SCI 225 PATHOPHYSIOLOGY FINAL EXAM PRACTICE QUESTIONS
WITH ANSWERS & RATIONALES | NIGHTINGALE COLLEGE 2025–
2026 UPDATE
1. A 67-year-old patient has chronic hypertension. Which cellular adaptation is
most likely to occur in the left ventricle?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Increased workload from hypertension causes cardiac myocytes to
enlarge (hypertrophy) to handle the pressure.
2. Which of the following best describes necrosis compared with apoptosis?
A. Energy-dependent, non-inflammatory process
B. Programmed cell death with cell shrinkage
C. Unregulated cell death with cell swelling and inflammation
D. Cellular adaptation to stress that is reversible
Correct Answer: C
Rationale: Necrosis is uncontrolled, energy-independent, and triggers
inflammation. Apoptosis is controlled and noninflammatory.
3. During acute inflammation, what is the primary role of neutrophils?
A. Produce antibodies
B. Secrete histamine to increase vascular permeability
C. Present antigen to T cells
D. Phagocytose bacteria and cellular debris
Correct Answer: D
Rationale: Neutrophils are the first responders that ingest pathogens and cellular
debris during acute inflammation.
,4. A patient with SIADH will most likely have which laboratory finding?
A. Hypernatremia and low urine osmolality
B. Hyponatremia and concentrated urine (high urine osmolality)
C. Hyperkalemia and polyuria
D. Hypokalemia and dilute urine
Correct Answer: B
Rationale: SIADH leads to excessive ADH → water retention → dilutional
hyponatremia with concentrated urine.
5. Which electrolyte imbalance is most dangerous due to its effect on cardiac
conduction?
A. Hypocalcemia
B. Hypomagnesemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: C
Rationale: Hyperkalemia disrupts cardiac conduction and can cause life-
threatening arrhythmias.
6. A patient has metabolic acidosis with an increased anion gap. The most likely
cause is:
A. Vomiting
B. Diuretic use
C. Lactic acidosis (or ketoacidosis, toxins)
D. Hyperaldosteronism
Correct Answer: C
Rationale: High anion gap metabolic acidosis is caused by accumulation of
unmeasured acids such as lactic acid, ketones, or toxins.
7. In atherosclerosis, which event is considered an early and central step in plaque
formation?
, A. Smooth muscle cell apoptosis
B. Endothelial injury and LDL oxidation
C. Immediate thrombosis of the vessel lumen
D. Calcium deposition only after rupture
Correct Answer: B
Rationale: Endothelial damage allows LDL entry and oxidation, which triggers
inflammation and foam cell formation.
8. A 58-year-old man has crushing chest pain; ECG shows ST-elevation in II, III,
aVF. Which artery is most likely occluded?
A. Left anterior descending (LAD)
B. Left circumflex (LCx)
C. Right coronary artery (RCA)
D. Posterior descending branch only
Correct Answer: C
Rationale: ST elevation in II, III, aVF indicates an inferior myocardial infarction,
usually due to RCA occlusion.
9. Which manifestation is most characteristic of left-sided heart failure?
A. Peripheral edema and JVD
B. Hepatomegaly and splenomegaly
C. Pulmonary congestion leading to dyspnea and orthopnea
D. Elevated systemic arterial pressure only
Correct Answer: C
Rationale: Left heart failure causes pulmonary venous congestion, resulting in
dyspnea, orthopnea, and pulmonary edema.
10. A COPD patient with chronic hypercapnia relies on which respiratory drive?
A. Central chemoreceptors (CO₂)
B. Peripheral chemoreceptors (low O₂)
C. Baroreceptors (BP)
D. Stretch receptors
WITH ANSWERS & RATIONALES | NIGHTINGALE COLLEGE 2025–
2026 UPDATE
1. A 67-year-old patient has chronic hypertension. Which cellular adaptation is
most likely to occur in the left ventricle?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Increased workload from hypertension causes cardiac myocytes to
enlarge (hypertrophy) to handle the pressure.
2. Which of the following best describes necrosis compared with apoptosis?
A. Energy-dependent, non-inflammatory process
B. Programmed cell death with cell shrinkage
C. Unregulated cell death with cell swelling and inflammation
D. Cellular adaptation to stress that is reversible
Correct Answer: C
Rationale: Necrosis is uncontrolled, energy-independent, and triggers
inflammation. Apoptosis is controlled and noninflammatory.
3. During acute inflammation, what is the primary role of neutrophils?
A. Produce antibodies
B. Secrete histamine to increase vascular permeability
C. Present antigen to T cells
D. Phagocytose bacteria and cellular debris
Correct Answer: D
Rationale: Neutrophils are the first responders that ingest pathogens and cellular
debris during acute inflammation.
,4. A patient with SIADH will most likely have which laboratory finding?
A. Hypernatremia and low urine osmolality
B. Hyponatremia and concentrated urine (high urine osmolality)
C. Hyperkalemia and polyuria
D. Hypokalemia and dilute urine
Correct Answer: B
Rationale: SIADH leads to excessive ADH → water retention → dilutional
hyponatremia with concentrated urine.
5. Which electrolyte imbalance is most dangerous due to its effect on cardiac
conduction?
A. Hypocalcemia
B. Hypomagnesemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: C
Rationale: Hyperkalemia disrupts cardiac conduction and can cause life-
threatening arrhythmias.
6. A patient has metabolic acidosis with an increased anion gap. The most likely
cause is:
A. Vomiting
B. Diuretic use
C. Lactic acidosis (or ketoacidosis, toxins)
D. Hyperaldosteronism
Correct Answer: C
Rationale: High anion gap metabolic acidosis is caused by accumulation of
unmeasured acids such as lactic acid, ketones, or toxins.
7. In atherosclerosis, which event is considered an early and central step in plaque
formation?
, A. Smooth muscle cell apoptosis
B. Endothelial injury and LDL oxidation
C. Immediate thrombosis of the vessel lumen
D. Calcium deposition only after rupture
Correct Answer: B
Rationale: Endothelial damage allows LDL entry and oxidation, which triggers
inflammation and foam cell formation.
8. A 58-year-old man has crushing chest pain; ECG shows ST-elevation in II, III,
aVF. Which artery is most likely occluded?
A. Left anterior descending (LAD)
B. Left circumflex (LCx)
C. Right coronary artery (RCA)
D. Posterior descending branch only
Correct Answer: C
Rationale: ST elevation in II, III, aVF indicates an inferior myocardial infarction,
usually due to RCA occlusion.
9. Which manifestation is most characteristic of left-sided heart failure?
A. Peripheral edema and JVD
B. Hepatomegaly and splenomegaly
C. Pulmonary congestion leading to dyspnea and orthopnea
D. Elevated systemic arterial pressure only
Correct Answer: C
Rationale: Left heart failure causes pulmonary venous congestion, resulting in
dyspnea, orthopnea, and pulmonary edema.
10. A COPD patient with chronic hypercapnia relies on which respiratory drive?
A. Central chemoreceptors (CO₂)
B. Peripheral chemoreceptors (low O₂)
C. Baroreceptors (BP)
D. Stretch receptors
