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2026 NURS 6501 Advanced Pathophysiology Final Exam
Study Guide | 200 Actual Comprehensive Questions and
Verified Answers
SECTION 1 – CELLULAR INJURY, ADAPTATION & GENETICS (1–20)
1. A patient with chronic hypertension develops left ventricular hypertrophy.
This is an example of which cellular adaptation?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Hypertrophy
Answer: D
Rationale: Hypertrophy is an increase in cell size, leading to organ enlargement. In
hypertension, the heart muscle cells enlarge due to increased workload.
Hyperplasia (B) is an increase in cell number; metaplasia (C) is replacement of one
cell type by another; atrophy (A) is a decrease in size.
2. A patient with a history of smoking undergoes bronchoscopy, and a biopsy
shows that the normal ciliated columnar epithelium has been replaced by
stratified squamous epithelium. This is an example of:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Answer: C
Rationale: Metaplasia is a reversible change in which one mature cell type is
replaced by another. In smokers, the airway epithelium adapts to chronic
irritation by changing to a more resilient squamous type. This is not dysplasia
(disordered growth) or anaplasia (loss of differentiation).
pg. 1
,2
3. A patient with a myocardial infarction has elevated troponin levels 6 hours
after the onset of chest pain. What is the most likely mechanism of cell death in
the affected myocardium?
A. Apoptosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Caseous necrosis
Answer: B
Rationale: Coagulative necrosis is typical of ischemic injury in most solid organs,
including the heart. The architecture is preserved initially due to protein
denaturation. Liquefactive necrosis (C) occurs in brain infarcts; caseous (D) is seen
in tuberculosis; apoptosis (A) is programmed cell death.
4. A newborn is diagnosed with a genetic disorder characterized by a deletion
on the short arm of chromosome 5, resulting in a cat-like cry, microcephaly, and
severe intellectual disability. This disorder is:
A. Down syndrome
B. Cri du chat syndrome
C. Turner syndrome
D. Klinefelter syndrome
Answer: B
Rationale: Cri du chat syndrome results from a deletion on chromosome 5p. The
characteristic high-pitched cry resembles a cat's meow. Down syndrome (A) is
trisomy 21; Turner (C) is 45,X; Klinefelter (D) is 47,XXY.
5. A patient with a mutation in the CFTR gene develops thick secretions in the
lungs and pancreas. This disorder is inherited in which pattern?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked recessive
D. Mitochondrial
pg. 2
,3
Answer: B
Rationale: Cystic fibrosis is an autosomal recessive disorder; both copies of the
CFTR gene must be mutated for disease to manifest. Parents are carriers.
6. A child is diagnosed with Duchenne muscular dystrophy. Which statement
about the inheritance of this disorder is correct?
A. It affects males and females equally.
B. It is an X-linked recessive disorder primarily affecting males.
C. It is autosomal dominant.
D. It is caused by a mitochondrial mutation.
Answer: B
Rationale: Duchenne muscular dystrophy is X-linked recessive. Males are affected
because they have only one X chromosome; females are carriers.
7. A biopsy of a tumor shows cells with marked variation in size and shape,
hyperchromatic nuclei, and increased mitotic figures. This description is most
consistent with:
A. Metaplasia
B. Anaplasia
C. Hypertrophy
D. Atrophy
Answer: B
Rationale: Anaplasia is a hallmark of malignancy, characterized by loss of
differentiation, pleomorphism (variation in size/shape), hyperchromatic nuclei,
and atypical mitoses. Metaplasia (A) is a benign adaptive change.
8. A patient with a history of alcohol abuse develops fat accumulation in the
liver (hepatic steatosis). This is an example of:
A. Hypertrophy
B. Hyperplasia
pg. 3
, 4
C. Intracellular accumulation (reversible cell injury)
D. Necrosis
Answer: C
Rationale: Fatty liver (steatosis) is an accumulation of triglycerides within
hepatocytes, a form of reversible cell injury. It can progress to steatohepatitis and
cirrhosis if the insult continues.
9. A patient presents with a genetic disorder characterized by a lack of melanin
production due to a defect in the enzyme tyrosinase. This disorder is:
A. Phenylketonuria
B. Albinism
C. Marfan syndrome
D. Tay-Sachs disease
Answer: B
Rationale: Albinism results from mutations in genes involved in melanin synthesis,
often affecting tyrosinase activity. Phenylketonuria (A) involves phenylalanine
hydroxylase deficiency.
10. Which of the following is an example of a chromosomal aneuploidy?
A. Cystic fibrosis
B. Huntington disease
C. Down syndrome (trisomy 21)
D. Sickle cell anemia
Answer: C
Rationale: Aneuploidy is an abnormal number of chromosomes. Trisomy 21
(Down syndrome) is a common aneuploidy. The other options are single-gene
disorders.
11. A patient with a BRCA1 mutation is at significantly increased risk for which
cancers?
