NSG 3850 PATHOPHYSIOLOGY II EXAM 4
STUDY GUIDE 200 NCLEX QUESTIONS
AND ANSWERS (2026 UPDATE) GRADED A+
Master your upcoming nursing exam with this premium, high-yield
collection of 200 NCLEX-style multiple-choice questions, accurate
answers, and comprehensive rationales designed specifically for the
NSG 3850 curriculum. This meticulously updated 2026 review delivers
complete breadth and depth across hepatobiliary, endocrine,
immunological, and hematological disorders. Perfect for quick
scanning or deep-dive study sessions, this layout guarantees top
marks and serves as an excellent resource for boosting your store
downloads and sales.
Part 1: Hepatobiliary and Gallbladder Disorders (Questions 1–15)
1. A patient presents with acute jaundice, dark urine, and fatigue.
The nurse notes the patient recently returned from an
international trip with poor sanitation. Which serological marker
confirms a diagnosis of acute Hepatitis A?
A) Anti-HCV
B) HBsAg
C) Anti-HAV IgM
D) Anti-HAV IgG
Answer: C) Anti-HAV IgM
Rationale: Anti-HAV IgM is the definitive marker for an acute,
active Hepatitis A infection. Anti-HAV IgG indicates past
infection or permanent immunity, not an active state. HBsAg is
specific to Hepatitis B, and Anti-HCV is for Hepatitis C.
,2. Which transmission route is the primary risk factor for the
acquisition and spread of the Hepatitis A virus?
A) Bloodborne pathogens
B) Fecal-oral route
C) Sexual contact
D) Airborne droplets
Answer: B) Fecal-oral route
Rationale: Hepatitis A is primarily transmitted via the fecal-oral
route, usually due to contaminated food, water, or poor hand
hygiene. Hepatitis B and C are primarily transmitted via
bloodborne or sexual routes.
3. A patient with chronic Hepatitis C infection is demonstrating
progressive confusion, flapping tremors of the hands (asterixis),
and altered level of consciousness. Which manifestation is this
patient exhibiting?
A) Acute respiratory distress
B) Hepatic encephalopathy
C) Nephrotic syndrome
D) Thyroid storm
Answer: B) Hepatic encephalopathy
Rationale: Hepatic encephalopathy is a severe complication of
chronic liver disease (such as Hepatitis C) characterized by
cognitive deficits, altered level of consciousness, and
neuromuscular dysfunction caused by systemic toxin
accumulation.
4. A nurse receives a lab report showing an "Anti-HCV Positive"
test result for a patient. How should the nurse accurately
interpret this finding?
A) The patient has active immunity against Hepatitis B.
B) The patient has antibodies against the Hepatitis C virus.
C) The patient is a carrier of Hepatitis A.
D) The patient requires immediate isolation for an airborne
disease.
Answer: B) The patient has antibodies against the Hepatitis C
, virus.
Rationale: An Anti-HCV positive test indicates the presence of
antibodies to the Hepatitis C virus, confirming exposure and
potential chronic infection, which requires further RNA testing.
5. Which dual mechanism drives the development of ascites in a
patient suffering from advanced liver cirrhosis?
A) Decreased portal pressure and elevated albumin production
B) Portal hypertension and decreased albumin production
C) High systemic blood pressure and fluid overload
D) Splenic rupture and decreased bile secretion
Answer: B) Portal hypertension and decreased albumin
production
Rationale: Ascites forms because portal hypertension increases
hydrostatic pressure in the portal veins, while the failing liver's
decreased albumin production lowers oncotic pressure,
allowing fluid to leak into the peritoneal cavity.
6. Which neurotoxic substance accumulates in the blood and
crosses the blood-brain barrier to cause hepatic
encephalopathy?
A) Bilirubin
B) Ammonia
C) Creatinine
D) Urea
Answer: B) Ammonia
Rationale: When the liver fails, it can no longer convert ammonia
(a byproduct of protein metabolism) into urea. High systemic
ammonia levels cross the blood-brain barrier, causing
neurotoxicity and encephalopathy.
7. A nurse is reviewing risk factors for a patient diagnosed with
Non-Alcoholic Steatohepatitis (NASH). Which condition is
considered a primary metabolic risk factor for NASH?
A) Celiac disease
B) Chronic hypotension
, C) Diabetes mellitus
D) Hyperthyroidism
Answer: C) Diabetes mellitus
Rationale: NASH is closely linked to metabolic syndrome,
obesity, diabetes mellitus, hyperlipidemia, and the use of total
parenteral nutrition (TPN), which promote fat deposition within
hepatocytes.
8. What is the fundamental underlying etiology responsible for the
formation of cholelithiasis?
A) Hyperactivity of the pancreatic duct
B) Supersaturation of bile with cholesterol
C) Atrophy of the common bile duct
D) Excessive destruction of red blood cells
Answer: B) Supersaturation of bile with cholesterol
Rationale: Cholelithiasis (gallstones) occurs primarily when bile
becomes supersaturated with cholesterol, leading to crystal
formation, stone growth, and subsequent bile stasis.
9. Which patient has the highest risk for developing cholelithiasis
and bile stasis?
A) A patient with an active hyperthyroid crisis
B) A patient with a high spinal cord injury
C) A patient on a low-fat, high-fiber diet
D) A patient with chronic iron-deficiency anemia
Answer: B) A patient with a high spinal cord injury
Rationale: Risk factors for cholelithiasis include high spinal cord
injuries (due to gallbladder hypomotility), rapid weight loss,
obesity, and pregnancy.
10. A patient presents with sharp right upper quadrant (RUQ)
pain that radiates to the right shoulder, accompanied by nausea.
The patient states the pain worsened after eating a
cheeseburger. What is the likely diagnosis?
