Pathophysiology NCLEX Review
Exam 2026: Most Repeated
Concepts||Questions And Answers
With Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 85
Time Limit: 2 hours (recommended)
Instructions: Choose the best answer. Correct answers are highlighted in bold.
Rationales are provided.
Section 1: Cellular Adaptation & Injury (Questions 1–10)
1. A patient with chronic obstructive pulmonary disease (COPD) has an
increase in the size of right ventricular myocytes. This is an example of which
cellular adaptation?
• A. Hyperplasia
• B. Metaplasia
• C. Hypertrophy – Rationale: Increased workload (pulmonary hypertension)
causes individual cells to enlarge.
• D. Dysplasia
2. A smoker develops replacement of normal ciliated columnar epithelium in
the bronchi with stratified squamous epithelium. This is known as:
• A. Anaplasia
• B. Metaplasia – Rationale: Reversible replacement of one differentiated cell
type with another, often due to chronic irritation.
, • C. Atrophy
• D. Neoplasia
3. Which cellular change is considered a hallmark of irreversible cell injury?
• A. Loss of microvilli
• B. Severe mitochondrial swelling with rupture – Rationale: Irreversible
injury includes membrane rupture, lysosomal enzyme leakage, and nuclear
changes.
• C. Ribosomal detachment
• D. Fatty change
4. A patient's liver biopsy shows small lipid vacuoles within hepatocytes after
alcohol abuse. This finding is most consistent with:
• A. Apoptosis
• B. Steatosis (fatty liver) – Rationale: Impaired fat metabolism leads to
triglyceride accumulation.
• C. Necrosis
• D. Hypertrophy
5. Which type of necrosis is most commonly seen in the lungs of a patient with
tuberculosis?
• A. Coagulative necrosis
• B. Caseous necrosis – Rationale: Cheese-like appearance from combined
coagulative and liquefactive necrosis; TB hallmark.
• C. Liquefactive necrosis
• D. Fat necrosis
6. Following a myocardial infarction (MI), which type of necrosis is observed
in the heart muscle?
• A. Coagulative necrosis – Rationale: Preservation of tissue architecture for
days due to denatured proteins.
• B. Liquefactive necrosis
, • C. Gangrenous necrosis
• D. Caseous necrosis
7. Which change is characteristic of apoptosis, not necrosis?
• A. Cell swelling
• B. Caspase activation and cell shrinkage – Rationale: Programmed cell
death; orderly, no inflammation.
• C. Membrane lysis
• D. Random DNA breakdown
8. A patient with chronic hepatitis C has enlarged, regenerating nodules in the
liver. This is an example of:
• A. Metaplasia
• B. Atrophy
• C. Hyperplasia – Rationale: Increased number of hepatocytes due to
chronic injury and regeneration.
• D. Dystrophic calcification
9. Dystrophic calcification is most likely to occur in:
• A. Normal tissues with hypercalcemia
• B. Damaged or necrotic tissues – Rationale: Calcium deposits in areas of
injury despite normal serum calcium (e.g., atherosclerotic plaques, damaged
heart valves).
• C. Kidneys only
• D. Metastatic tumors
10. A patient with a cancerous tumor shows loss of cellular differentiation and
variation in cell size/shape. This is called:
• A. Hyperplasia
• B. Anaplasia – Rationale: Hallmark of malignancy; cells lack normal
features.
• C. Dysplasia
Exam 2026: Most Repeated
Concepts||Questions And Answers
With Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 85
Time Limit: 2 hours (recommended)
Instructions: Choose the best answer. Correct answers are highlighted in bold.
Rationales are provided.
Section 1: Cellular Adaptation & Injury (Questions 1–10)
1. A patient with chronic obstructive pulmonary disease (COPD) has an
increase in the size of right ventricular myocytes. This is an example of which
cellular adaptation?
• A. Hyperplasia
• B. Metaplasia
• C. Hypertrophy – Rationale: Increased workload (pulmonary hypertension)
causes individual cells to enlarge.
• D. Dysplasia
2. A smoker develops replacement of normal ciliated columnar epithelium in
the bronchi with stratified squamous epithelium. This is known as:
• A. Anaplasia
• B. Metaplasia – Rationale: Reversible replacement of one differentiated cell
type with another, often due to chronic irritation.
, • C. Atrophy
• D. Neoplasia
3. Which cellular change is considered a hallmark of irreversible cell injury?
• A. Loss of microvilli
• B. Severe mitochondrial swelling with rupture – Rationale: Irreversible
injury includes membrane rupture, lysosomal enzyme leakage, and nuclear
changes.
• C. Ribosomal detachment
• D. Fatty change
4. A patient's liver biopsy shows small lipid vacuoles within hepatocytes after
alcohol abuse. This finding is most consistent with:
• A. Apoptosis
• B. Steatosis (fatty liver) – Rationale: Impaired fat metabolism leads to
triglyceride accumulation.
• C. Necrosis
• D. Hypertrophy
5. Which type of necrosis is most commonly seen in the lungs of a patient with
tuberculosis?
• A. Coagulative necrosis
• B. Caseous necrosis – Rationale: Cheese-like appearance from combined
coagulative and liquefactive necrosis; TB hallmark.
• C. Liquefactive necrosis
• D. Fat necrosis
6. Following a myocardial infarction (MI), which type of necrosis is observed
in the heart muscle?
• A. Coagulative necrosis – Rationale: Preservation of tissue architecture for
days due to denatured proteins.
• B. Liquefactive necrosis
, • C. Gangrenous necrosis
• D. Caseous necrosis
7. Which change is characteristic of apoptosis, not necrosis?
• A. Cell swelling
• B. Caspase activation and cell shrinkage – Rationale: Programmed cell
death; orderly, no inflammation.
• C. Membrane lysis
• D. Random DNA breakdown
8. A patient with chronic hepatitis C has enlarged, regenerating nodules in the
liver. This is an example of:
• A. Metaplasia
• B. Atrophy
• C. Hyperplasia – Rationale: Increased number of hepatocytes due to
chronic injury and regeneration.
• D. Dystrophic calcification
9. Dystrophic calcification is most likely to occur in:
• A. Normal tissues with hypercalcemia
• B. Damaged or necrotic tissues – Rationale: Calcium deposits in areas of
injury despite normal serum calcium (e.g., atherosclerotic plaques, damaged
heart valves).
• C. Kidneys only
• D. Metastatic tumors
10. A patient with a cancerous tumor shows loss of cellular differentiation and
variation in cell size/shape. This is called:
• A. Hyperplasia
• B. Anaplasia – Rationale: Hallmark of malignancy; cells lack normal
features.
• C. Dysplasia
