FINAL EXAM NR571/NR 571: (LATEST
2026/2027 UPDATE), COMPLEX DIAGNOSIS
& MANAGEMENT IN ACUTE CARE REVIEW
WITH CORRECT/ACCURATE ANSWERS
AT CHAMBERLAIN COLLEGE OF NURSING
COMPLEX DIAGNOSIS AND MANAGEMENT
IN ACUTE CARE PRACTICUM
Question 1
Alkaline phosphatase (ALP) levels are severely elevated in which condition?
A. Viral hepatitis
B. Alcoholic liver disease
C. Hepatocellular carcinoma
D. Biliary obstruction
Correct Answer: D
Rationale:
Alkaline phosphatase is produced by bile duct epithelium and rises significantly when bile flow is
obstructed. While ALP may be mildly elevated in hepatocellular disease, marked elevations are
characteristic of cholestatic and biliary disease. Conditions such as gallstones or biliary strictures cause
severe elevations. Differentiating hepatocellular versus cholestatic patterns guides diagnosis.
Question 2
Which route is responsible for transmission of Hepatitis A virus?
A. Sexual contact
B. Blood exposure
C. Fecal–oral route
D. Perinatal transmission
Correct Answer: C
,Rationale:
Hepatitis A is transmitted via the fecal–oral route, commonly through contaminated food or water. It is
endemic in developing countries where sanitation is limited. Most children acquire immunity early in life.
Unlike hepatitis B or C, it does not cause chronic infection.
Question 3
Which populations are at greatest risk for Hepatitis B infection?
A. Food handlers
B. IV drug users and dialysis patients
C. Daycare workers
D. Travelers to endemic areas
Correct Answer: B
Rationale:
Hepatitis B is transmitted through blood and body fluids, placing IV drug users, dialysis patients, and
healthcare workers at high risk. Sexual transmission is also common. Occupational exposure increases risk in
healthcare settings. Vaccination is highly effective in prevention.
Question 4
Which hepatitis virus is the leading cause of cirrhosis and hepatocellular carcinoma worldwide?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D
Correct Answer: B
Rationale:
Hepatitis B is the leading global cause of cirrhosis and liver cancer, particularly in endemic regions.
Chronic infection leads to progressive fibrosis. Vertical transmission contributes significantly worldwide.
Vaccination programs have reduced incidence in developed countries.
Question 5
Hepatitis C is most commonly transmitted through which mechanism?
,A. Sexual transmission
B. Fecal–oral route
C. Intravenous drug use
D. Perinatal transmission
Correct Answer: C
Rationale:
Hepatitis C is primarily spread through IV drug use due to shared needles. It accounts for approximately
40% of chronic liver disease. Sexual transmission is uncommon. Chronic infection often progresses silently
to cirrhosis.
Question 6
Which statement best describes Hepatitis D infection?
A. It causes mild self-limited disease
B. It is transmitted via fecal–oral route
C. It requires Hepatitis B for replication
D. It is prevented by antiviral therapy alone
Correct Answer: C
Rationale:
Hepatitis D is a defective virus that requires Hepatitis B surface antigen for replication. It worsens disease
severity when co-infection or superinfection occurs. Vaccination against Hepatitis B prevents Hepatitis D
infection. Outcomes are often severe.
Question 7
A positive anti-HBc antibody indicates which condition?
A. Immunity from vaccination
B. Acute infection only
C. Past or ongoing infection
D. False-positive result
Correct Answer: C
Rationale:
Anti-HBc indicates exposure to Hepatitis B virus and is present in both past and ongoing infections. It is
not present in vaccinated individuals. Differentiating IgM vs IgG helps identify acute versus chronic
infection. This marker is essential in hepatitis panels.
, Question 8
What does a positive anti-HBs antibody indicate?
A. Active infection
B. Chronic hepatitis
C. Immunity from vaccination or recovery
D. Window period infection
Correct Answer: C
Rationale:
Anti-HBs indicates the presence of protective antibodies. This occurs after successful vaccination or
recovery from infection. It signifies immunity. Absence of anti-HBs suggests vulnerability to infection.
Question 9
Nonalcoholic steatohepatitis (NASH) is most commonly associated with which conditions?
A. Chronic viral infection
B. Obesity, diabetes, and hyperlipidemia
C. Autoimmune disease
D. Alcohol misuse
Correct Answer: B
Rationale:
NASH is strongly associated with metabolic syndrome, including obesity, type 2 diabetes, and
dyslipidemia. It represents progression from simple steatosis to inflammation and fibrosis. Untreated NASH
may lead to cirrhosis. Lifestyle modification is critical.
Question 10
What is the primary treatment for nonalcoholic steatohepatitis (NASH)?