A. Lung and liver
pg. 4
2026 NURS 6501 Advanced Pathophysiology Final Exam
Study Guide | 200 Actual Comprehensive Questions and
Verified Answers
SECTION 1 – CELLULAR INJURY, ADAPTATION & GENETICS (1–20)
1. A patient with chronic hypertension develops left ventricular hypertrophy.
This is an example of which cellular adaptation?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Hypertrophy
Answer: D
Rationale: Hypertrophy is an increase in cell size, leading to organ enlargement. In
hypertension, the heart muscle cells enlarge due to increased workload.
Hyperplasia (B) is an increase in cell number; metaplasia (C) is replacement of one
cell type by another; atrophy (A) is a decrease in size.
2. A patient with a history of smoking undergoes bronchoscopy, and a biopsy
shows that the normal ciliated columnar epithelium has been replaced by
stratified squamous epithelium. This is an example of:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Answer: C
Rationale: Metaplasia is a reversible change in which one mature cell type is
replaced by another. In smokers, the airway epithelium adapts to chronic
irritation by changing to a more resilient squamous type. This is not dysplasia
(disordered growth) or anaplasia (loss of differentiation).
pg. 1
,2
3. A patient with a myocardial infarction has elevated troponin levels 6 hours
after the onset of chest pain. What is the most likely mechanism of cell death in
the affected myocardium?
A. Apoptosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Caseous necrosis
Answer: B
Rationale: Coagulative necrosis is typical of ischemic injury in most solid organs,
including the heart. The architecture is preserved initially due to protein
denaturation. Liquefactive necrosis (C) occurs in brain infarcts; caseous (D) is seen
in tuberculosis; apoptosis (A) is programmed cell death.
4. A newborn is diagnosed with a genetic disorder characterized by a deletion
on the short arm of chromosome 5, resulting in a cat-like cry, microcephaly, and
severe intellectual disability. This disorder is:
A. Down syndrome
B. Cri du chat syndrome
C. Turner syndrome
D. Klinefelter syndrome
Answer: B
Rationale: Cri du chat syndrome results from a deletion on chromosome 5p. The
characteristic high-pitched cry resembles a cat's meow. Down syndrome (A) is
trisomy 21; Turner (C) is 45,X; Klinefelter (D) is 47,XXY.
5. A patient with a mutation in the CFTR gene develops thick secretions in the
lungs and pancreas. This disorder is inherited in which pattern?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked recessive
D. Mitochondrial
pg. 2
,3
Answer: B
Rationale: Cystic fibrosis is an autosomal recessive disorder; both copies of the
CFTR gene must be mutated for disease to manifest. Parents are carriers.
6. A child is diagnosed with Duchenne muscular dystrophy. Which statement
about the inheritance of this disorder is correct?
A. It affects males and females equally.
B. It is an X-linked recessive disorder primarily affecting males.
C. It is autosomal dominant.
D. It is caused by a mitochondrial mutation.
Answer: B
Rationale: Duchenne muscular dystrophy is X-linked recessive. Males are affected
because they have only one X chromosome; females are carriers.
7. A biopsy of a tumor shows cells with marked variation in size and shape,
hyperchromatic nuclei, and increased mitotic figures. This description is most
consistent with:
A. Metaplasia
B. Anaplasia
C. Hypertrophy
D. Atrophy
Answer: B
Rationale: Anaplasia is a hallmark of malignancy, characterized by loss of
differentiation, pleomorphism (variation in size/shape), hyperchromatic nuclei,
and atypical mitoses. Metaplasia (A) is a benign adaptive change.
8. A patient with a history of alcohol abuse develops fat accumulation in the
liver (hepatic steatosis). This is an example of:
A. Hypertrophy
B. Hyperplasia
pg. 3
, 4
C. Intracellular accumulation (reversible cell injury)
D. Necrosis
Answer: C
Rationale: Fatty liver (steatosis) is an accumulation of triglycerides within
hepatocytes, a form of reversible cell injury. It can progress to steatohepatitis and
cirrhosis if the insult continues.
9. A patient presents with a genetic disorder characterized by a lack of melanin
production due to a defect in the enzyme tyrosinase. This disorder is:
A. Phenylketonuria
B. Albinism
C. Marfan syndrome
D. Tay-Sachs disease
Answer: B
Rationale: Albinism results from mutations in genes involved in melanin synthesis,
often affecting tyrosinase activity. Phenylketonuria (A) involves phenylalanine
hydroxylase deficiency.
10. Which of the following is an example of a chromosomal aneuploidy?
A. Cystic fibrosis
B. Huntington disease
C. Down syndrome (trisomy 21)
D. Sickle cell anemia
Answer: C
Rationale: Aneuploidy is an abnormal number of chromosomes. Trisomy 21
(Down syndrome) is a common aneuploidy. The other options are single-gene
disorders.
11. A patient with a BRCA1 mutation is at significantly increased risk for which
cancers?
A. Lung and liver
pg. 4
