NSG 3800 actual Exam 4 | Nursing Practice Adult Health II |
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
Section I — Alterations in Metabolism: Questions 1–60
1. Which organ is primarily responsible for producing bile?
A. Pancreas
B. Liver
C. Gallbladder
D. Spleen
Correct Answer: B. Liver
Rationale: The liver produces bile, which assists with fat digestion. The
gallbladder stores and concentrates bile.
2. What is the primary function of the gallbladder?
A. Produce insulin
B. Produce bile
C. Store and concentrate bile
D. Synthesize albumin
Correct Answer: C. Store and concentrate bile
Rationale: The gallbladder stores bile produced by the liver and
releases it into the duodenum after meals.
3. Cholelithiasis refers to:
A. Inflammation of the liver
B. Gallstones
,C. Pancreatic inflammation
D. Bile duct cancer
Correct Answer: B. Gallstones
Rationale: Cholelithiasis is the presence of stones within the gallbladder
or biliary system.
4. A patient with cholelithiasis is most likely to report:
A. Left lower quadrant pain
B. Right upper quadrant pain
C. Suprapubic pain
D. Left shoulder pain
Correct Answer: B. Right upper quadrant pain
Rationale: Gallbladder disease commonly produces right upper
quadrant abdominal pain, especially after fatty meals.
5. Biliary colic commonly occurs after:
A. Fasting
B. A high-fat meal
C. Drinking water
D. Eating high-fiber cereal
Correct Answer: B. A high-fat meal
Rationale: Fat stimulates gallbladder contraction, which can cause pain
when gallstones obstruct bile flow.
6. Which finding is most concerning in a patient with gallstones?
A. Mild nausea
B. Intermittent bloating
C. Fever with severe RUQ pain
D. Decreased appetite
,Correct Answer: C. Fever with severe RUQ pain
Rationale: Fever with significant RUQ pain may indicate acute
cholecystitis or another complication requiring evaluation.
7. A patient with acute cholecystitis should initially expect which
dietary intervention?
A. High-fat diet
B. Low-fat diet
C. High-cholesterol diet
D. Large meals
Correct Answer: B. Low-fat diet
Rationale: Reducing dietary fat decreases gallbladder stimulation and
may reduce symptoms.
8. Which symptom may occur with biliary obstruction?
A. Clay-colored stools
B. Black tongue
C. Clear urine
D. Excessive salivation
Correct Answer: A. Clay-colored stools
Rationale: Reduced bile reaching the intestine can produce pale or clay-
colored stools.
9. Dark urine and jaundice in a patient with gallstones suggest:
A. Increased bile flow
B. Biliary obstruction
C. Hypoglycemia
D. Renal failure
, Correct Answer: B. Biliary obstruction
Rationale: Obstruction can cause conjugated bilirubin to accumulate in
blood and be excreted in urine.
10. Which procedure is commonly used to visualize and treat the
biliary tree?
A. EEG
B. ERCP
C. Colonoscopy
D. Bronchoscopy
Correct Answer: B. ERCP
Rationale: Endoscopic retrograde cholangiopancreatography can
visualize the biliary and pancreatic ducts and may allow stone removal.
11. After ERCP, the nurse should assess for:
A. Return of gag reflex
B. Hearing loss
C. Peripheral pulses only
D. Visual acuity
Correct Answer: A. Return of gag reflex
Rationale: Sedation and instrumentation can impair protective airway
reflexes. Oral intake is generally withheld until swallowing safety is
confirmed.
12. Which complication should be monitored after ERCP?
A. Pancreatitis
B. Cataracts
C. Hypothyroidism
D. Appendicitis
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
Section I — Alterations in Metabolism: Questions 1–60
1. Which organ is primarily responsible for producing bile?
A. Pancreas
B. Liver
C. Gallbladder
D. Spleen
Correct Answer: B. Liver
Rationale: The liver produces bile, which assists with fat digestion. The
gallbladder stores and concentrates bile.
2. What is the primary function of the gallbladder?
A. Produce insulin
B. Produce bile
C. Store and concentrate bile
D. Synthesize albumin
Correct Answer: C. Store and concentrate bile
Rationale: The gallbladder stores bile produced by the liver and
releases it into the duodenum after meals.
3. Cholelithiasis refers to:
A. Inflammation of the liver
B. Gallstones
,C. Pancreatic inflammation
D. Bile duct cancer
Correct Answer: B. Gallstones
Rationale: Cholelithiasis is the presence of stones within the gallbladder
or biliary system.
4. A patient with cholelithiasis is most likely to report:
A. Left lower quadrant pain
B. Right upper quadrant pain
C. Suprapubic pain
D. Left shoulder pain
Correct Answer: B. Right upper quadrant pain
Rationale: Gallbladder disease commonly produces right upper
quadrant abdominal pain, especially after fatty meals.
5. Biliary colic commonly occurs after:
A. Fasting
B. A high-fat meal
C. Drinking water
D. Eating high-fiber cereal
Correct Answer: B. A high-fat meal
Rationale: Fat stimulates gallbladder contraction, which can cause pain
when gallstones obstruct bile flow.
6. Which finding is most concerning in a patient with gallstones?
A. Mild nausea
B. Intermittent bloating
C. Fever with severe RUQ pain
D. Decreased appetite
,Correct Answer: C. Fever with severe RUQ pain
Rationale: Fever with significant RUQ pain may indicate acute
cholecystitis or another complication requiring evaluation.
7. A patient with acute cholecystitis should initially expect which
dietary intervention?
A. High-fat diet
B. Low-fat diet
C. High-cholesterol diet
D. Large meals
Correct Answer: B. Low-fat diet
Rationale: Reducing dietary fat decreases gallbladder stimulation and
may reduce symptoms.
8. Which symptom may occur with biliary obstruction?
A. Clay-colored stools
B. Black tongue
C. Clear urine
D. Excessive salivation
Correct Answer: A. Clay-colored stools
Rationale: Reduced bile reaching the intestine can produce pale or clay-
colored stools.
9. Dark urine and jaundice in a patient with gallstones suggest:
A. Increased bile flow
B. Biliary obstruction
C. Hypoglycemia
D. Renal failure
, Correct Answer: B. Biliary obstruction
Rationale: Obstruction can cause conjugated bilirubin to accumulate in
blood and be excreted in urine.
10. Which procedure is commonly used to visualize and treat the
biliary tree?
A. EEG
B. ERCP
C. Colonoscopy
D. Bronchoscopy
Correct Answer: B. ERCP
Rationale: Endoscopic retrograde cholangiopancreatography can
visualize the biliary and pancreatic ducts and may allow stone removal.
11. After ERCP, the nurse should assess for:
A. Return of gag reflex
B. Hearing loss
C. Peripheral pulses only
D. Visual acuity
Correct Answer: A. Return of gag reflex
Rationale: Sedation and instrumentation can impair protective airway
reflexes. Oral intake is generally withheld until swallowing safety is
confirmed.
12. Which complication should be monitored after ERCP?
A. Pancreatitis
B. Cataracts
C. Hypothyroidism
D. Appendicitis
