NSG 3850 Comprehensive
Final Exam – 2026 Edition
Question 1
The nurse is caring for a client who has developed ascites as a
complication of advanced liver disease. The nurse recognizes which of the
following as the etiological risk factor behind the complication?
A. Serum hypoparathyroidism
B. Portal hypertension
C. Plasma hyperalbuminemia
D. An accumulation of ammonia in the peritoneal cavity
Rationale:
A is incorrect – Hypoparathyroidism affects calcium balance and does not
cause ascites.
BANSWER– Portal hypertension increases hydrostatic pressure, forcing
fluid into the peritoneal cavity.
C is incorrect – Hyperalbuminemia would increase plasma oncotic pressure
and reduce ascites; liver disease causes hypoalbuminemia.
,D is incorrect – Ammonia accumulates in the blood, not peritoneal cavity,
and causes encephalopathy, not ascites.
Question 2
The nurse is caring for a client who has acute cholecystitis. The nurse
recognizes which of the following as the contributing factor to the
pathological process of this condition?
A. Enzymatic activation causes an autoimmune response in the gallbladder
that causes stones
B. Lecithin production by the gallbladder causes the solidification of
cholesterol into stones
C. Vascular insufficiency to the gallbladder causes ischemic injury and
hardened cystic ducts
D. Cystic duct obstruction causes pathological processes within the
gallbladder
Rationale:
A is incorrect – Autoimmune response is not typical in acute cholecystitis.
B is incorrect – Lecithin normally prevents stone formation; lecithin
deficiency, not overproduction, contributes to stones.
C is incorrect – Vascular insufficiency is rare; obstruction is the primary
mechanism.
DANSWER– Cystic duct obstruction (usually by a gallstone) leads to bile
stasis, inflammation, and infection.
,Question 3
The nurse is caring for a client who has chronic cholelithiasis. Which of the
following should the nurse expect the client to report?
A. Persistent epigastric pain
B. Functional dyspepsia
C. A gray-blue color at the flank
D. Left upper quadrant (LUQ) pain that radiates to the back
Rationale:
AANSWER– Chronic cholelithiasis often causes dull, persistent epigastric
or right upper quadrant pain, especially after fatty meals.
B is incorrect – Functional dyspepsia is not characteristic of cholelithiasis.
C is incorrect – Gray-blue flank discoloration (Cullen sign) suggests
hemorrhagic pancreatitis.
D is incorrect – LUQ pain radiating to back is more typical of pancreatitis.
Question 4
The nurse is discussing the pathogenesis of hepatitis virus A (HAV) with a
client who is at increased risk. Which of the following statements should the
nurse include in the discussion?
A. "It is very important to get regular hepatitis titers if you are on dialysis."
B. "Lack of safe water and poor sanitation are big risk factors."
, C. "This is a chronic illness with no lifelong immunity."
D. "Do not travel for extended periods overseas."
Rationale:
A is incorrect – Dialysis patients are at risk for hepatitis B and C, not
specifically HAV.
BANSWER– HAV is transmitted fecal-orally; poor sanitation and
contaminated water are major risk factors.
C is incorrect – HAV causes acute, not chronic, illness and confers lifelong
immunity after infection.
D is incorrect – Travel to endemic areas increases risk, but the statement is
too absolute and not the primary teaching point.
Question 5
The nurse is caring for a client who has hepatitis virus C (HCV) and a
positive anti-HCV laboratory value. Which of the following conclusions
should the nurse make?
A. There are antibodies to the virus present
B. The client is in the early stage of infection
C. The client has immunity to the virus
D. The infection is in remission
Rationale:
Final Exam – 2026 Edition
Question 1
The nurse is caring for a client who has developed ascites as a
complication of advanced liver disease. The nurse recognizes which of the
following as the etiological risk factor behind the complication?
A. Serum hypoparathyroidism
B. Portal hypertension
C. Plasma hyperalbuminemia
D. An accumulation of ammonia in the peritoneal cavity
Rationale:
A is incorrect – Hypoparathyroidism affects calcium balance and does not
cause ascites.
BANSWER– Portal hypertension increases hydrostatic pressure, forcing
fluid into the peritoneal cavity.
C is incorrect – Hyperalbuminemia would increase plasma oncotic pressure
and reduce ascites; liver disease causes hypoalbuminemia.
,D is incorrect – Ammonia accumulates in the blood, not peritoneal cavity,
and causes encephalopathy, not ascites.
Question 2
The nurse is caring for a client who has acute cholecystitis. The nurse
recognizes which of the following as the contributing factor to the
pathological process of this condition?
A. Enzymatic activation causes an autoimmune response in the gallbladder
that causes stones
B. Lecithin production by the gallbladder causes the solidification of
cholesterol into stones
C. Vascular insufficiency to the gallbladder causes ischemic injury and
hardened cystic ducts
D. Cystic duct obstruction causes pathological processes within the
gallbladder
Rationale:
A is incorrect – Autoimmune response is not typical in acute cholecystitis.
B is incorrect – Lecithin normally prevents stone formation; lecithin
deficiency, not overproduction, contributes to stones.
C is incorrect – Vascular insufficiency is rare; obstruction is the primary
mechanism.
DANSWER– Cystic duct obstruction (usually by a gallstone) leads to bile
stasis, inflammation, and infection.
,Question 3
The nurse is caring for a client who has chronic cholelithiasis. Which of the
following should the nurse expect the client to report?
A. Persistent epigastric pain
B. Functional dyspepsia
C. A gray-blue color at the flank
D. Left upper quadrant (LUQ) pain that radiates to the back
Rationale:
AANSWER– Chronic cholelithiasis often causes dull, persistent epigastric
or right upper quadrant pain, especially after fatty meals.
B is incorrect – Functional dyspepsia is not characteristic of cholelithiasis.
C is incorrect – Gray-blue flank discoloration (Cullen sign) suggests
hemorrhagic pancreatitis.
D is incorrect – LUQ pain radiating to back is more typical of pancreatitis.
Question 4
The nurse is discussing the pathogenesis of hepatitis virus A (HAV) with a
client who is at increased risk. Which of the following statements should the
nurse include in the discussion?
A. "It is very important to get regular hepatitis titers if you are on dialysis."
B. "Lack of safe water and poor sanitation are big risk factors."
, C. "This is a chronic illness with no lifelong immunity."
D. "Do not travel for extended periods overseas."
Rationale:
A is incorrect – Dialysis patients are at risk for hepatitis B and C, not
specifically HAV.
BANSWER– HAV is transmitted fecal-orally; poor sanitation and
contaminated water are major risk factors.
C is incorrect – HAV causes acute, not chronic, illness and confers lifelong
immunity after infection.
D is incorrect – Travel to endemic areas increases risk, but the statement is
too absolute and not the primary teaching point.
Question 5
The nurse is caring for a client who has hepatitis virus C (HCV) and a
positive anti-HCV laboratory value. Which of the following conclusions
should the nurse make?
A. There are antibodies to the virus present
B. The client is in the early stage of infection
C. The client has immunity to the virus
D. The infection is in remission
Rationale:
