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2026 NUR 2063 Pathophysiology Final Exam Study Guide | 150
Actual Final Exam Questions and Verified Answers
SECTION 1 – CELLULAR INJURY, ADAPTATION & NEOPLASIA (1–15)
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, cardiac 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 chronic smoker undergoes bronchoscopy, and biopsy shows normal ciliated
columnar epithelium replaced by stratified squamous epithelium. This is:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Answer: C
Rationale: Metaplasia is a reversible change where one mature cell type is
replaced by another. In smokers, airway epithelium adapts to chronic irritation by
changing to a more resilient squamous type.
3. A patient with a myocardial infarction has elevated troponin. The most likely
mechanism of cell death in the affected myocardium is:
pg. 1
,2
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. Liquefactive necrosis (C) occurs in brain infarcts; caseous (D)
is seen in tuberculosis; apoptosis (A) is programmed cell death.
4. A newborn has a deletion on chromosome 5p, resulting in a cat-like cry,
microcephaly, and severe intellectual disability. This 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.
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
Answer: B
Rationale: Cystic fibrosis is autosomal recessive; both copies of the CFTR gene
must be mutated for disease to manifest.
6. A child is diagnosed with Duchenne muscular dystrophy. Which statement
about the inheritance is correct?
pg. 2
,3
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 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, hyperchromatic nuclei, and atypical mitoses.
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
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.
pg. 3
, 4
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
B. Breast and ovarian
C. Colorectal and pancreatic
D. Leukemia and lymphoma
Answer: B
Rationale: BRCA1 and BRCA2 mutations impair DNA repair and are associated
with hereditary breast and ovarian cancer syndrome.
pg. 4
2026 NUR 2063 Pathophysiology Final Exam Study Guide | 150
Actual Final Exam Questions and Verified Answers
SECTION 1 – CELLULAR INJURY, ADAPTATION & NEOPLASIA (1–15)
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, cardiac 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 chronic smoker undergoes bronchoscopy, and biopsy shows normal ciliated
columnar epithelium replaced by stratified squamous epithelium. This is:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Answer: C
Rationale: Metaplasia is a reversible change where one mature cell type is
replaced by another. In smokers, airway epithelium adapts to chronic irritation by
changing to a more resilient squamous type.
3. A patient with a myocardial infarction has elevated troponin. The most likely
mechanism of cell death in the affected myocardium is:
pg. 1
,2
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. Liquefactive necrosis (C) occurs in brain infarcts; caseous (D)
is seen in tuberculosis; apoptosis (A) is programmed cell death.
4. A newborn has a deletion on chromosome 5p, resulting in a cat-like cry,
microcephaly, and severe intellectual disability. This 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.
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
Answer: B
Rationale: Cystic fibrosis is autosomal recessive; both copies of the CFTR gene
must be mutated for disease to manifest.
6. A child is diagnosed with Duchenne muscular dystrophy. Which statement
about the inheritance is correct?
pg. 2
,3
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 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, hyperchromatic nuclei, and atypical mitoses.
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
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.
pg. 3
, 4
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
B. Breast and ovarian
C. Colorectal and pancreatic
D. Leukemia and lymphoma
Answer: B
Rationale: BRCA1 and BRCA2 mutations impair DNA repair and are associated
with hereditary breast and ovarian cancer syndrome.
pg. 4
