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NURS 497
NURS 497 Exam 3 Newest (2026/2027) Complete
Questions and Answers | Graded A
1. In the liver, free bilirubin moves from the plasma in the sinusoids into the
hepatocytes, where it is converted into:
A. Conjugated bilirubin.
B. Unconjugated bilirubin.
C. Urobilinogen.
D. Biliverdin.
CORRECT ANSWER: A
Rationale: Within hepatocytes, free (unconjugated) bilirubin is conjugated
with glucuronic acid, making it water-soluble. This conjugated bilirubin is
then excreted into bile.
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2. The autopsy of a 55-year-old revealed an inflamed and fatty liver with
necrotic hepatocytes. What is the most likely cause of this condition?
A. Viral infection
B. Bacterial infection
C. Alcoholic steatohepatitis
D. Drug overdose
CORRECT ANSWER: C
Rationale: Alcoholic steatohepatitis is characterized by liver inflammation,
fat accumulation (steatosis), and hepatocyte necrosis, directly resulting from
chronic excessive alcohol consumption.
3. The presence of bright red stools is referred to as:
A. Hematochezia.
B. Hematemesis.
C. Melena.
D. Occult bleeding.
CORRECT ANSWER: A
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Rationale: Hematochezia is the passage of bright red blood or maroon-
colored stools, typically indicating lower GI bleeding. Melena is black, tarry
stool indicating upper GI bleeding.
4. Which of the following data obtained by the nurse during the assessment
of a client with cirrhosis is of most concern?
A. The client's hands flap back and forth when the arms are extended.
B. The client complains of right upper-quadrant pain with abdominal
palpation.
C. The client's skin has multiple spider-shaped blood vessels on the abdomen.
D. The client has ascites and a 2-kg weight gain from the previous day.
CORRECT ANSWER: A
Rationale: Asterixis (a flapping tremor of the hands) is a sign of hepatic
encephalopathy, a serious and potentially life-threatening complication of
cirrhosis and liver failure.
5. A 54-year-old reports vomiting blood. Tests reveal portal hypertension.
Which of the following is the most likely cause of this condition?
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A. Renal stenosis
B. Cirrhosis of the liver
C. Left ventricular failure
D. Thrombosis in the spleen
CORRECT ANSWER: B
Rationale: Cirrhosis is the most common cause of portal hypertension.
Increased resistance to blood flow through the scarred liver leads to
increased pressure in the portal venous system, causing varices (e.g.,
esophageal) that can rupture and bleed.
6. In alcoholic cirrhosis, hepatocellular damage is caused by:
A. Acidosis.
B. Bile toxicity.
C. Fatty infiltrations.
D. Acetaldehyde accumulation.
CORRECT ANSWER: D
Rationale: Acetaldehyde, the primary toxic metabolite of ethanol, is directly
NURS 497
NURS 497
NURS 497 Exam 3 Newest (2026/2027) Complete
Questions and Answers | Graded A
1. In the liver, free bilirubin moves from the plasma in the sinusoids into the
hepatocytes, where it is converted into:
A. Conjugated bilirubin.
B. Unconjugated bilirubin.
C. Urobilinogen.
D. Biliverdin.
CORRECT ANSWER: A
Rationale: Within hepatocytes, free (unconjugated) bilirubin is conjugated
with glucuronic acid, making it water-soluble. This conjugated bilirubin is
then excreted into bile.
NURS 497
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NURS 497
2. The autopsy of a 55-year-old revealed an inflamed and fatty liver with
necrotic hepatocytes. What is the most likely cause of this condition?
A. Viral infection
B. Bacterial infection
C. Alcoholic steatohepatitis
D. Drug overdose
CORRECT ANSWER: C
Rationale: Alcoholic steatohepatitis is characterized by liver inflammation,
fat accumulation (steatosis), and hepatocyte necrosis, directly resulting from
chronic excessive alcohol consumption.
3. The presence of bright red stools is referred to as:
A. Hematochezia.
B. Hematemesis.
C. Melena.
D. Occult bleeding.
CORRECT ANSWER: A
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NURS 497
Rationale: Hematochezia is the passage of bright red blood or maroon-
colored stools, typically indicating lower GI bleeding. Melena is black, tarry
stool indicating upper GI bleeding.
4. Which of the following data obtained by the nurse during the assessment
of a client with cirrhosis is of most concern?
A. The client's hands flap back and forth when the arms are extended.
B. The client complains of right upper-quadrant pain with abdominal
palpation.
C. The client's skin has multiple spider-shaped blood vessels on the abdomen.
D. The client has ascites and a 2-kg weight gain from the previous day.
CORRECT ANSWER: A
Rationale: Asterixis (a flapping tremor of the hands) is a sign of hepatic
encephalopathy, a serious and potentially life-threatening complication of
cirrhosis and liver failure.
5. A 54-year-old reports vomiting blood. Tests reveal portal hypertension.
Which of the following is the most likely cause of this condition?
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NURS 497
A. Renal stenosis
B. Cirrhosis of the liver
C. Left ventricular failure
D. Thrombosis in the spleen
CORRECT ANSWER: B
Rationale: Cirrhosis is the most common cause of portal hypertension.
Increased resistance to blood flow through the scarred liver leads to
increased pressure in the portal venous system, causing varices (e.g.,
esophageal) that can rupture and bleed.
6. In alcoholic cirrhosis, hepatocellular damage is caused by:
A. Acidosis.
B. Bile toxicity.
C. Fatty infiltrations.
D. Acetaldehyde accumulation.
CORRECT ANSWER: D
Rationale: Acetaldehyde, the primary toxic metabolite of ethanol, is directly
NURS 497
