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NSG 3850 EXAM 4 (ACTUAL EXAM 2026) — ALL
QUESTIONS AND CORRECT ANSWERS | VERIFIED
ANSWERS | GALEN COLLEGE OF NURSING 100 Practice
Questions with Detailed Answers and Rationales
SECTION 1: GALLBLADDER DISORDERS (Questions 1-10)
1. A nurse is teaching a patient about the pathophysiology of
cholelithiasis. Which statement indicates the patient understands
the condition?
A) "Gallstones form because my liver produces too much bile."
B) "Gallstones form when cholesterol in my bile precipitates and
crystals grow."
C) "Gallstones are caused by an infection in my gallbladder."
D) "Gallstones only form in people who eat a high-fat diet."
Answer: B
Rationale: Cholelithiasis develops through three phases: (1)
supersaturation of bile with cholesterol causing precipitation of
cholesterol, (2) nucleation of crystals, and (3) hypermobility (stasis
of bile) allowing stone growth. Cholesterol crystals may initiate
gallstone formation. Risk factors include prolonged fasting, rapid
weight loss, oral contraceptives, diabetes, spinal cord injury, TPN,
pregnancy, obesity, and high cholesterol.
,2
2. Which of the following patients is at highest risk for developing
cholelithiasis?
A) A 25-year-old male who exercises regularly
B) A 45-year-old female who is pregnant and has diabetes
C) A 30-year-old male with a spinal cord injury who is on TPN
D) Both B and C are at high risk
Answer: D
Rationale: Risk factors for cholelithiasis include pregnancy
(hormonal changes), diabetes, spinal cord injury (decreased
gallbladder motility), TPN, prolonged fasting, rapid weight loss,
oral contraceptives, and obesity. Both patients B and C have
multiple risk factors.
3. A patient with acute cholecystitis asks the nurse what causes
the inflammation. The best response is:**
A) "It is caused by a viral infection."
B) "It is caused by the continued presence of gallstones causing
inflammation of the gallbladder wall."
C) "It is an autoimmune response."
D) "It is caused by excessive alcohol consumption."
Answer: B
Rationale: Cholecystitis is inflammation of the gallbladder wall
related to the continued presence of gallstones. If untreated, it can
escalate; gangrene may occur, and the gallbladder can rupture
causing peritonitis. Predisposing factors for chronic cholecystitis
include diabetes and obesity.
,3
4. A patient with chronic cholecystitis is at increased risk for which
complication?
A) Liver cirrhosis
B) Biliary sepsis and porcelain gallbladder
C) Pancreatic cancer
D) Kidney stones
Answer: B
Rationale: Chronic cholecystitis can lead to complications like
biliary sepsis and scarring/calcified (porcelain gallbladder), which
causes a higher risk for cancer. Diagnostics typically include CT,
US, or MRI, but can use HIDA, MRCA, or ERCP.
5. A patient presents with jaundice, decreased clotting factors, and
hypoalbuminemia. The nurse recognizes these as signs of:
A) Cholelithiasis
B) Liver disease
C) Pancreatitis
D) Kidney failure
Answer: B
Rationale: Liver disease manifestations include jaundice (from
impaired bilirubin metabolism), decreased clotting factors,
hypoalbuminemia (from ascites/edema related to low serum
oncotic pressure), portal HTN, muscle wasting, ascites, impaired
absorption of vitamins A, D, E, K, and hypertriglyceridemia. Liver
disease can also disrupt lipoprotein metabolism causing
dyslipidemias.
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6. A patient with gallstones is scheduled for a HIDA scan. The
nurse should explain that this test:
A) Uses sound waves to visualize the gallbladder
B) Uses a radioactive tracer to assess gallbladder function
C) Uses magnetic fields to create images
D) Directly visualizes the bile ducts through endoscopy
Answer: B
Rationale:HIDA (hepatobiliary iminodiacetic acid) scan uses a
radioactive tracer to assess gallbladder function and bile duct
patency. Other diagnostics include CT, ultrasound, MRI, MRCA,
and ERCP.
7. Which of the following is NOT a risk factor for cholelithiasis?
A) Prolonged fasting
B) Rapid weight loss
C) Regular exercise
D) Oral contraceptive use
Answer: C
Rationale: Regular exercise is not a risk factor for cholelithiasis.
Risk factors include prolonged fasting, rapid weight loss, oral
contraceptives, diabetes, spinal cord injury, TPN, pregnancy,
obesity, and high cholesterol.
