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PATHOPHARMACOLOGICAL FOUNDATIONS
FOR ADVANCED NURSING PRACTICE FINAL
EXAM – 2026–2027 EDITION ADVANCED
PATHOPHYSIOLOGY &
PHARMACOTHERAPEUTICS | CLINICAL
APPLICATION | PRESCRIPTIVE READINESS
TABLE OF CONTENTS
| Section | Topic | Questions |
| 1 | Cellular & Molecular Pathophysiology | 25 |
| 2 | Cardiovascular Pathopharmacology | 25 |
| 3 | Respiratory Pathopharmacology | 20 |
| 4 | Neurologic & Psychiatric Pathopharmacology | 25 |
| 5 | Endocrine & Metabolic Pathopharmacology | 25 |
| 6 | Renal & Fluid/Electrolyte Pathopharmacology | 20 |
| 7 | Gastrointestinal & Hepatic Pathopharmacology | 20 |
| 8 | Immunologic & Infectious Disease Pathopharmacology | 20 |
| 9 | Hematologic & Oncologic Pathopharmacology | 20 |
| 10 | Advanced NGN Case Studies (6 cases × 5 items each) | 30 |
| **TOTAL** | | **200** |
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SECTION 1 – CELLULAR & MOLECULAR PATHOPHYSIOLOGY
(25 Questions)
**High-Yield Topics:** Apoptosis vs necrosis, Cellular adaptation,
Oxidative stress, Inflammation mediators, Genetic mutations,
Epigenetics.
**1. A patient with chronic hypoxia secondary to COPD has increased
red blood cell mass. This is an example of which cellular adaptation?**
- A) Hyperplasia
- B) Hypertrophy
- C) Metaplasia
- D) Hyperplasia of erythroid precursors
** Correct Answer: D**
**Rationale:** Chronic hypoxia → increased erythropoietin →
hyperplasia of erythroid lineage in bone marrow. Hyperplasia =
increased cell number.
---
**2. Which cellular change is reversible?**
- A) Coagulative necrosis
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- B) Liquefactive necrosis
- C) Fatty change (steatosis)
- D) Caseous necrosis
** Correct Answer: C**
**Rationale:** Fatty change (lipid accumulation) is reversible if the
injurious stimulus is removed. Necrosis is irreversible.
---
**3. A researcher studying atherosclerosis finds that oxidized LDL
uptake by macrophages leads to foam cell formation. This process is
primarily mediated by:**
- A) LDL receptors
- B) Scavenger receptors (CD36, SR-A)
- C) ABC transporters
- D) VLDL receptors
** Correct Answer: B**
**Rationale:** Scavenger receptors (unregulated) allow massive
cholesterol uptake → foam cells. LDL receptors are downregulated by
intracellular cholesterol.
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---
**4. Which cytokine is primarily responsible for fever induction?**
- A) IL-10
- B) TNF-α
- C) IL-1β
- D) TGF-β
** Correct Answer: C**
**Rationale:** IL-1β, IL-6, and TNF-α are endogenous pyrogens. IL-1β
acts on hypothalamic prostaglandin E2 → increased thermoset point.
---
**5. A patient with a BRCA1 mutation has increased risk for breast and
ovarian cancer. The BRCA1 gene product functions in:**
- A) Cell cycle promotion
- B) DNA repair (homologous recombination)
- C) Apoptosis inhibition
- D) Angiogenesis
** Correct Answer: B**
PATHOPHARMACOLOGICAL FOUNDATIONS
FOR ADVANCED NURSING PRACTICE FINAL
EXAM – 2026–2027 EDITION ADVANCED
PATHOPHYSIOLOGY &
PHARMACOTHERAPEUTICS | CLINICAL
APPLICATION | PRESCRIPTIVE READINESS
TABLE OF CONTENTS
| Section | Topic | Questions |
| 1 | Cellular & Molecular Pathophysiology | 25 |
| 2 | Cardiovascular Pathopharmacology | 25 |
| 3 | Respiratory Pathopharmacology | 20 |
| 4 | Neurologic & Psychiatric Pathopharmacology | 25 |
| 5 | Endocrine & Metabolic Pathopharmacology | 25 |
| 6 | Renal & Fluid/Electrolyte Pathopharmacology | 20 |
| 7 | Gastrointestinal & Hepatic Pathopharmacology | 20 |
| 8 | Immunologic & Infectious Disease Pathopharmacology | 20 |
| 9 | Hematologic & Oncologic Pathopharmacology | 20 |
| 10 | Advanced NGN Case Studies (6 cases × 5 items each) | 30 |
| **TOTAL** | | **200** |
,2|Page
SECTION 1 – CELLULAR & MOLECULAR PATHOPHYSIOLOGY
(25 Questions)
**High-Yield Topics:** Apoptosis vs necrosis, Cellular adaptation,
Oxidative stress, Inflammation mediators, Genetic mutations,
Epigenetics.
**1. A patient with chronic hypoxia secondary to COPD has increased
red blood cell mass. This is an example of which cellular adaptation?**
- A) Hyperplasia
- B) Hypertrophy
- C) Metaplasia
- D) Hyperplasia of erythroid precursors
** Correct Answer: D**
**Rationale:** Chronic hypoxia → increased erythropoietin →
hyperplasia of erythroid lineage in bone marrow. Hyperplasia =
increased cell number.
---
**2. Which cellular change is reversible?**
- A) Coagulative necrosis
,3|Page
- B) Liquefactive necrosis
- C) Fatty change (steatosis)
- D) Caseous necrosis
** Correct Answer: C**
**Rationale:** Fatty change (lipid accumulation) is reversible if the
injurious stimulus is removed. Necrosis is irreversible.
---
**3. A researcher studying atherosclerosis finds that oxidized LDL
uptake by macrophages leads to foam cell formation. This process is
primarily mediated by:**
- A) LDL receptors
- B) Scavenger receptors (CD36, SR-A)
- C) ABC transporters
- D) VLDL receptors
** Correct Answer: B**
**Rationale:** Scavenger receptors (unregulated) allow massive
cholesterol uptake → foam cells. LDL receptors are downregulated by
intracellular cholesterol.
, 4|Page
---
**4. Which cytokine is primarily responsible for fever induction?**
- A) IL-10
- B) TNF-α
- C) IL-1β
- D) TGF-β
** Correct Answer: C**
**Rationale:** IL-1β, IL-6, and TNF-α are endogenous pyrogens. IL-1β
acts on hypothalamic prostaglandin E2 → increased thermoset point.
---
**5. A patient with a BRCA1 mutation has increased risk for breast and
ovarian cancer. The BRCA1 gene product functions in:**
- A) Cell cycle promotion
- B) DNA repair (homologous recombination)
- C) Apoptosis inhibition
- D) Angiogenesis
** Correct Answer: B**
