Test your knowledge of hepatitis B with this NCLEX-style quiz designed for nursing students and healthcare learners. These questions cover essential concepts such as transmission routes, lab interpretation (HBsAg, anti-HBs, and anti-HBc), vaccination immunity, pregnancy management, and newborn prophylaxis.
Understanding hepatitis B is critical for safe patient care, infection control, and preventing vertical transmission from mother to infant. Take this quiz to strengthen your clinical reasoning and build confidence in interpreting hepatitis B serology and applying evidence-based nursing interventions.
Hepatitis B NCLEX GI Review Questions
Hepatitis B GI NCLEX Practice Review Quiz
- Which of the following is NOT a typical transmission route of the hepatitis B virus?
A. Sexual intercourse
B. Sharing needles
C. Unclean medical equipment
D. Kissing
The answer is D: Kissing. Hepatitis B is transmitted through sexual contact, blood exposure, and contaminated needles or equipment…not through casual contact like kissing.
- A patient with a severe case of hepatitis B is experiencing pale-colored stools. The nurse knows this is due to:
A. Buildup of bile in the liver
B. Loss of clotting factors
C. Development of a gastrointestinal ileus
D. Liver’s inability to manage bilirubin
The answer is D: Liver’s inability to manage bilirubin. When the liver is damaged, it cannot properly process and excrete bilirubin into bile, leading to pale stools.
- At what location would the nurse expect to note abdominal tenderness in a patient with severe hepatitis B?
A. Left lower quadrant
B. Right upper quadrant
C. Left upper quadrant
D. Right lower quadrant
The answer is B: Right upper quadrant. The liver is located in the RUQ, so hepatitis causes tenderness in that area.
- A pregnant patient who is 10 weeks’ gestation arrives for their first prenatal appointment. What test will be ordered to assess if the patient is currently infected with the hepatitis B virus?
A. HBsAg
B. Anti-HBs
C. Total anti-HBc
D. Bilirubin
The answer is A: HBsAg. This indicates an active hepatitis B infection. Anti-HBs indicates immunity, anti-HBc indicates past or current exposure, and bilirubin reflects liver function, not infection status.
- A 26-year-old patient has never been tested for hepatitis B. A triple panel is recommended. The nurse knows this panel includes which tests? (Select all that apply)
A. AST/ALT
B. Bilirubin
C. Anti-HBs
D. HBsAg
E. Total anti-HBc
The answer is C, D, and E. The panel includes anti-HBs (immunity), HBsAg (current infection), and total anti-HBc (past or current exposure).
- A patient who has never been infected with hepatitis B has been vaccinated. Which blood test would confirm immunity to the virus?
A. HBsAg
B. Anti-HBc
C. AST/ALT
D. Anti-HBs
The answer is D: Anti-HBs. This confirms immunity from vaccination. HBsAg and anti-HBc should be negative because there was no infection.
- A patient receives a test result that is negative for total anti-HBc. How does the nurse interpret this result?
A. The patient has had a past infection of hepatitis B.
B. The patient is not immune to hepatitis B.
C. The patient is currently infected with hepatitis B virus.
D. The patient has never been infected with the hepatitis B virus.
The answer is D: The patient has never been infected with hepatitis B virus. A negative total anti-HBc means no past or current exposure.
- A pregnant patient is hepatitis B positive and has a high viral load. When is the typical time antivirals are started to decrease the risk of transmission?
A. 6–12 weeks’ gestation
B. 12–24 weeks’ gestation
C. 28–32 weeks’ gestation
D. Immediately after delivery
The answer is C: 28–32 weeks’ gestation. Tenofovir is started in the third trimester when viral load is high to decrease the risk of passing the virus to the newborn.
- What newborn preventative measures are taken to prevent transmission of hepatitis B to a baby born to a mother who tests positive? (Select all that apply)
A. Administer hepatitis B vaccine within ~12 hours of birth
B. Hold hepatitis B vaccine until 2 months of age
C. Administer hepatitis B immunoglobulin within ~12 hours of birth
D. Test newborn for hepatitis B within ~12 hours of birth
The answer is A and C. The newborn should receive hepatitis B vaccine and HBIG within 12 hours of birth for protection.
- Fill in the blank: The childhood vaccine schedule recommends ______ doses of the hepatitis B vaccine given at ______.
A. 3 doses; birth, 2 months, and 6–18 months
B. 2 doses; 2 months and 6–18 months
C. 3 doses; birth, 2 months, and 24 months
D. 2 doses; birth and 2 months
The answer is A: 3 doses; birth, 2 months, and 6–18 months. This schedule ensures early protection and long-term immunity. Note: In 2025, the CDC updated these guidelines so that infants born to hepatitis B–negative mothers may have the first vaccine dose delayed until 2 months of age.
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