Oxidative stress in liver → Specific cells will trigger fats in the liver
What is the end result of liver inflammation? - ANS Scarring → Collagen formation → Fibrous
tissue that is nonfunctiona
What can non-alcoholic fatty liver disease (NAFLD) lead to? - ANS Cirrhosis
What is the etiology of NAFLD? - ANS Etiology of NAFLD is unknown, but highly correlated
with obesity, HLD, DM and metabolic syndromes
What is non-alcoholic steatosis (NASH)? - ANS Advancement of NAFLD
What can NASH progress to? - ANS Liver failure
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, What is cholestasis? - ANS Conjugated bilirubin backs up
What symptom results from cholestasis? - ANS Jaundice:
Bilirubin builds up in blood → Hyperbilirubinemia → Jaundice
What was the cause of pre-hepatic jaundice provided in class? - ANS Excessive blood
hemolysis (occurs with certain anemias)
What was the cause of post-hepatic jaundice provided in class? - ANS Gallstones
What was the cause of intrahepatic jaundice provided in class? - ANS Hepatocyte injury
(inside of the liver)
What is the most likely cause of biliary obstruction? - ANS Gallstones
Why does pruritis occur in advanced liver disease? - ANS Bile salts deposit in skin → Pruritus
What are spider angiomas? - ANS Fine capillaries that fan out
Why do spider angiomas occur with liver disease? - ANS Liver's ability to metabolize
hormones (particularly estrogen) is decreased/impaired → Elevated levels of estrogen (liver
unable to process) → Vasodilation
What is caput medusa? - ANS Dilated veins in umbilical area
List 3 liver enzymes tested for liver disorders - ANS (1) Alanine transaminase (ALT)
(2) Aspartate transaminase (AST)
(3) Alkaline phosphatase
4 | Page @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
100% CORRECT ANSWERS | LATEST
VERSION 2025/2026.
Where is the liver located? - ANS Right upper quadrant of abdomen
List the 2 main blood vessels supplying the liver - ANS (1) Hepatic artery
(2) Portal vein
What are the 3 main etiologies/causes of liver disease? - ANS (1) Hepatocellular injury
(2) Obstructive injury (i.e. Cholelithiasis)
(3) Both: Combination of hepatocellular injury and obstructive injury
Explain how RBC is broken down into unconjugated bilirubin - ANS Hemoglobin (Hgb) broken
down to heme + globin → Heme broken down to iron + porphyrin → Porphyrin converted to
biliverdin → Biliverdin converted to free OR unconjugated bilirubin
What is the difference between unconjugated and conjugated bilirubin? - ANS Unconjugated
bilirubin = In bloodstream, Conjugated bilirubin = Performed by liver
Explain how unconjugated bilirubin eventually gets excreted in the urine - ANS In liver,
unconjugated bilirubin converted to water-soluble conjugated form → Conjugated bilirubin
excreted in bile → Bile is later excrete in urine = Yellow color
1 | Page @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Why is some bilirubin excreted in bowel? - ANS Some conjugated bilirubin in colon is
converted to urobilinogen by bacteria and excreted in bowel
In a lab test, what is conjugated bilirubin called? - ANS Direct bilirubin
When the function of the liver is altered and there is a decrease in clotting factor synthesis,
what problem(s) can you expect? - ANS Problem with coagulation
When the function of the liver is altered and there is a decrease in albumin, what problem(s)
and resulting signs/symptoms can you expect? - ANS ↓ Albumin (problems with protein) →
Third spacing → Edema, ascites
When the function of the liver is altered and there is a decrease in detoxification activity, what
problem(s) can you expect? - ANS ↓ Detoxification activity → Excess accumulation of drugs,
hormones & metabolites
When the function of the liver is altered and there is a decrease in the storage of nutrients,
what problem(s) can you expect? - ANS Muscle wasting
When the function of the liver is altered and there is a decrease in bilirubin conjugation, what
signs/symptoms can you expect? - ANS Discoloration
I.e. jaundice overall, sclera icterus = jaundice/yellow sclera, jaundice of oral cavity
When the function of the liver is altered and there is a decrease in deamination activity, what 3
signs/symptoms can you expect? - ANS (1) Dark-colored urine
(2) Gray-colored stool
(3) Steatorrhea (loss of fat digestion)
List 3 things that cause liver inflammation - ANS (1) Viruses
(2) Drugs
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,(3) Toxic substances (i.e. alcohol)
Summarize what happens with acute liver inflammation/infection? - ANS WBCs, ↑
Permeability of cell membranes of hepatocytes → Swelling liver → Beginning hepatomegaly
signs
What does chronic viral liver infection increase the risk for? - ANS Liver cancer
List 3 viruses that can cause liver inflammation - ANS (1) Hepatitis viruses: A, B, C, D or G
(2) Cytomegalovirus (CMV) (Can cause chickenpox, herpes simplex and mononucleosis)
(3) Epstein-Barr virus (Causes infectious mononucleosis [mono])
Which drug, taken in excess, can cause liver inflammation? - ANS Acetaminophen
Explain how enzymes can cause liver inflammation - ANS Enzymes can be activated by
medications → Oxidative stress in liver → Specific cells will trigger fats in the liver
What is the end result of liver inflammation? - ANS Scarring → Collagen formation → Fibrous
tissue that is nonfunctiona
What can non-alcoholic fatty liver disease (NAFLD) lead to? - ANS Cirrhosis
What is the etiology of NAFLD? - ANS Etiology of NAFLD is unknown, but highly correlated
with obesity, HLD, DM and metabolic syndromes
What is non-alcoholic steatosis (NASH)? - ANS Advancement of NAFLD
What can NASH progress to? - ANS Liver failure
3 | Page @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, What is cholestasis? - ANS Conjugated bilirubin backs up
What symptom results from cholestasis? - ANS Jaundice:
Bilirubin builds up in blood → Hyperbilirubinemia → Jaundice
What was the cause of pre-hepatic jaundice provided in class? - ANS Excessive blood
hemolysis (occurs with certain anemias)
What was the cause of post-hepatic jaundice provided in class? - ANS Gallstones
What was the cause of intrahepatic jaundice provided in class? - ANS Hepatocyte injury
(inside of the liver)
What is the most likely cause of biliary obstruction? - ANS Gallstones
Why does pruritis occur in advanced liver disease? - ANS Bile salts deposit in skin → Pruritus
What are spider angiomas? - ANS Fine capillaries that fan out
Why do spider angiomas occur with liver disease? - ANS Liver's ability to metabolize
hormones (particularly estrogen) is decreased/impaired → Elevated levels of estrogen (liver
unable to process) → Vasodilation
What is caput medusa? - ANS Dilated veins in umbilical area
List 3 liver enzymes tested for liver disorders - ANS (1) Alanine transaminase (ALT)
(2) Aspartate transaminase (AST)
(3) Alkaline phosphatase
4 | Page @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
