Final Exam
150 NCLEX-Style Practice Questions with Answers & Rationales
These are questions covering typical Pathophysiology content areas (cellular injury/adaptation,
inflammation/immunity, genetics/neoplasia, cardiovascular, respiratory, renal, gastrointestinal/hepatic, endocrine,
neurological, musculoskeletal/rheumatologic, hematologic, infectious disease/immune deficiency,
reproductive/integumentary, fluid/electrolyte/acid-base, and stress/adaptation/multisystem pathophysiology).
Contents
Cellular Injury, Adaptation & Death (Questions 1–10)
Inflammation, Immunity & Wound Healing (Questions 11–20)
Genetics & Neoplasia (Questions 21–30)
Cardiovascular Pathophysiology (Questions 31–40)
Respiratory Pathophysiology (Questions 41–50)
Renal & Urinary Pathophysiology (Questions 51–60)
Gastrointestinal & Hepatic Pathophysiology (Questions 61–70)
Endocrine Pathophysiology (Questions 71–80)
Neurological Pathophysiology (Questions 81–90)
Musculoskeletal & Immune/Rheumatologic Pathophysiology (Questions 91–100)
Hematologic Pathophysiology (Questions 101–110)
Infectious Disease & Immune Deficiency Pathophysiology (Questions 111–120)
Reproductive & Integumentary Pathophysiology (Questions 121–130)
Fluid, Electrolyte & Acid-Base Pathophysiology (Questions 131–140)
Stress, Adaptation & Multisystem Pathophysiology (Questions 141–150)
,Cellular Injury, Adaptation & Death
1. Which type of cellular adaptation involves an increase in cell size without an increase in cell number?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: A
Rationale: Hypertrophy is an increase in individual cell size, often in response to increased workload (e.g.,
cardiac muscle in hypertension).
2. Which cellular adaptation involves an increase in the number of cells in a tissue?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Dysplasia
Correct Answer: A
Rationale: Hyperplasia refers to an increase in cell number, which can be physiologic (e.g., breast tissue during
pregnancy) or pathologic.
3. Which cellular adaptation is a decrease in cell size due to loss of cellular substance, often from disuse or
reduced workload?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: A
Rationale: Atrophy is a reduction in cell size and function, commonly seen with disuse (e.g., immobilized
limb), reduced blood supply, or aging.
4. Which cellular adaptation involves the replacement of one differentiated cell type with another, often in
response to chronic irritation?
A. Metaplasia
B. Hypertrophy
C. Atrophy
D. Hyperplasia
Correct Answer: A
Rationale: Metaplasia is a reversible change where one mature cell type is replaced by another, often better
suited to withstand chronic stress (e.g., respiratory epithelium changing in smokers).
5. Which type of cell death is characterized by programmed, energy-dependent cellular self-destruction
without triggering inflammation?
A. Apoptosis
B. Necrosis
C. Autolysis
D. Gangrene
Correct Answer: A
Rationale: Apoptosis is a regulated, ATP-dependent process of cell death that does not provoke an
inflammatory response, unlike necrosis.
6. Which type of cell death results from severe cellular injury and is characterized by cell swelling, membrane
rupture, and an inflammatory response?
A. Necrosis
B. Apoptosis
C. Physiologic cell turnover
D. Programmed cell death
, Correct Answer: A
Rationale: Necrosis is unregulated cell death from severe injury, causing membrane rupture, release of cellular
contents, and inflammation.
7. Which type of hypoxic cell injury results from a local reduction in blood flow due to arterial obstruction?
A. Ischemia
B. Hypoxemia
C. Anemic hypoxia
D. Histotoxic hypoxia
Correct Answer: A
Rationale: Ischemia refers to reduced blood flow to a tissue, typically from arterial obstruction, leading to
inadequate oxygen and nutrient delivery.
8. Which type of necrosis is characteristic of ischemic injury to solid organs (e.g., kidney, heart), preserving
the tissue's basic architecture initially?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: A
Rationale: Coagulative necrosis preserves tissue architecture temporarily and is typical of ischemic injury in
solid organs like the heart and kidney.
9. Which type of necrosis is characteristic of brain tissue injury and bacterial infections, resulting in liquid,
cystic tissue?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fibrinoid necrosis
Correct Answer: A
Rationale: Liquefactive necrosis involves enzymatic digestion of dead cells, resulting in a liquid mass, typical
of brain infarcts and bacterial abscesses.
10. Which best describes 'free radical injury' as a mechanism of cellular damage?
A. Unstable molecules with unpaired electrons damage cellular components like lipids, proteins, and DNA
B. A process that only occurs during normal physiologic function with no damage potential
C. A mechanism unrelated to cellular aging or disease
D. A protective mechanism against cellular injury
Correct Answer: A
Rationale: Free radicals are highly reactive molecules that can damage cell membranes, proteins, and DNA,
contributing to cellular injury, aging, and disease.
, Inflammation, Immunity & Wound Healing
11. Which are the classic cardinal signs of acute inflammation?
A. Redness, heat, swelling, pain, and loss of function
B. Pallor, coolness, and numbness
C. Cyanosis and diaphoresis
D. Jaundice and pruritus
Correct Answer: A
Rationale: The cardinal signs of inflammation (redness, heat, swelling, pain, loss of function) result from
vascular and cellular responses to injury.
12. Which cell type is typically the first responder (first phagocyte) to arrive at a site of acute inflammation?
A. Neutrophil
B. Macrophage
C. Lymphocyte
D. Eosinophil
Correct Answer: A
Rationale: Neutrophils are typically the first white blood cells to migrate to the site of acute inflammation,
arriving within hours.
13. Which chemical mediator of inflammation causes vasodilation and increased vascular permeability,
released by mast cells?
A. Histamine
B. Insulin
C. Thrombin
D. Erythropoietin
Correct Answer: A
Rationale: Histamine, released from mast cells and basophils, causes vasodilation and increased capillary
permeability during the inflammatory response.
14. Which type of immunity is provided by antibodies transferred from mother to infant via breast milk or
placenta?
A. Passive immunity
B. Active immunity
C. Innate immunity
D. Cell-mediated immunity
Correct Answer: A
Rationale: Passive immunity involves the transfer of preformed antibodies (e.g., maternal antibodies),
providing temporary protection without the recipient's own immune response.
15. Which type of immunity develops after exposure to an antigen (through infection or vaccination),
producing memory cells?
A. Active immunity
B. Passive immunity
C. Innate immunity only
D. Nonspecific immunity
Correct Answer: A
Rationale: Active immunity develops when the immune system responds to an antigen, creating memory cells
for long-term, specific protection.
16. Which class of immunoglobulin is most abundant in serum and provides long-term immunity?
A. IgG
B. IgM
C. IgE
D. IgA
Correct Answer: A