HERZING UNIVERSITY NSG 120 NURSING PATHOPHYSIOLOGY HESI EXAM 1
COMPLETE PRACTICE TEST BANK QUESTIONS AND ANSWERS | VERIFIED
SOLUTIONS | UPDATED 2026/2027 STUDY GUIDE
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
HERZING UNIVERSITY NSG 120 NURSING PATHOPHYSIOLOGY
HESI EXAM 1 PRACTICE EXAMINATION
2026/2027 EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
100+ MULTIPLE-CHOICE QUESTIONS
PASSING SCORE: 70%
TESTING TIME: 120 MINUTES
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
TABLE OF CONTENT
Cellular Adaptation & Injury
Inflammation & Immune Response
Fluid & Electrolyte Imbalances
Acid-Base Balance Disorders
Cardiovascular Pathophysiology
Respiratory System Disorders
Renal System Pathophysiology
Endocrine System Disorders
Hematologic & Oncologic Processes
Neurologic Pathophysiology
HERZING UNIVERSITY SCHOOL OF NURSING || ALIGNED WITH CURRENT NURSING
EDUCATION BLUEPRINTS || PATHOPHYSIOLOGY CORE COMPETENCIES ||
PROFESSIONAL STUDY GUIDE || 100% EDUCATIONAL PRACTICE MATERIAL ||
COMPREHENSIVE NURSING EXAM PREPARATION || PREPARED FOR ACADEMIC AND
LICENSURE SUCCESS || FOR TRAINING PURPOSES ONLY - 2026/2027
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
CELLULAR ADAPTATION & INJURY
,Q1. A patient with chronic hypertension develops left ventricular hypertrophy. Which
cellular adaptation best explains this finding?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Dysplasia
Correct Answer: 🔴 B. Hypertrophy
Explanation: 🔹 Hypertrophy is an increase in cell size due to increased workload,
commonly seen in cardiac muscle under pressure overload such as hypertension.
Hyperplasia refers to increased cell number, atrophy is a decrease in cell size, and
dysplasia indicates abnormal cellular development often associated with precancerous
changes.
Q2. A patient experiencing prolonged immobilization develops muscle wasting. What
is the primary pathophysiologic process?
A. Hypertrophy
B. Metaplasia
C. Atrophy
D. Neoplasia
Correct Answer: 🔴 C. Atrophy
Explanation: 🔹 Atrophy occurs due to decreased workload, resulting in reduced cell size
and function. Immobilization leads to disuse atrophy. Hypertrophy is the opposite
process, while metaplasia and neoplasia involve cellular transformation and abnormal
growth.
Q3. A biopsy shows replacement of normal bronchial ciliated epithelium with
squamous epithelium in a chronic smoker. This is an example of:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: 🔴 B. Metaplasia
Explanation: 🔹 Metaplasia is a reversible change where one mature cell type is replaced
by another due to chronic irritation. Smoking commonly causes squamous metaplasia in
the respiratory tract.
,Q4. Which condition best represents reversible cell injury?
A. Necrosis
B. Apoptosis
C. Coagulative necrosis
D. Gangrene
Correct Answer: 🔴 B. Apoptosis
Explanation: 🔹 Apoptosis is programmed cell death and is a controlled, non-
inflammatory process that is reversible in early stages. Necrosis and gangrene represent
irreversible injury.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
INFLAMMATION & IMMUNE RESPONSE
Q5. Which chemical mediator is primarily responsible for vasodilation during acute
inflammation?
A. Histamine
B. Insulin
C. Hemoglobin
D. Fibrinogen
Correct Answer: 🔴 A. Histamine
Explanation: 🔹 Histamine released from mast cells causes vasodilation and increased
vascular permeability, producing redness and swelling during inflammation.
Q6. A patient presents with fever, leukocytosis, and localized redness. These findings
indicate:
A. Chronic inflammation
B. Acute inflammatory response
C. Autoimmune suppression
D. Immunodeficiency
Correct Answer: 🔴 B. Acute inflammatory response
Explanation: 🔹 Acute inflammation is characterized by rapid onset symptoms such as
redness, heat, swelling, pain, and systemic signs like fever and leukocytosis.
Q7. Which leukocyte is most active in bacterial infections during acute inflammation?
A. Eosinophils
B. Basophils
C. Neutrophils
, D. Lymphocytes
Correct Answer: 🔴 C. Neutrophils
Explanation: 🔹 Neutrophils are the first responders in acute bacterial infections and are
key phagocytic cells in early inflammation.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
FLUID & ELECTROLYTE BALANCE
Q8. A patient with severe vomiting is at highest risk for which imbalance?
A. Hyperkalemia
B. Metabolic alkalosis
C. Respiratory acidosis
D. Hypernatremia
Correct Answer: 🔴 B. Metabolic alkalosis
Explanation: 🔹 Vomiting leads to loss of gastric acid (HCl), resulting in increased blood
pH and metabolic alkalosis.
Q9. Which electrolyte imbalance is most associated with cardiac dysrhythmias?
A. Hypokalemia
B. Hypercalcemia
C. Hypernatremia
D. Hypermagnesemia
Correct Answer: 🔴 A. Hypokalemia
Explanation: 🔹 Potassium is critical for cardiac conduction. Low potassium increases risk
of dysrhythmias and muscle weakness.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
ACID-BASE BALANCE
Q10. ABG results show: pH 7.30, PaCO₂ 55 mmHg. This indicates:
A. Metabolic alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: 🔴 B. Respiratory acidosis
Explanation: 🔹 Elevated CO₂ with decreased pH indicates respiratory acidosis,
commonly caused by hypoventilation.
