NSG120 PATHOPHYSIOLOGY HESI SUCCESS
GUIDE 2026 COMPREHENSIVE EXAMINATION
(130 QUESTIONS: HERZING UNIVERSITY
SECTION 1: CELLULAR ADAPTATION, INJURY, & NEOPLASIA (Questions 1–20)
Q1. When cells decrease in size due to disuse or loss of endocrine stimulation,
this type of cellular adaptation is known as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: C
Rationale: Atrophy is a decrease in cellular size. Hypertrophy (A) is increased cell
size; hyperplasia (B) is increased cell number; metaplasia (D) is replacement of
one cell type with another.
Q2. A patient experiences prolonged ischemia. The "point of no return"
(irreversible cell injury) occurs when:
A) ATP decreases
B) Ribosomes detach
C) Plasma membrane integrity is lost
D) Cell swelling occurs
,Correct Answer: C
Rationale: Loss of plasma membrane integrity allows lysosomal enzymes to leak,
causing irreversible damage. ATP depletion (A) and cell swelling (D) are reversible.
Q3. Which condition demonstrates pathologic hyperplasia?
A) Left ventricular hypertrophy from hypertension
B) Enlarged prostate (Benign Prostatic Hyperplasia)
C) Skeletal muscle growth from exercise
D) Callus formation on the skin
Correct Answer: B
Rationale: BPH is an abnormal increase in cell number due to hormonal
stimulation. A and C are hypertrophy; D is physiologic hyperplasia.
Q4. An infarct is an area of necrosis caused by:
A) Bacterial infection
B) Lack of blood supply
C) Physical trauma
D) Chemical exposure
Correct Answer: B
Rationale: Infarct = coagulative necrosis from ischemia (lack of blood flow).
Q5. A 41-year-old female with a family history of breast cancer asks how a lump
can appear so quickly. The nurse's best response is based on which principle?
A) A tumor is undetectable until it has doubled 30 times and contains at least 1
billion cells.
B) Many tumor cells never leave the M-phase of the cell cycle.
C) Cancer cells are undifferentiated and come in various shapes and sizes.
D) If the breast has cysts, fluid makes it hard to feel hard lumps.
Correct Answer: A
Rationale: A 1 cm tumor has typically undergone 30 doublings and contains ~1
billion cells.
,Q6. Which is characteristic of benign neoplasms?
A) Tend to grow and spread rapidly
B) Rob normal tissues of essential nutrients
C) Compress and erode blood vessels
D) Inability to metastasize to distant sites
Correct Answer: D
Rationale: Benign tumors are localized and do not metastasize (though they can
cause compression).
Q7. The normal function of the p53 tumor suppressor gene is to:
A) Promote angiogenesis
B) Repair DNA or induce apoptosis
C) Activate oncogenes
D) Suppress immunity
Correct Answer: B
Rationale: p53 halts the cell cycle for DNA repair; if damage is irreparable, it
triggers apoptosis.
Q8. Mutations in a proto-oncogene lead to:
A) Overactivity of the gene
B) Formation of an oncogene
C) Promotion of cell proliferation
D) All of these
Correct Answer: D
Rationale: Proto-oncogenes become overactive oncogenes that drive
uncontrolled proliferation.
Q9. Which is a malignant tumor of glandular epithelial cells?
A) Osteoma
B) Lymphoma
C) Adenocarcinoma
D) Leiomyoma
, Correct Answer: C
Rationale: "Adeno-" = gland; "carcinoma" = malignant epithelial tumor.
Q10. Programmed cell death is called:
Correct Answer: Apoptosis
Rationale: Apoptosis is energy-dependent and does not trigger inflammation.
Q11. A patient has a mutation in the BRCA1 gene. This increases risk for which
cancers? (Select all that apply)
A) Breast
B) Ovarian
C) Colon
D) Lung
Correct Answers: A, B
Rationale: BRCA1 increases risk for breast and ovarian cancer.
Q12. Which term describes the spread of cancer cells through blood or lymph?
A) Invasion
B) Metastasis
C) Angiogenesis
D) Dysplasia
Correct Answer: B
Rationale: Metastasis = distant spread.
Q13. A patient's tumor biopsy shows anaplasia. This means:
A) Cells are well-differentiated
B) Cells are undifferentiated and abnormal
C) Cells are benign
D) Cells are inflamed
Correct Answer: B
Rationale: Anaplasia = loss of differentiation, characteristic of malignancy.
