1|Page
NSG 5003 ADVANCED PATHOPHYSIOLOGY
PRACTICE EXAM 2025: 153 HIGH-YIELD
QUESTIONS WITH DETAILED RATIONALES |
COMPLETE REVIEW FOR GRADUATE NURSING
| GRADED A+ | FIRST-TRY PASS GUARANTEE
# Table of Contents
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cellular Biology & Adaptation | 1–15 |
| 2 | Genetics & Genomics | 16–25 |
| 3 | Inflammation & Wound Healing | 26–35 |
| 4 | Immunity & Immune Disorders | 36–45 |
| 5 | Fluid, Electrolyte, & Acid-Base Balance | 46–55 |
| 6 | Cardiovascular Pathophysiology | 56–70 |
| 7 | Pulmonary Pathophysiology | 71–85 |
| 8 | Renal & Urinary Pathophysiology | 86–95 |
| 9 | Endocrine Pathophysiology | 96–110 |
| 10 | Neurological Pathophysiology | 111–125 |
| 11 | Gastrointestinal Pathophysiology | 126–135 |
| 12 | Musculoskeletal & Integumentary | 136–145 |
| 13 | Multisystem & Advanced Topics | 146–153 |
,2|Page
# Section 1: Cellular Biology & Adaptation (Questions 1–15)
**Question 1**
A 55-year-old man with chronic alcoholism develops hepatomegaly.
Liver biopsy shows enlarged hepatocytes with cytoplasmic fat droplets
and increased smooth endoplasmic reticulum. This represents which
type of cellular adaptation?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
**Rationale 1:**
**Correct answer: C** – Hypertrophy is increased cell size due to
increased workload or stimulation. Chronic alcohol induces CYP2E1
(SER) and lipid accumulation → hepatocyte hypertrophy. Hyperplasia =
increased cell number. Metaplasia = one cell type replaced by another.
Dysplasia = disordered growth.
---
**Question 2**
Which cellular change is **irreversible** and indicates cell death?
A. Fatty change
,3|Page
B. Plasma membrane blebbing
C. Nuclear pyknosis
D. Swelling of endoplasmic reticulum
**Rationale 2:**
**Correct answer: C** – Pyknosis (nuclear shrinkage and darkening) is
irreversible, as are karyorrhexis and karyolysis. Fatty change, blebbing,
and ER swelling are reversible if the insult is removed.
---
**Question 3**
A pathologist notes caseous necrosis in a lung granuloma. Which
organism is most likely?
A. *Streptococcus pneumoniae*
B. *Mycobacterium tuberculosis*
C. *Staphylococcus aureus*
D. *Pseudomonas aeruginosa*
**Rationale 3:**
**Correct answer: B** – Caseous necrosis (cheese-like, friable) is
hallmark of tuberculosis. Other bacteria cause liquefactive or
coagulative necrosis.
, 4|Page
**Question 4**
Ischemia-reperfusion injury is primarily mediated by:
A. Hypoxia-inducible factor (HIF)
B. Reactive oxygen species (ROS)
C. Lactic acidosis
D. Glycogen depletion
**Rationale 4:**
**Correct answer: B** – Reperfusion generates ROS (superoxide,
hydrogen peroxide, hydroxyl radical) from xanthine oxidase and
mitochondria → further cell damage. HIF is adaptive to hypoxia. Lactic
acidosis and glycogen depletion occur during ischemia but not the
primary reperfusion mediator.
---
**Question 5**
Which is an example of **physiologic hyperplasia**?
A. Endometrial hyperplasia due to estrogen
B. Benign prostatic hyperplasia (BPH)
C. Liver regeneration after partial hepatectomy
D. Psoriasis (epidermal hyperplasia)
NSG 5003 ADVANCED PATHOPHYSIOLOGY
PRACTICE EXAM 2025: 153 HIGH-YIELD
QUESTIONS WITH DETAILED RATIONALES |
COMPLETE REVIEW FOR GRADUATE NURSING
| GRADED A+ | FIRST-TRY PASS GUARANTEE
# Table of Contents
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cellular Biology & Adaptation | 1–15 |
| 2 | Genetics & Genomics | 16–25 |
| 3 | Inflammation & Wound Healing | 26–35 |
| 4 | Immunity & Immune Disorders | 36–45 |
| 5 | Fluid, Electrolyte, & Acid-Base Balance | 46–55 |
| 6 | Cardiovascular Pathophysiology | 56–70 |
| 7 | Pulmonary Pathophysiology | 71–85 |
| 8 | Renal & Urinary Pathophysiology | 86–95 |
| 9 | Endocrine Pathophysiology | 96–110 |
| 10 | Neurological Pathophysiology | 111–125 |
| 11 | Gastrointestinal Pathophysiology | 126–135 |
| 12 | Musculoskeletal & Integumentary | 136–145 |
| 13 | Multisystem & Advanced Topics | 146–153 |
,2|Page
# Section 1: Cellular Biology & Adaptation (Questions 1–15)
**Question 1**
A 55-year-old man with chronic alcoholism develops hepatomegaly.
Liver biopsy shows enlarged hepatocytes with cytoplasmic fat droplets
and increased smooth endoplasmic reticulum. This represents which
type of cellular adaptation?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
**Rationale 1:**
**Correct answer: C** – Hypertrophy is increased cell size due to
increased workload or stimulation. Chronic alcohol induces CYP2E1
(SER) and lipid accumulation → hepatocyte hypertrophy. Hyperplasia =
increased cell number. Metaplasia = one cell type replaced by another.
Dysplasia = disordered growth.
---
**Question 2**
Which cellular change is **irreversible** and indicates cell death?
A. Fatty change
,3|Page
B. Plasma membrane blebbing
C. Nuclear pyknosis
D. Swelling of endoplasmic reticulum
**Rationale 2:**
**Correct answer: C** – Pyknosis (nuclear shrinkage and darkening) is
irreversible, as are karyorrhexis and karyolysis. Fatty change, blebbing,
and ER swelling are reversible if the insult is removed.
---
**Question 3**
A pathologist notes caseous necrosis in a lung granuloma. Which
organism is most likely?
A. *Streptococcus pneumoniae*
B. *Mycobacterium tuberculosis*
C. *Staphylococcus aureus*
D. *Pseudomonas aeruginosa*
**Rationale 3:**
**Correct answer: B** – Caseous necrosis (cheese-like, friable) is
hallmark of tuberculosis. Other bacteria cause liquefactive or
coagulative necrosis.
, 4|Page
**Question 4**
Ischemia-reperfusion injury is primarily mediated by:
A. Hypoxia-inducible factor (HIF)
B. Reactive oxygen species (ROS)
C. Lactic acidosis
D. Glycogen depletion
**Rationale 4:**
**Correct answer: B** – Reperfusion generates ROS (superoxide,
hydrogen peroxide, hydroxyl radical) from xanthine oxidase and
mitochondria → further cell damage. HIF is adaptive to hypoxia. Lactic
acidosis and glycogen depletion occur during ischemia but not the
primary reperfusion mediator.
---
**Question 5**
Which is an example of **physiologic hyperplasia**?
A. Endometrial hyperplasia due to estrogen
B. Benign prostatic hyperplasia (BPH)
C. Liver regeneration after partial hepatectomy
D. Psoriasis (epidermal hyperplasia)
