Nursing Pathophysiology
Comprehensive Exam: 2026
Edition||Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 85
Target Audience: Pre-licensure Nursing Students (BSN/ADN)
Topics: Cellular Adaptation, Inflammation, Genetics, Fluid/Electrolytes, & Major
Organ Systems
Part I: Cellular Adaptation, Injury, & Neoplasia (Questions 1-15)
1. A patient with chronic hepatitis C develops liver cirrhosis. The hepatocytes
have converted into cells that resemble intestinal epithelium. This process is
known as:
• A. Hyperplasia
• B. Dysplasia
• C. Metaplasia
• D. Anaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another (e.g., columnar to squamous or vice versa). Here, liver cells change to
intestinal-type cells due to chronic inflammation.
2. A patient is diagnosed with cervical intraepithelial neoplasia (CIN) on Pap
smear. This finding represents disordered cellular growth that is not yet
cancerous. This is called:
• A. Hyperplasia
, • B. Dysplasia
• C. Hypertrophy
• D. Atrophy
Rationale: Dysplasia is abnormal changes in cell size, shape, and organization. It
is often pre-neoplastic but can be reversible if the stimulus is removed.
3. During cardiac ischemia, myocardial cells switch from aerobic to anaerobic
metabolism. This leads to:
• A. Increased ATP production
• B. Alkalosis
• C. Lactic acid accumulation and decreased intracellular pH
• D. Increased protein synthesis
Rationale: Anaerobic glycolysis produces lactic acid, lowering intracellular pH,
which denatures enzymes and damages lysosomal membranes, leading to cell
death.
4. Which characteristic is unique to malignant (cancer) cells compared to
benign tumor cells?
• A. Well-differentiated morphology
• B. Slow growth rate
• C. Metastasis
• D. Encapsulation
Rationale: Malignant cells invade basement membranes and spread to distant sites
(metastasis). Benign tumors are encapsulated and do not metastasize.
5. A patient receiving chemotherapy has tumor lysis syndrome. Which
electrolyte imbalance is most critical in the first 24 hours?
• A. Hyperkalemia
• B. Hyponatremia
• C. Hypocalcemia
• D. Hypomagnesemia
, Rationale: Rapid lysis of cancer cells releases intracellular potassium, causing
life-threatening hyperkalemia (cardiac dysrhythmias). Hyperuricemia and
hyperphosphatemia also occur.
6. A nurse recalls that free radicals cause cell damage by:
• A. Activating DNA repair enzymes
• B. Increasing ATP synthesis
• C. Peroxidation of cell membrane lipids
• D. Enhancing calcium excretion
Rationale: Reactive oxygen species (ROS) attack polyunsaturated fatty acids in
cell membranes (lipid peroxidation), leading to loss of membrane integrity and cell
lysis.
7. Which cellular adaptation is most likely to occur in the heart following
long-term untreated hypertension?
• A. Hyperplasia
• B. Concentric hypertrophy
• C. Metaplasia
• D. Atrophy
Rationale: Pressure overload (hypertension) causes increased workload, leading to
addition of sarcomeres in parallel → thickened ventricular wall (concentric
hypertrophy).
8. Oncogenes are mutated forms of normal genes called:
• A. Tumor suppressor genes
• B. Proto-oncogenes
• C. Apoptosis genes
• D. DNA polymerases
Rationale: Proto-oncogenes normally promote cell growth. When mutated into
oncogenes, they become overactive, driving uncontrolled proliferation.
Comprehensive Exam: 2026
Edition||Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 85
Target Audience: Pre-licensure Nursing Students (BSN/ADN)
Topics: Cellular Adaptation, Inflammation, Genetics, Fluid/Electrolytes, & Major
Organ Systems
Part I: Cellular Adaptation, Injury, & Neoplasia (Questions 1-15)
1. A patient with chronic hepatitis C develops liver cirrhosis. The hepatocytes
have converted into cells that resemble intestinal epithelium. This process is
known as:
• A. Hyperplasia
• B. Dysplasia
• C. Metaplasia
• D. Anaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another (e.g., columnar to squamous or vice versa). Here, liver cells change to
intestinal-type cells due to chronic inflammation.
2. A patient is diagnosed with cervical intraepithelial neoplasia (CIN) on Pap
smear. This finding represents disordered cellular growth that is not yet
cancerous. This is called:
• A. Hyperplasia
, • B. Dysplasia
• C. Hypertrophy
• D. Atrophy
Rationale: Dysplasia is abnormal changes in cell size, shape, and organization. It
is often pre-neoplastic but can be reversible if the stimulus is removed.
3. During cardiac ischemia, myocardial cells switch from aerobic to anaerobic
metabolism. This leads to:
• A. Increased ATP production
• B. Alkalosis
• C. Lactic acid accumulation and decreased intracellular pH
• D. Increased protein synthesis
Rationale: Anaerobic glycolysis produces lactic acid, lowering intracellular pH,
which denatures enzymes and damages lysosomal membranes, leading to cell
death.
4. Which characteristic is unique to malignant (cancer) cells compared to
benign tumor cells?
• A. Well-differentiated morphology
• B. Slow growth rate
• C. Metastasis
• D. Encapsulation
Rationale: Malignant cells invade basement membranes and spread to distant sites
(metastasis). Benign tumors are encapsulated and do not metastasize.
5. A patient receiving chemotherapy has tumor lysis syndrome. Which
electrolyte imbalance is most critical in the first 24 hours?
• A. Hyperkalemia
• B. Hyponatremia
• C. Hypocalcemia
• D. Hypomagnesemia
, Rationale: Rapid lysis of cancer cells releases intracellular potassium, causing
life-threatening hyperkalemia (cardiac dysrhythmias). Hyperuricemia and
hyperphosphatemia also occur.
6. A nurse recalls that free radicals cause cell damage by:
• A. Activating DNA repair enzymes
• B. Increasing ATP synthesis
• C. Peroxidation of cell membrane lipids
• D. Enhancing calcium excretion
Rationale: Reactive oxygen species (ROS) attack polyunsaturated fatty acids in
cell membranes (lipid peroxidation), leading to loss of membrane integrity and cell
lysis.
7. Which cellular adaptation is most likely to occur in the heart following
long-term untreated hypertension?
• A. Hyperplasia
• B. Concentric hypertrophy
• C. Metaplasia
• D. Atrophy
Rationale: Pressure overload (hypertension) causes increased workload, leading to
addition of sarcomeres in parallel → thickened ventricular wall (concentric
hypertrophy).
8. Oncogenes are mutated forms of normal genes called:
• A. Tumor suppressor genes
• B. Proto-oncogenes
• C. Apoptosis genes
• D. DNA polymerases
Rationale: Proto-oncogenes normally promote cell growth. When mutated into
oncogenes, they become overactive, driving uncontrolled proliferation.