A) Acute Pancreatitis
B) Appendicitis
STUDY GUIDE 200 NCLEX QUESTIONS
AND ANSWERS (2026 UPDATE) GRADED A+
Master your upcoming nursing exam with this premium, high-yield
collection of 200 NCLEX-style multiple-choice questions, accurate
answers, and comprehensive rationales designed specifically for the
NSG 3850 curriculum. This meticulously updated 2026 review delivers
complete breadth and depth across hepatobiliary, endocrine,
immunological, and hematological disorders. Perfect for quick
scanning or deep-dive study sessions, this layout guarantees top
marks and serves as an excellent resource for boosting your store
downloads and sales.
Part 1: Hepatobiliary and Gallbladder Disorders (Questions 1–15)
1. A patient presents with acute jaundice, dark urine, and fatigue.
The nurse notes the patient recently returned from an
international trip with poor sanitation. Which serological marker
confirms a diagnosis of acute Hepatitis A?
A) Anti-HCV
B) HBsAg
C) Anti-HAV IgM
D) Anti-HAV IgG
Answer: C) Anti-HAV IgM
Rationale: Anti-HAV IgM is the definitive marker for an acute,
active Hepatitis A infection. Anti-HAV IgG indicates past
infection or permanent immunity, not an active state. HBsAg is
specific to Hepatitis B, and Anti-HCV is for Hepatitis C.
,2. Which transmission route is the primary risk factor for the
acquisition and spread of the Hepatitis A virus?
A) Bloodborne pathogens
B) Fecal-oral route
C) Sexual contact
D) Airborne droplets
Answer: B) Fecal-oral route
Rationale: Hepatitis A is primarily transmitted via the fecal-oral
route, usually due to contaminated food, water, or poor hand
hygiene. Hepatitis B and C are primarily transmitted via
bloodborne or sexual routes.
3. A patient with chronic Hepatitis C infection is demonstrating
progressive confusion, flapping tremors of the hands (asterixis),
and altered level of consciousness. Which manifestation is this
patient exhibiting?
A) Acute respiratory distress
B) Hepatic encephalopathy
C) Nephrotic syndrome
D) Thyroid storm
Answer: B) Hepatic encephalopathy
Rationale: Hepatic encephalopathy is a severe complication of
chronic liver disease (such as Hepatitis C) characterized by
cognitive deficits, altered level of consciousness, and
neuromuscular dysfunction caused by systemic toxin
accumulation.
4. A nurse receives a lab report showing an "Anti-HCV Positive"
test result for a patient. How should the nurse accurately
interpret this finding?
A) The patient has active immunity against Hepatitis B.
B) The patient has antibodies against the Hepatitis C virus.
C) The patient is a carrier of Hepatitis A.
D) The patient requires immediate isolation for an airborne
disease.
Answer: B) The patient has antibodies against the Hepatitis C
, virus.
Rationale: An Anti-HCV positive test indicates the presence of
antibodies to the Hepatitis C virus, confirming exposure and
potential chronic infection, which requires further RNA testing.
5. Which dual mechanism drives the development of ascites in a
patient suffering from advanced liver cirrhosis?
A) Decreased portal pressure and elevated albumin production
B) Portal hypertension and decreased albumin production
C) High systemic blood pressure and fluid overload
D) Splenic rupture and decreased bile secretion
Answer: B) Portal hypertension and decreased albumin
production
Rationale: Ascites forms because portal hypertension increases
hydrostatic pressure in the portal veins, while the failing liver's
decreased albumin production lowers oncotic pressure,
allowing fluid to leak into the peritoneal cavity.
6. Which neurotoxic substance accumulates in the blood and
crosses the blood-brain barrier to cause hepatic
encephalopathy?
A) Bilirubin
B) Ammonia
C) Creatinine
D) Urea
Answer: B) Ammonia
Rationale: When the liver fails, it can no longer convert ammonia
(a byproduct of protein metabolism) into urea. High systemic
ammonia levels cross the blood-brain barrier, causing
neurotoxicity and encephalopathy.
7. A nurse is reviewing risk factors for a patient diagnosed with
Non-Alcoholic Steatohepatitis (NASH). Which condition is
considered a primary metabolic risk factor for NASH?
A) Celiac disease
B) Chronic hypotension
, C) Diabetes mellitus
D) Hyperthyroidism
Answer: C) Diabetes mellitus
Rationale: NASH is closely linked to metabolic syndrome,
obesity, diabetes mellitus, hyperlipidemia, and the use of total
parenteral nutrition (TPN), which promote fat deposition within
hepatocytes.
8. What is the fundamental underlying etiology responsible for the
formation of cholelithiasis?
A) Hyperactivity of the pancreatic duct
B) Supersaturation of bile with cholesterol
C) Atrophy of the common bile duct
D) Excessive destruction of red blood cells
Answer: B) Supersaturation of bile with cholesterol
Rationale: Cholelithiasis (gallstones) occurs primarily when bile
becomes supersaturated with cholesterol, leading to crystal
formation, stone growth, and subsequent bile stasis.
9. Which patient has the highest risk for developing cholelithiasis
and bile stasis?
A) A patient with an active hyperthyroid crisis
B) A patient with a high spinal cord injury
C) A patient on a low-fat, high-fiber diet
D) A patient with chronic iron-deficiency anemia
Answer: B) A patient with a high spinal cord injury
Rationale: Risk factors for cholelithiasis include high spinal cord
injuries (due to gallbladder hypomotility), rapid weight loss,
obesity, and pregnancy.
10. A patient presents with sharp right upper quadrant (RUQ)
pain that radiates to the right shoulder, accompanied by nausea.
The patient states the pain worsened after eating a
cheeseburger. What is the likely diagnosis?
A) Acute Pancreatitis
B) Appendicitis
