NSG 3850 EXAM 4 | ACTUAL QUESTIONS
AND ANSWERS LATEST UPDATED 2026/2027
(GRADED A+)- GALEN COLLEGE OF
NURSING
AT GALEN COLLEGE OF NURSING
NSG 3850 Exam 2026/2027
Pathophysiology for Nurses II– Multiple Choice with
Rationales
NSG 3850 Exam 4 – Version A
1. The nurse is caring for a client who has developed ascites as a
complication of advanced liver disease. Which of the following is the
primary etiological risk factor behind this complication?
a. Portal hypertension
b. Plasma hypoalbuminemia
c. An impaired absorption of fat-soluble vitamins
d. An accumulation of ammonia in the peritoneal cavity
Answer: b. Plasma hypoalbuminemia
Rationale: Low plasma albumin reduces oncotic pressure, allowing fluid to
accumulate in the peritoneal cavity. While portal hypertension contributes,
hypoalbuminemia directly causes fluid retention. This is the most common
mechanism of ascites in liver disease.
2. The nurse is caring for a client who has acute cholecystitis. Which
factor contributes most to the pathological process of this
, condition?
a. Enzymatic activation causing autoimmune gallbladder stones
b. Lecithin production causing cholesterol solidification
c. Vascular insufficiency causing ischemic injury
d. Cystic duct obstruction
Answer: d. Cystic duct obstruction
Rationale: Obstruction of the cystic duct, usually by gallstones, leads to bile
accumulation, inflammation, and infection in the gallbladder. This is the
primary mechanism of acute cholecystitis. Other factors like ischemia or
infection may follow but are secondary.
3. The nurse is caring for a client who has chronic cholelithiasis.
Which symptom should the nurse expect the client to report?
a. Persistent epigastric pain
b. Functional dyspepsia
c. Gray-blue color at the flank
d. Left upper quadrant pain radiating to the back
Answer: a. Persistent epigastric pain
Rationale: Chronic gallstones commonly cause recurrent or persistent right
upper quadrant or epigastric pain. Pain may radiate to the back but is usually
mild and recurrent. Severe acute symptoms indicate complications like
cholecystitis or pancreatitis.
4. The nurse is discussing the pathogenesis of hepatitis A virus
(HAV) with a client. Which statement is correct?
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.”
Answer: b. “Lack of safe water and poor sanitation are big risk factors.”
Rationale: HAV is transmitted via the fecal-oral route. Contaminated water
and poor sanitation are major risk factors. Most HAV infections are acute,
self-limiting, and provide lifelong immunity after recovery.
5. The nurse is caring for a client with hepatitis C virus (HCV) and a
positive anti-HCV laboratory value. What does this indicate?
a. There are antibodies to the virus present
AND ANSWERS LATEST UPDATED 2026/2027
(GRADED A+)- GALEN COLLEGE OF
NURSING
AT GALEN COLLEGE OF NURSING
NSG 3850 Exam 2026/2027
Pathophysiology for Nurses II– Multiple Choice with
Rationales
NSG 3850 Exam 4 – Version A
1. The nurse is caring for a client who has developed ascites as a
complication of advanced liver disease. Which of the following is the
primary etiological risk factor behind this complication?
a. Portal hypertension
b. Plasma hypoalbuminemia
c. An impaired absorption of fat-soluble vitamins
d. An accumulation of ammonia in the peritoneal cavity
Answer: b. Plasma hypoalbuminemia
Rationale: Low plasma albumin reduces oncotic pressure, allowing fluid to
accumulate in the peritoneal cavity. While portal hypertension contributes,
hypoalbuminemia directly causes fluid retention. This is the most common
mechanism of ascites in liver disease.
2. The nurse is caring for a client who has acute cholecystitis. Which
factor contributes most to the pathological process of this
, condition?
a. Enzymatic activation causing autoimmune gallbladder stones
b. Lecithin production causing cholesterol solidification
c. Vascular insufficiency causing ischemic injury
d. Cystic duct obstruction
Answer: d. Cystic duct obstruction
Rationale: Obstruction of the cystic duct, usually by gallstones, leads to bile
accumulation, inflammation, and infection in the gallbladder. This is the
primary mechanism of acute cholecystitis. Other factors like ischemia or
infection may follow but are secondary.
3. The nurse is caring for a client who has chronic cholelithiasis.
Which symptom should the nurse expect the client to report?
a. Persistent epigastric pain
b. Functional dyspepsia
c. Gray-blue color at the flank
d. Left upper quadrant pain radiating to the back
Answer: a. Persistent epigastric pain
Rationale: Chronic gallstones commonly cause recurrent or persistent right
upper quadrant or epigastric pain. Pain may radiate to the back but is usually
mild and recurrent. Severe acute symptoms indicate complications like
cholecystitis or pancreatitis.
4. The nurse is discussing the pathogenesis of hepatitis A virus
(HAV) with a client. Which statement is correct?
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.”
Answer: b. “Lack of safe water and poor sanitation are big risk factors.”
Rationale: HAV is transmitted via the fecal-oral route. Contaminated water
and poor sanitation are major risk factors. Most HAV infections are acute,
self-limiting, and provide lifelong immunity after recovery.
5. The nurse is caring for a client with hepatitis C virus (HCV) and a
positive anti-HCV laboratory value. What does this indicate?
a. There are antibodies to the virus present
