,NSG 3850 Exam 4 Pathophysiology for Nurses II Questions And
Answers 2026/2027 Galen College
Q1. Which substance is the major component of normal bile?
A) Hemoglobin
B) Albumin
C) Water, electrolytes, and organic solutes
D) Insulin
Correct Answer: C) Water, electrolytes, and organic solutes
Rationale: Bile consists primarily of water, electrolytes, and organic solutes
and is produced by the liver before being stored and concentrated in the
gallbladder.
Q2. Which three processes are most closely associated with
cholesterol gallstone formation?
A) Bile supersaturation, crystal nucleation, and gallbladder hypomotility
B) Increased insulin secretion, hemolysis, and hyperventilation
C) Increased bile dilution, rapid emptying, and low cholesterol
D) Reduced crystal formation, increased motility, and bile alkalinization
Correct Answer: A) Bile supersaturation, crystal nucleation, and gallbladder
hypomotility
Rationale: Cholesterol stones develop when bile becomes supersaturated
with cholesterol, crystals form, and impaired gallbladder emptying permits
the crystals to enlarge.
Q3. Which patient has an increased risk for cholelithiasis?
A) Patient who exercises regularly and maintains stable weight
B) Patient with prolonged fasting and rapid weight loss
C) Patient with normal gallbladder motility
D) Patient with adequate nutritional intake
Correct Answer: B) Patient with prolonged fasting and rapid weight loss
Rationale: Prolonged fasting and rapid weight loss can increase cholesterol
concentration in bile and reduce gallbladder emptying, promoting stone
formation.
Q4. Which symptom is most characteristic of biliary colic from
chronic cholelithiasis?
, A) Severe right upper quadrant or epigastric pain after a fatty meal
B) Persistent productive cough
C) Flank pain radiating to the groin
D) Painless hematuria
Correct Answer: A) Severe right upper quadrant or epigastric pain after a
fatty meal
Rationale: Gallstones can transiently obstruct the cystic duct, producing
episodic right upper quadrant or epigastric pain that is often triggered by
fatty foods.
Q5. Which finding is most consistent with acute cholecystitis?
A) Painless jaundice without abdominal symptoms
B) Severe right upper quadrant pain with fever and abdominal tenderness
C) Chronic constipation
D) Bilateral lower-extremity edema only
Correct Answer: B) Severe right upper quadrant pain with fever and
abdominal tenderness
Rationale: Acute inflammation of the gallbladder commonly produces
persistent right upper quadrant pain, tenderness, nausea, vomiting, fever,
and leukocytosis.
Q6. Which complication may occur if acute cholecystitis progresses
untreated?
A) Gallbladder gangrene or perforation
B) Improved gallbladder emptying
C) Increased pancreatic insulin production
D) Renal stone dissolution
Correct Answer: A) Gallbladder gangrene or perforation
Rationale: Persistent obstruction and inflammation can compromise the
gallbladder wall, leading to ischemia, necrosis, perforation, abscess,
peritonitis, or sepsis.
Q7. Which finding is more characteristic of chronic cholecystitis than
acute cholecystitis?
A) Recurrent biliary pain associated with fatty foods
B) Sudden severe sepsis
Answers 2026/2027 Galen College
Q1. Which substance is the major component of normal bile?
A) Hemoglobin
B) Albumin
C) Water, electrolytes, and organic solutes
D) Insulin
Correct Answer: C) Water, electrolytes, and organic solutes
Rationale: Bile consists primarily of water, electrolytes, and organic solutes
and is produced by the liver before being stored and concentrated in the
gallbladder.
Q2. Which three processes are most closely associated with
cholesterol gallstone formation?
A) Bile supersaturation, crystal nucleation, and gallbladder hypomotility
B) Increased insulin secretion, hemolysis, and hyperventilation
C) Increased bile dilution, rapid emptying, and low cholesterol
D) Reduced crystal formation, increased motility, and bile alkalinization
Correct Answer: A) Bile supersaturation, crystal nucleation, and gallbladder
hypomotility
Rationale: Cholesterol stones develop when bile becomes supersaturated
with cholesterol, crystals form, and impaired gallbladder emptying permits
the crystals to enlarge.
Q3. Which patient has an increased risk for cholelithiasis?
A) Patient who exercises regularly and maintains stable weight
B) Patient with prolonged fasting and rapid weight loss
C) Patient with normal gallbladder motility
D) Patient with adequate nutritional intake
Correct Answer: B) Patient with prolonged fasting and rapid weight loss
Rationale: Prolonged fasting and rapid weight loss can increase cholesterol
concentration in bile and reduce gallbladder emptying, promoting stone
formation.
Q4. Which symptom is most characteristic of biliary colic from
chronic cholelithiasis?
, A) Severe right upper quadrant or epigastric pain after a fatty meal
B) Persistent productive cough
C) Flank pain radiating to the groin
D) Painless hematuria
Correct Answer: A) Severe right upper quadrant or epigastric pain after a
fatty meal
Rationale: Gallstones can transiently obstruct the cystic duct, producing
episodic right upper quadrant or epigastric pain that is often triggered by
fatty foods.
Q5. Which finding is most consistent with acute cholecystitis?
A) Painless jaundice without abdominal symptoms
B) Severe right upper quadrant pain with fever and abdominal tenderness
C) Chronic constipation
D) Bilateral lower-extremity edema only
Correct Answer: B) Severe right upper quadrant pain with fever and
abdominal tenderness
Rationale: Acute inflammation of the gallbladder commonly produces
persistent right upper quadrant pain, tenderness, nausea, vomiting, fever,
and leukocytosis.
Q6. Which complication may occur if acute cholecystitis progresses
untreated?
A) Gallbladder gangrene or perforation
B) Improved gallbladder emptying
C) Increased pancreatic insulin production
D) Renal stone dissolution
Correct Answer: A) Gallbladder gangrene or perforation
Rationale: Persistent obstruction and inflammation can compromise the
gallbladder wall, leading to ischemia, necrosis, perforation, abscess,
peritonitis, or sepsis.
Q7. Which finding is more characteristic of chronic cholecystitis than
acute cholecystitis?
A) Recurrent biliary pain associated with fatty foods
B) Sudden severe sepsis