GUIDE 2026 COMPREHENSIVE EXAMINATION
(130 QUESTIONS: HERZING UNIVERSITY
SECTION 1: CELLULAR ADAPTATION, INJURY, & NEOPLASIA (Questions 1–20)
Q1. When cells decrease in size due to disuse or loss of endocrine stimulation,
this type of cellular adaptation is known as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: C
Rationale: Atrophy is a decrease in cellular size. Hypertrophy (A) is increased cell
size; hyperplasia (B) is increased cell number; metaplasia (D) is replacement of
one cell type with another.
Q2. A patient experiences prolonged ischemia. The "point of no return"
(irreversible cell injury) occurs when:
A) ATP decreases
B) Ribosomes detach
C) Plasma membrane integrity is lost
D) Cell swelling occurs
,Correct Answer: C
Rationale: Loss of plasma membrane integrity allows lysosomal enzymes to leak,
causing irreversible damage. ATP depletion (A) and cell swelling (D) are reversible.
Q3. Which condition demonstrates pathologic hyperplasia?
A) Left ventricular hypertrophy from hypertension
B) Enlarged prostate (Benign Prostatic Hyperplasia)
C) Skeletal muscle growth from exercise
D) Callus formation on the skin
Correct Answer: B
Rationale: BPH is an abnormal increase in cell number due to hormonal
stimulation. A and C are hypertrophy; D is physiologic hyperplasia.
Q4. An infarct is an area of necrosis caused by:
A) Bacterial infection
B) Lack of blood supply
C) Physical trauma
D) Chemical exposure
Correct Answer: B
Rationale: Infarct = coagulative necrosis from ischemia (lack of blood flow).
Q5. A 41-year-old female with a family history of breast cancer asks how a lump
can appear so quickly. The nurse's best response is based on which principle?
A) A tumor is undetectable until it has doubled 30 times and contains at least 1
billion cells.
B) Many tumor cells never leave the M-phase of the cell cycle.
C) Cancer cells are undifferentiated and come in various shapes and sizes.
D) If the breast has cysts, fluid makes it hard to feel hard lumps.
Correct Answer: A
Rationale: A 1 cm tumor has typically undergone 30 doublings and contains ~1
billion cells.
,Q6. Which is characteristic of benign neoplasms?
A) Tend to grow and spread rapidly
B) Rob normal tissues of essential nutrients
C) Compress and erode blood vessels
D) Inability to metastasize to distant sites
Correct Answer: D
Rationale: Benign tumors are localized and do not metastasize (though they can
cause compression).
Q7. The normal function of the p53 tumor suppressor gene is to:
A) Promote angiogenesis
B) Repair DNA or induce apoptosis
C) Activate oncogenes
D) Suppress immunity
Correct Answer: B
Rationale: p53 halts the cell cycle for DNA repair; if damage is irreparable, it
triggers apoptosis.
Q8. Mutations in a proto-oncogene lead to:
A) Overactivity of the gene
B) Formation of an oncogene
C) Promotion of cell proliferation
D) All of these
Correct Answer: D
Rationale: Proto-oncogenes become overactive oncogenes that drive
uncontrolled proliferation.
Q9. Which is a malignant tumor of glandular epithelial cells?
A) Osteoma
B) Lymphoma
C) Adenocarcinoma
D) Leiomyoma
, Correct Answer: C
Rationale: "Adeno-" = gland; "carcinoma" = malignant epithelial tumor.
Q10. Programmed cell death is called:
Correct Answer: Apoptosis
Rationale: Apoptosis is energy-dependent and does not trigger inflammation.
Q11. A patient has a mutation in the BRCA1 gene. This increases risk for which
cancers? (Select all that apply)
A) Breast
B) Ovarian
C) Colon
D) Lung
Correct Answers: A, B
Rationale: BRCA1 increases risk for breast and ovarian cancer.
Q12. Which term describes the spread of cancer cells through blood or lymph?
A) Invasion
B) Metastasis
C) Angiogenesis
D) Dysplasia
Correct Answer: B
Rationale: Metastasis = distant spread.
Q13. A patient's tumor biopsy shows anaplasia. This means:
A) Cells are well-differentiated
B) Cells are undifferentiated and abnormal
C) Cells are benign
D) Cells are inflamed
Correct Answer: B
Rationale: Anaplasia = loss of differentiation, characteristic of malignancy.