COMPLETE PRACTICE TEST BANK QUESTIONS AND ANSWERS | VERIFIED
SOLUTIONS | UPDATED 2026/2027 STUDY GUIDE
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
HERZING UNIVERSITY NSG 120 NURSING PATHOPHYSIOLOGY
HESI EXAM 1 PRACTICE EXAMINATION
2026/2027 EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
100+ MULTIPLE-CHOICE QUESTIONS
PASSING SCORE: 70%
TESTING TIME: 120 MINUTES
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
TABLE OF CONTENT
Cellular Adaptation & Injury
Inflammation & Immune Response
Fluid & Electrolyte Imbalances
Acid-Base Balance Disorders
Cardiovascular Pathophysiology
Respiratory System Disorders
Renal System Pathophysiology
Endocrine System Disorders
Hematologic & Oncologic Processes
Neurologic Pathophysiology
HERZING UNIVERSITY SCHOOL OF NURSING || ALIGNED WITH CURRENT NURSING
EDUCATION BLUEPRINTS || PATHOPHYSIOLOGY CORE COMPETENCIES ||
PROFESSIONAL STUDY GUIDE || 100% EDUCATIONAL PRACTICE MATERIAL ||
COMPREHENSIVE NURSING EXAM PREPARATION || PREPARED FOR ACADEMIC AND
LICENSURE SUCCESS || FOR TRAINING PURPOSES ONLY - 2026/2027
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
CELLULAR ADAPTATION & INJURY
,Q1. A patient with chronic hypertension develops left ventricular hypertrophy. Which
cellular adaptation best explains this finding?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Dysplasia
Correct Answer: 🔴 B. Hypertrophy
Explanation: 🔹 Hypertrophy is an increase in cell size due to increased workload,
commonly seen in cardiac muscle under pressure overload such as hypertension.
Hyperplasia refers to increased cell number, atrophy is a decrease in cell size, and
dysplasia indicates abnormal cellular development often associated with precancerous
changes.
Q2. A patient experiencing prolonged immobilization develops muscle wasting. What
is the primary pathophysiologic process?
A. Hypertrophy
B. Metaplasia
C. Atrophy
D. Neoplasia
Correct Answer: 🔴 C. Atrophy
Explanation: 🔹 Atrophy occurs due to decreased workload, resulting in reduced cell size
and function. Immobilization leads to disuse atrophy. Hypertrophy is the opposite
process, while metaplasia and neoplasia involve cellular transformation and abnormal
growth.
Q3. A biopsy shows replacement of normal bronchial ciliated epithelium with
squamous epithelium in a chronic smoker. This is an example of:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: 🔴 B. Metaplasia
Explanation: 🔹 Metaplasia is a reversible change where one mature cell type is replaced
by another due to chronic irritation. Smoking commonly causes squamous metaplasia in
the respiratory tract.
,Q4. Which condition best represents reversible cell injury?
A. Necrosis
B. Apoptosis
C. Coagulative necrosis
D. Gangrene
Correct Answer: 🔴 B. Apoptosis
Explanation: 🔹 Apoptosis is programmed cell death and is a controlled, non-
inflammatory process that is reversible in early stages. Necrosis and gangrene represent
irreversible injury.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
INFLAMMATION & IMMUNE RESPONSE
Q5. Which chemical mediator is primarily responsible for vasodilation during acute
inflammation?
A. Histamine
B. Insulin
C. Hemoglobin
D. Fibrinogen
Correct Answer: 🔴 A. Histamine
Explanation: 🔹 Histamine released from mast cells causes vasodilation and increased
vascular permeability, producing redness and swelling during inflammation.
Q6. A patient presents with fever, leukocytosis, and localized redness. These findings
indicate:
A. Chronic inflammation
B. Acute inflammatory response
C. Autoimmune suppression
D. Immunodeficiency
Correct Answer: 🔴 B. Acute inflammatory response
Explanation: 🔹 Acute inflammation is characterized by rapid onset symptoms such as
redness, heat, swelling, pain, and systemic signs like fever and leukocytosis.
Q7. Which leukocyte is most active in bacterial infections during acute inflammation?
A. Eosinophils
B. Basophils
C. Neutrophils
, D. Lymphocytes
Correct Answer: 🔴 C. Neutrophils
Explanation: 🔹 Neutrophils are the first responders in acute bacterial infections and are
key phagocytic cells in early inflammation.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
FLUID & ELECTROLYTE BALANCE
Q8. A patient with severe vomiting is at highest risk for which imbalance?
A. Hyperkalemia
B. Metabolic alkalosis
C. Respiratory acidosis
D. Hypernatremia
Correct Answer: 🔴 B. Metabolic alkalosis
Explanation: 🔹 Vomiting leads to loss of gastric acid (HCl), resulting in increased blood
pH and metabolic alkalosis.
Q9. Which electrolyte imbalance is most associated with cardiac dysrhythmias?
A. Hypokalemia
B. Hypercalcemia
C. Hypernatremia
D. Hypermagnesemia
Correct Answer: 🔴 A. Hypokalemia
Explanation: 🔹 Potassium is critical for cardiac conduction. Low potassium increases risk
of dysrhythmias and muscle weakness.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
ACID-BASE BALANCE
Q10. ABG results show: pH 7.30, PaCO₂ 55 mmHg. This indicates:
A. Metabolic alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: 🔴 B. Respiratory acidosis
Explanation: 🔹 Elevated CO₂ with decreased pH indicates respiratory acidosis,
commonly caused by hypoventilation.
