1|Page
NR507 WEEK 8 FINAL EXAM 2026: ADVANCED
PATHOPHYSIOLOGY – 300 NCLEX-STYLE
QUESTIONS & ANSWERS WITH RATIONALES
(GRADED A+)
## Table of Contents
| Section | Topic Area | Question Numbers |
|---------|------------|------------------|
| 1 | Cellular & Molecular Basis of Disease | 1–30 |
| 2 | Inflammation & Immunity | 31–60 |
| 3 | Hematologic Disorders | 61–80 |
| 4 | Cardiovascular Disorders | 81–110 |
| 5 | Respiratory Disorders | 111–135 |
| 6 | Renal & Urinary Disorders | 136–160 |
| 7 | Gastrointestinal & Hepatobiliary Disorders | 161–185 |
| 8 | Endocrine & Metabolic Disorders | 186–210 |
| 9 | Neurologic Disorders | 211–235 |
| 10 | Musculoskeletal & Integumentary Disorders | 236–255 |
| 11 | Reproductive & Genetic Disorders | 256–275 |
| 12 | Multisystem & Critical Care Integration | 276–300 |
,2|Page
## Section 1: Cellular & Molecular Basis of Disease (Questions 1–30)
**1.** A 45-year-old with chronic hepatitis B develops liver cell
enlargement due to increased protein synthesis. This is an example of:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
**Answer:** B) Hypertrophy
**Rationale:** Hypertrophy is increased cell size without increased
number, often due to increased workload or hormonal stimulation.
Hyperplasia (A) is increased cell number. Metaplasia (C) is reversible
change of one cell type to another. Dysplasia (D) is disordered growth.
**2.** Reperfusion injury following myocardial infarction is primarily
mediated by:
A) Hypoxia-inducible factor
B) Reactive oxygen species
C) Lactic acidosis
D) Apoptosis
**Answer:** B) Reactive oxygen species
,3|Page
**Rationale:** ROS (superoxide, hydrogen peroxide, hydroxyl radical)
cause oxidative damage to membranes, DNA, and proteins upon
reperfusion. HIF (A) responds to hypoxia. Lactic acidosis (C) occurs
during ischemia. Apoptosis (D) is programmed cell death.
**3.** Caseous necrosis is pathognomonic for:
A) Ischemic bowel
B) Tuberculosis
C) Acute pancreatitis
D) Syphilis
**Answer:** B) Tuberculosis
**Rationale:** Caseous necrosis (soft, cheese-like, friable) is
characteristic of TB. Ischemic bowel → coagulative necrosis (A).
Pancreatitis → fat necrosis (C). Syphilis → gummatous necrosis (D).
**4.** A 60-year-old smoker has lung cells changing from columnar to
squamous. This is:
A) Anaplasia
B) Dysplasia
C) Metaplasia
D) Neoplasia
**Answer:** C) Metaplasia
, 4|Page
**Rationale:** Metaplasia is reversible replacement of one
differentiated cell type with another (columnar → squamous in response
to irritation). Anaplasia (A) = loss of differentiation in cancer. Dysplasia
(B) = disordered growth. Neoplasia (D) = new abnormal growth.
**5.** Which type of necrosis preserves tissue architecture for several
days?
A) Liquefactive
B) Coagulative
C) Fat
D) Fibrinoid
**Answer:** B) Coagulative
**Rationale:** Coagulative necrosis (ischemic injury, except brain)
maintains tissue outline due to protein denaturation. Liquefactive (A) =
brain, abscess. Fat (C) = pancreas. Fibrinoid (D) = blood vessels in
vasculitis.
**6.** A TP53 mutation that eliminates apoptosis allows damaged cells
to survive. This gene is a:
A) Proto-oncogene
B) Tumor suppressor gene
C) Oncogene
D) DNA repair gene
NR507 WEEK 8 FINAL EXAM 2026: ADVANCED
PATHOPHYSIOLOGY – 300 NCLEX-STYLE
QUESTIONS & ANSWERS WITH RATIONALES
(GRADED A+)
## Table of Contents
| Section | Topic Area | Question Numbers |
|---------|------------|------------------|
| 1 | Cellular & Molecular Basis of Disease | 1–30 |
| 2 | Inflammation & Immunity | 31–60 |
| 3 | Hematologic Disorders | 61–80 |
| 4 | Cardiovascular Disorders | 81–110 |
| 5 | Respiratory Disorders | 111–135 |
| 6 | Renal & Urinary Disorders | 136–160 |
| 7 | Gastrointestinal & Hepatobiliary Disorders | 161–185 |
| 8 | Endocrine & Metabolic Disorders | 186–210 |
| 9 | Neurologic Disorders | 211–235 |
| 10 | Musculoskeletal & Integumentary Disorders | 236–255 |
| 11 | Reproductive & Genetic Disorders | 256–275 |
| 12 | Multisystem & Critical Care Integration | 276–300 |
,2|Page
## Section 1: Cellular & Molecular Basis of Disease (Questions 1–30)
**1.** A 45-year-old with chronic hepatitis B develops liver cell
enlargement due to increased protein synthesis. This is an example of:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
**Answer:** B) Hypertrophy
**Rationale:** Hypertrophy is increased cell size without increased
number, often due to increased workload or hormonal stimulation.
Hyperplasia (A) is increased cell number. Metaplasia (C) is reversible
change of one cell type to another. Dysplasia (D) is disordered growth.
**2.** Reperfusion injury following myocardial infarction is primarily
mediated by:
A) Hypoxia-inducible factor
B) Reactive oxygen species
C) Lactic acidosis
D) Apoptosis
**Answer:** B) Reactive oxygen species
,3|Page
**Rationale:** ROS (superoxide, hydrogen peroxide, hydroxyl radical)
cause oxidative damage to membranes, DNA, and proteins upon
reperfusion. HIF (A) responds to hypoxia. Lactic acidosis (C) occurs
during ischemia. Apoptosis (D) is programmed cell death.
**3.** Caseous necrosis is pathognomonic for:
A) Ischemic bowel
B) Tuberculosis
C) Acute pancreatitis
D) Syphilis
**Answer:** B) Tuberculosis
**Rationale:** Caseous necrosis (soft, cheese-like, friable) is
characteristic of TB. Ischemic bowel → coagulative necrosis (A).
Pancreatitis → fat necrosis (C). Syphilis → gummatous necrosis (D).
**4.** A 60-year-old smoker has lung cells changing from columnar to
squamous. This is:
A) Anaplasia
B) Dysplasia
C) Metaplasia
D) Neoplasia
**Answer:** C) Metaplasia
, 4|Page
**Rationale:** Metaplasia is reversible replacement of one
differentiated cell type with another (columnar → squamous in response
to irritation). Anaplasia (A) = loss of differentiation in cancer. Dysplasia
(B) = disordered growth. Neoplasia (D) = new abnormal growth.
**5.** Which type of necrosis preserves tissue architecture for several
days?
A) Liquefactive
B) Coagulative
C) Fat
D) Fibrinoid
**Answer:** B) Coagulative
**Rationale:** Coagulative necrosis (ischemic injury, except brain)
maintains tissue outline due to protein denaturation. Liquefactive (A) =
brain, abscess. Fat (C) = pancreas. Fibrinoid (D) = blood vessels in
vasculitis.
**6.** A TP53 mutation that eliminates apoptosis allows damaged cells
to survive. This gene is a:
A) Proto-oncogene
B) Tumor suppressor gene
C) Oncogene
D) DNA repair gene
