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NSG 3850 EXAM 4 2026/2027 | PATHOPHYSIOLOGY
FOR NURSES II | 40 VERIFIED Q&A | DETAILED
RATIONALES | PASS GUARANTEED – A+ GRADED
SECTION 1: HEPATIC & BILIARY DISORDERS – Questions 1-15
Q1: Ascites Etiology in Liver Disease
The nurse is caring for a client who developed ascites as a complication of advanced liver disease.
The nurse recognizes which of the following as the etiological risk factors behind the complication?
A. Plasma hyperalbuminemia
B. Portal hypertension
C. Impaired absorption of fat-soluble vitamins
D. Accumulation of ammonia in the peritoneal cavity
Correct Answer: B
Rationale: Ascites in advanced liver disease results from a combination of portal hypertension
(increased hydrostatic pressure) and decreased plasma oncotic pressure due to hypoalbuminemia.
Portal hypertension is the primary etiological risk factor driving fluid into the peritoneal cavity.
Option A is incorrect because albumin is decreased (hypoalbuminemia), not increased. Option C
relates to vitamin absorption, not ascites. Option D describes hepatic encephalopathy, not ascites .
Q2: Acute Cholecystitis Contributing Factor
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
B. Lecithin production by the gallbladder causes solidification of cholesterol
C. Vascular insufficiency causes ischemic injury and hardened cystic ducts
D. Cystic duct obstruction causes pathological processes within the gallbladder
Correct Answer: D
Rationale: Acute cholecystitis most commonly occurs when a gallstone obstructs the cystic duct,
preventing bile from leaving the gallbladder. This causes bile stasis, inflammation, increased
intraluminal pressure, and eventual infection. While ischemia and infection can develop later, cystic
duct obstruction is the primary contributing factor .
Q3: Chronic Cholelithiasis Expected Report
The nurse is caring for a client who has chronic cholelithiasis. Which of the following should the
nurse expect the client to report?
, 2
A. Abdominal pain upon waking up
B. Left upper quadrant abdominal pain
C. Persistent epigastric pain
D. Right upper quadrant pain radiating to the right shoulder
Correct Answer: C
Rationale: Chronic cholelithiasis often presents with persistent epigastric pain, which may be dull
and aching. This pain can be intermittent and is often associated with meals, particularly fatty foods.
Right upper quadrant pain radiating to the right shoulder is more characteristic of acute
cholecystitis, not chronic cholelithiasis .
Q4: Hepatitis A Transmission
The nurse is discussing the pathogenesis of hepatitis 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."
Correct Answer: B
Rationale: Hepatitis A is transmitted via the fecal-oral route, and lack of safe water and poor
sanitation are major risk factors. Hepatitis A is an acute, self-limiting illness that does not cause
chronic infection, and infection confers lifelong immunity .
Q5: Hepatitis C Positive Antibody Interpretation
The nurse is caring for a client who has hepatitis 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.
Correct Answer: A
Rationale: A positive anti-HCV test indicates the presence of antibodies to the hepatitis C virus. It
does not distinguish between acute, chronic, or resolved infection. A positive antibody test means
the client has been exposed to the virus .
Q6: Hepatitis D Transmission
The nurse is caring for a client who has hepatitis D (HDV). The nurse is aware that this is primarily
transmitted by which route and occurs with which hepatitis virus infection?
NSG 3850 EXAM 4 2026/2027 | PATHOPHYSIOLOGY
FOR NURSES II | 40 VERIFIED Q&A | DETAILED
RATIONALES | PASS GUARANTEED – A+ GRADED
SECTION 1: HEPATIC & BILIARY DISORDERS – Questions 1-15
Q1: Ascites Etiology in Liver Disease
The nurse is caring for a client who developed ascites as a complication of advanced liver disease.
The nurse recognizes which of the following as the etiological risk factors behind the complication?
A. Plasma hyperalbuminemia
B. Portal hypertension
C. Impaired absorption of fat-soluble vitamins
D. Accumulation of ammonia in the peritoneal cavity
Correct Answer: B
Rationale: Ascites in advanced liver disease results from a combination of portal hypertension
(increased hydrostatic pressure) and decreased plasma oncotic pressure due to hypoalbuminemia.
Portal hypertension is the primary etiological risk factor driving fluid into the peritoneal cavity.
Option A is incorrect because albumin is decreased (hypoalbuminemia), not increased. Option C
relates to vitamin absorption, not ascites. Option D describes hepatic encephalopathy, not ascites .
Q2: Acute Cholecystitis Contributing Factor
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
B. Lecithin production by the gallbladder causes solidification of cholesterol
C. Vascular insufficiency causes ischemic injury and hardened cystic ducts
D. Cystic duct obstruction causes pathological processes within the gallbladder
Correct Answer: D
Rationale: Acute cholecystitis most commonly occurs when a gallstone obstructs the cystic duct,
preventing bile from leaving the gallbladder. This causes bile stasis, inflammation, increased
intraluminal pressure, and eventual infection. While ischemia and infection can develop later, cystic
duct obstruction is the primary contributing factor .
Q3: Chronic Cholelithiasis Expected Report
The nurse is caring for a client who has chronic cholelithiasis. Which of the following should the
nurse expect the client to report?
, 2
A. Abdominal pain upon waking up
B. Left upper quadrant abdominal pain
C. Persistent epigastric pain
D. Right upper quadrant pain radiating to the right shoulder
Correct Answer: C
Rationale: Chronic cholelithiasis often presents with persistent epigastric pain, which may be dull
and aching. This pain can be intermittent and is often associated with meals, particularly fatty foods.
Right upper quadrant pain radiating to the right shoulder is more characteristic of acute
cholecystitis, not chronic cholelithiasis .
Q4: Hepatitis A Transmission
The nurse is discussing the pathogenesis of hepatitis 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."
Correct Answer: B
Rationale: Hepatitis A is transmitted via the fecal-oral route, and lack of safe water and poor
sanitation are major risk factors. Hepatitis A is an acute, self-limiting illness that does not cause
chronic infection, and infection confers lifelong immunity .
Q5: Hepatitis C Positive Antibody Interpretation
The nurse is caring for a client who has hepatitis 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.
Correct Answer: A
Rationale: A positive anti-HCV test indicates the presence of antibodies to the hepatitis C virus. It
does not distinguish between acute, chronic, or resolved infection. A positive antibody test means
the client has been exposed to the virus .
Q6: Hepatitis D Transmission
The nurse is caring for a client who has hepatitis D (HDV). The nurse is aware that this is primarily
transmitted by which route and occurs with which hepatitis virus infection?
