EXAM 4
Tested Questions with Rationales
Pathophysiology
Galen College of Nursing
This Document Description:
This document contains a collection of tested
and verified questions with accurate answers
from EXAM 4 of NSG 3280 at the Galen College of
Nursing. It covers core topics assessed in the
course and reflects the actual exam format and
question style. Ideal for exam preparation and concept
reinforcement.
,Table of Contents
NSG 3280 Exam 4. ............................................................ 2
NSG 3280 Exam 4 Review. ........................................... 35
NSG 3280 Exam 4.
1.1 A sexually active young adult presents with dysuria and purulent
urethral discharge. Which pathophysiologic process is most
consistent with gonorrhea?
A. Viral latency in sensory ganglia
B. Gram-negative diplococci invading columnar epithelium
C. Fungal overgrowth in vaginal mucosa
D. Spirochete-mediated destruction of large joints
Answer: B. Gram-negative diplococci invading columnar epithelium
Expert Rationale: Gonorrhea is caused by Neisseria gonorrhoeae, a
gram-negative diplococcus that attaches to and penetrates columnar
epithelium, triggering inflammation. This explains dysuria, discharge, and
urethritis.
1.2 Which complication best reflects the long-term pathogenesis of
untreated gonorrhea?
A. Bone marrow suppression
B. Scarring of reproductive structures
C. Demyelination of peripheral nerves
D. Loss of lens elasticity
,Answer: B. Scarring of reproductive structures
Expert Rationale: Gonorrhea can spread through the lymphatic system
and cause scarring of the urethra, oviducts, and epididymis. This can
impair reproductive and urinary function.
1.3 A client is asymptomatic but screens positive on first-catch urine
testing for an STI. Which infection is most likely?
A. Syphilis
B. Chlamydia
C. HSV-2
D. HPV
Answer: B. Chlamydia
Expert Rationale: Chlamydia often affects columnar epithelium and is
frequently asymptomatic. Screening with vaginal secretions or first-catch
urine is emphasized because many cases go unnoticed.
1.4 A patient develops a painless chancre that resolves
spontaneously within weeks. Which STI stage is this?
A. Secondary syphilis
B. Primary syphilis
C. Latent syphilis
D. Tertiary syphilis
Answer: B. Primary syphilis
Expert Rationale: The hallmark of primary syphilis is a painless chancre at
the portal of entry. Although it resolves spontaneously, infection persists
and can progress without treatment.
1.5 Which manifestation most strongly suggests progression to
secondary syphilis?
A. Urinary retention
B. Low-grade fever with diffuse rash
, C. Painless scrotal mass
D. Hard, immobile breast lump
Answer: B. Low-grade fever with diffuse rash
Expert Rationale: Secondary syphilis commonly presents with systemic
findings such as low-grade fever, malaise, headache, lymphadenopathy,
and a characteristic rash due to ongoing vascular inflammation.
1.6 Which finding is most concerning for late syphilis?
A. Painful genital vesicles
B. Aortic insufficiency and neurologic decline
C. Thick white vaginal discharge
D. Pruritic genital warts
Answer: B. Aortic insufficiency and neurologic decline
Expert Rationale: Tertiary syphilis can damage the cardiovascular and
central nervous systems, causing aortic necrosis, aortic insufficiency,
paresis, blindness, and mental deterioration.
1.7 A client reports recurrent painful genital vesicles that heal and
then reappear unpredictably. Which infection best explains this?
A. HPV
B. HSV
C. Chlamydia
D. Gonorrhea
Answer: B. HSV
Expert Rationale: Herpes simplex virus causes an initial self-limiting
infection, but the virus remains in the body and recurs unpredictably.
Vesicles rupture and form painful ulcers.
1.8 Which statement best reflects the pathophysiology of HPV?
A. It causes painless chancres
B. It infects epithelial tissue and may persist silently