NSG 3850 EXAM 4 (ACTUAL EXAM 2026) — ALL
QUESTIONS AND CORRECT ANSWERS | VERIFIED
ANSWERS | GALEN COLLEGE OF NURSING 100 Practice
Questions with Detailed Answers and Rationales
SECTION 1: GALLBLADDER DISORDERS (Questions 1-10)
1. A nurse is teaching a patient about the pathophysiology of
cholelithiasis. Which statement indicates the patient understands
the condition?
A) "Gallstones form because my liver produces too much bile."
B) "Gallstones form when cholesterol in my bile precipitates and
crystals grow."
C) "Gallstones are caused by an infection in my gallbladder."
D) "Gallstones only form in people who eat a high-fat diet."
Answer: B
Rationale: Cholelithiasis develops through three phases: (1)
supersaturation of bile with cholesterol causing precipitation of
cholesterol, (2) nucleation of crystals, and (3) hypermobility (stasis
of bile) allowing stone growth. Cholesterol crystals may initiate
gallstone formation. Risk factors include prolonged fasting, rapid
weight loss, oral contraceptives, diabetes, spinal cord injury, TPN,
pregnancy, obesity, and high cholesterol.
,2
2. Which of the following patients is at highest risk for developing
cholelithiasis?
A) A 25-year-old male who exercises regularly
B) A 45-year-old female who is pregnant and has diabetes
C) A 30-year-old male with a spinal cord injury who is on TPN
D) Both B and C are at high risk
Answer: D
Rationale: Risk factors for cholelithiasis include pregnancy
(hormonal changes), diabetes, spinal cord injury (decreased
gallbladder motility), TPN, prolonged fasting, rapid weight loss,
oral contraceptives, and obesity. Both patients B and C have
multiple risk factors.
3. A patient with acute cholecystitis asks the nurse what causes
the inflammation. The best response is:**
A) "It is caused by a viral infection."
B) "It is caused by the continued presence of gallstones causing
inflammation of the gallbladder wall."
C) "It is an autoimmune response."
D) "It is caused by excessive alcohol consumption."
Answer: B
Rationale: Cholecystitis is inflammation of the gallbladder wall
related to the continued presence of gallstones. If untreated, it can
escalate; gangrene may occur, and the gallbladder can rupture
causing peritonitis. Predisposing factors for chronic cholecystitis
include diabetes and obesity.
,3
4. A patient with chronic cholecystitis is at increased risk for which
complication?
A) Liver cirrhosis
B) Biliary sepsis and porcelain gallbladder
C) Pancreatic cancer
D) Kidney stones
Answer: B
Rationale: Chronic cholecystitis can lead to complications like
biliary sepsis and scarring/calcified (porcelain gallbladder), which
causes a higher risk for cancer. Diagnostics typically include CT,
US, or MRI, but can use HIDA, MRCA, or ERCP.
5. A patient presents with jaundice, decreased clotting factors, and
hypoalbuminemia. The nurse recognizes these as signs of:
A) Cholelithiasis
B) Liver disease
C) Pancreatitis
D) Kidney failure
Answer: B
Rationale: Liver disease manifestations include jaundice (from
impaired bilirubin metabolism), decreased clotting factors,
hypoalbuminemia (from ascites/edema related to low serum
oncotic pressure), portal HTN, muscle wasting, ascites, impaired
absorption of vitamins A, D, E, K, and hypertriglyceridemia. Liver
disease can also disrupt lipoprotein metabolism causing
dyslipidemias.
, 4
6. A patient with gallstones is scheduled for a HIDA scan. The
nurse should explain that this test:
A) Uses sound waves to visualize the gallbladder
B) Uses a radioactive tracer to assess gallbladder function
C) Uses magnetic fields to create images
D) Directly visualizes the bile ducts through endoscopy
Answer: B
Rationale:HIDA (hepatobiliary iminodiacetic acid) scan uses a
radioactive tracer to assess gallbladder function and bile duct
patency. Other diagnostics include CT, ultrasound, MRI, MRCA,
and ERCP.
7. Which of the following is NOT a risk factor for cholelithiasis?
A) Prolonged fasting
B) Rapid weight loss
C) Regular exercise
D) Oral contraceptive use
Answer: C
Rationale: Regular exercise is not a risk factor for cholelithiasis.
Risk factors include prolonged fasting, rapid weight loss, oral
contraceptives, diabetes, spinal cord injury, TPN, pregnancy,
obesity, and high cholesterol.