A. Corticosteroids
B. Antiviral therapy
C. Diet and exercise
D. Liver transplantation
Correct Answer: C
2026/2027 UPDATE), COMPLEX DIAGNOSIS
& MANAGEMENT IN ACUTE CARE REVIEW
WITH CORRECT/ACCURATE ANSWERS
AT CHAMBERLAIN COLLEGE OF NURSING
COMPLEX DIAGNOSIS AND MANAGEMENT
IN ACUTE CARE PRACTICUM
Question 1
Alkaline phosphatase (ALP) levels are severely elevated in which condition?
A. Viral hepatitis
B. Alcoholic liver disease
C. Hepatocellular carcinoma
D. Biliary obstruction
Correct Answer: D
Rationale:
Alkaline phosphatase is produced by bile duct epithelium and rises significantly when bile flow is
obstructed. While ALP may be mildly elevated in hepatocellular disease, marked elevations are
characteristic of cholestatic and biliary disease. Conditions such as gallstones or biliary strictures cause
severe elevations. Differentiating hepatocellular versus cholestatic patterns guides diagnosis.
Question 2
Which route is responsible for transmission of Hepatitis A virus?
A. Sexual contact
B. Blood exposure
C. Fecal–oral route
D. Perinatal transmission
Correct Answer: C
,Rationale:
Hepatitis A is transmitted via the fecal–oral route, commonly through contaminated food or water. It is
endemic in developing countries where sanitation is limited. Most children acquire immunity early in life.
Unlike hepatitis B or C, it does not cause chronic infection.
Question 3
Which populations are at greatest risk for Hepatitis B infection?
A. Food handlers
B. IV drug users and dialysis patients
C. Daycare workers
D. Travelers to endemic areas
Correct Answer: B
Rationale:
Hepatitis B is transmitted through blood and body fluids, placing IV drug users, dialysis patients, and
healthcare workers at high risk. Sexual transmission is also common. Occupational exposure increases risk in
healthcare settings. Vaccination is highly effective in prevention.
Question 4
Which hepatitis virus is the leading cause of cirrhosis and hepatocellular carcinoma worldwide?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D
Correct Answer: B
Rationale:
Hepatitis B is the leading global cause of cirrhosis and liver cancer, particularly in endemic regions.
Chronic infection leads to progressive fibrosis. Vertical transmission contributes significantly worldwide.
Vaccination programs have reduced incidence in developed countries.
Question 5
Hepatitis C is most commonly transmitted through which mechanism?
,A. Sexual transmission
B. Fecal–oral route
C. Intravenous drug use
D. Perinatal transmission
Correct Answer: C
Rationale:
Hepatitis C is primarily spread through IV drug use due to shared needles. It accounts for approximately
40% of chronic liver disease. Sexual transmission is uncommon. Chronic infection often progresses silently
to cirrhosis.
Question 6
Which statement best describes Hepatitis D infection?
A. It causes mild self-limited disease
B. It is transmitted via fecal–oral route
C. It requires Hepatitis B for replication
D. It is prevented by antiviral therapy alone
Correct Answer: C
Rationale:
Hepatitis D is a defective virus that requires Hepatitis B surface antigen for replication. It worsens disease
severity when co-infection or superinfection occurs. Vaccination against Hepatitis B prevents Hepatitis D
infection. Outcomes are often severe.
Question 7
A positive anti-HBc antibody indicates which condition?
A. Immunity from vaccination
B. Acute infection only
C. Past or ongoing infection
D. False-positive result
Correct Answer: C
Rationale:
Anti-HBc indicates exposure to Hepatitis B virus and is present in both past and ongoing infections. It is
not present in vaccinated individuals. Differentiating IgM vs IgG helps identify acute versus chronic
infection. This marker is essential in hepatitis panels.
, Question 8
What does a positive anti-HBs antibody indicate?
A. Active infection
B. Chronic hepatitis
C. Immunity from vaccination or recovery
D. Window period infection
Correct Answer: C
Rationale:
Anti-HBs indicates the presence of protective antibodies. This occurs after successful vaccination or
recovery from infection. It signifies immunity. Absence of anti-HBs suggests vulnerability to infection.
Question 9
Nonalcoholic steatohepatitis (NASH) is most commonly associated with which conditions?
A. Chronic viral infection
B. Obesity, diabetes, and hyperlipidemia
C. Autoimmune disease
D. Alcohol misuse
Correct Answer: B
Rationale:
NASH is strongly associated with metabolic syndrome, including obesity, type 2 diabetes, and
dyslipidemia. It represents progression from simple steatosis to inflammation and fibrosis. Untreated NASH
may lead to cirrhosis. Lifestyle modification is critical.
Question 10
What is the primary treatment for nonalcoholic steatohepatitis (NASH)?
A. Corticosteroids
B. Antiviral therapy
C. Diet and exercise
D. Liver transplantation
Correct Answer: C
