NR 507 Advanced Pathophysiology Week 8
Comprehensive Final Examination 100
Questions with Correct Answers and Rationales
Latest 2026/27 Instant Pdf Download
SECTION A: Cellular Adaptation, Injury, and Immunity
(Questions 1-20)
1. A 52-year-old man with chronic hypertension develops left
ventricular hypertrophy. This adaptive change is best
described as:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: B) Hypertrophy
Expert Rationale: Hypertrophy is an increase in cell size due to
increased workload. In hypertension, the left ventricle faces
increased afterload, causing cardiac myocytes to enlarge.
Cardiac muscle cells cannot divide (hyperplasia), so they
undergo hypertrophy rather than hyperplasia .
2. A patient with chronic gastroesophageal reflux disease
(GERD) develops Barrett's esophagus. This cellular
adaptation is known as:
,A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Correct Answer: D) Metaplasia
Expert Rationale: Metaplasia is the reversible replacement of
one differentiated cell type with another, often in response to
chronic irritation. Barrett's esophagus is columnar metaplasia
of the lower esophageal epithelium, representing an adaptive
response to chronic acid exposure that increases the risk of
esophageal adenocarcinoma .
3. A patient with a myocardial infarction has cardiac muscle
cells that die due to prolonged ischemia. This type of cell
death is best described as:
A) Apoptosis
B) Necrosis
C) Autophagy
D) Senescence
Correct Answer: B) Necrosis
Expert Rationale: Necrosis is unprogrammed cell death
resulting from injury, characterized by cell swelling, organelle
dysfunction, and rupture of lysosomal membranes, leading to
inflammation. Prolonged ischemia from myocardial infarction
causes necrotic cell death .
,4. Which term describes the body's ability to maintain a
stable internal environment despite external changes?
A) Ischemia
B) Homeostasis
C) Necrosis
D) Atrophy
Correct Answer: B) Homeostasis
Expert Rationale: Homeostasis refers to the dynamic processes
that maintain a stable internal environment. Disease often
represents a breakdown of homeostatic mechanisms .
5. A patient with a mutation in the TP53 gene would most
likely have impaired:
A) DNA replication
B) Apoptosis
C) ATP synthesis
D) Phagocytosis
Correct Answer: B) Apoptosis
Expert Rationale: TP53 (p53) is a tumor suppressor gene that
triggers apoptosis or cell cycle arrest in response to DNA
damage. Mutation of this gene impairs the cell's ability to
undergo programmed cell death, increasing cancer risk .
6. Which of the following is characteristic of a benign tumor?
, A) Poorly differentiated cells
B) Metastasis to distant sites
C) Well-differentiated cells resembling normal tissue
D) Rapid growth rate
Correct Answer: C) Well-differentiated cells resembling
normal tissue
Expert Rationale: Benign tumors are typically well-
differentiated (resemble normal tissue), grow slowly, do not
invade surrounding tissues, and do not metastasize. Malignant
tumors are poorly differentiated and metastasize .
7. The first leukocytes to arrive at an inflammatory site are:
A) Macrophages
B) Lymphocytes
C) Neutrophils
D) Eosinophils
Correct Answer: C) Neutrophils
Expert Rationale: Neutrophils are the earliest responders to
inflammatory sites, arriving within hours. They are followed
by monocytes, which mature into macrophages. Neutrophils
are the most abundant white blood cells and are essential for
phagocytosis of pathogens .
8. A patient with a bee sting develops anaphylaxis. This is an
example of which type of hypersensitivity reaction?
Comprehensive Final Examination 100
Questions with Correct Answers and Rationales
Latest 2026/27 Instant Pdf Download
SECTION A: Cellular Adaptation, Injury, and Immunity
(Questions 1-20)
1. A 52-year-old man with chronic hypertension develops left
ventricular hypertrophy. This adaptive change is best
described as:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: B) Hypertrophy
Expert Rationale: Hypertrophy is an increase in cell size due to
increased workload. In hypertension, the left ventricle faces
increased afterload, causing cardiac myocytes to enlarge.
Cardiac muscle cells cannot divide (hyperplasia), so they
undergo hypertrophy rather than hyperplasia .
2. A patient with chronic gastroesophageal reflux disease
(GERD) develops Barrett's esophagus. This cellular
adaptation is known as:
,A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Correct Answer: D) Metaplasia
Expert Rationale: Metaplasia is the reversible replacement of
one differentiated cell type with another, often in response to
chronic irritation. Barrett's esophagus is columnar metaplasia
of the lower esophageal epithelium, representing an adaptive
response to chronic acid exposure that increases the risk of
esophageal adenocarcinoma .
3. A patient with a myocardial infarction has cardiac muscle
cells that die due to prolonged ischemia. This type of cell
death is best described as:
A) Apoptosis
B) Necrosis
C) Autophagy
D) Senescence
Correct Answer: B) Necrosis
Expert Rationale: Necrosis is unprogrammed cell death
resulting from injury, characterized by cell swelling, organelle
dysfunction, and rupture of lysosomal membranes, leading to
inflammation. Prolonged ischemia from myocardial infarction
causes necrotic cell death .
,4. Which term describes the body's ability to maintain a
stable internal environment despite external changes?
A) Ischemia
B) Homeostasis
C) Necrosis
D) Atrophy
Correct Answer: B) Homeostasis
Expert Rationale: Homeostasis refers to the dynamic processes
that maintain a stable internal environment. Disease often
represents a breakdown of homeostatic mechanisms .
5. A patient with a mutation in the TP53 gene would most
likely have impaired:
A) DNA replication
B) Apoptosis
C) ATP synthesis
D) Phagocytosis
Correct Answer: B) Apoptosis
Expert Rationale: TP53 (p53) is a tumor suppressor gene that
triggers apoptosis or cell cycle arrest in response to DNA
damage. Mutation of this gene impairs the cell's ability to
undergo programmed cell death, increasing cancer risk .
6. Which of the following is characteristic of a benign tumor?
, A) Poorly differentiated cells
B) Metastasis to distant sites
C) Well-differentiated cells resembling normal tissue
D) Rapid growth rate
Correct Answer: C) Well-differentiated cells resembling
normal tissue
Expert Rationale: Benign tumors are typically well-
differentiated (resemble normal tissue), grow slowly, do not
invade surrounding tissues, and do not metastasize. Malignant
tumors are poorly differentiated and metastasize .
7. The first leukocytes to arrive at an inflammatory site are:
A) Macrophages
B) Lymphocytes
C) Neutrophils
D) Eosinophils
Correct Answer: C) Neutrophils
Expert Rationale: Neutrophils are the earliest responders to
inflammatory sites, arriving within hours. They are followed
by monocytes, which mature into macrophages. Neutrophils
are the most abundant white blood cells and are essential for
phagocytosis of pathogens .
8. A patient with a bee sting develops anaphylaxis. This is an
example of which type of hypersensitivity reaction?
