,NUR 5461 FINAL EXAM – Advanced Pathophysiology
(2026)
William Paterson University (WPU) – Comprehensive Practice
Examination
Questions 1–200
SECTION 1: Cellular Adaptation, Injury & Neoplasia
(Questions 1–25)
1. A patient with hypertension develops left ventricular hypertrophy. This is an
example of which type of cellular adaptation?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Answer: C
Rationale: Hypertrophy is an increase in cell size. In hypertension, the left ventricle works
against increased pressure, causing heart muscle cells (myocytes) to enlarge as an
adaptive response.
2. The hallmark of apoptosis is:
A. Cell swelling and lysis with inflammation
B. Caseous necrosis
,C. Cell shrinkage, nuclear fragmentation, and formation of apoptotic bodies without
inflammation
D. Coagulative necrosis
Answer: C
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage, chromatin
condensation, nuclear fragmentation, and formation of apoptotic bodies that are
phagocytosed without causing inflammation.
3. A patient who smokes has chronic bronchial irritation. Normal ciliated columnar
epithelium is replaced by stratified squamous epithelium. This is an example of:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another as an adaptive response to chronic irritation. Smoking causes the bronchial
epithelium to change from ciliated columnar to stratified squamous.
4. Which type of necrosis is most commonly associated with tuberculosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis. It appears as a cheesy, white
material and represents a combination of coagulative and liquefactive necrosis.
, 5. A patient has a mutation in the BRCA1 gene. This gene is classified as a:
A. Proto-oncogene
B. Tumor suppressor gene
C. Oncogene
D. DNA repair gene
Answer: B
Rationale: BRCA1 is a tumor suppressor gene. Mutations in tumor suppressor genes lead
to loss of cell cycle regulation and contribute to cancer development.
6. Which of the following is a characteristic of malignant tumors?
A. Well-defined borders
B. Slow growth
C. Invasion and metastasis
D. Encapsulation
Answer: C
Rationale: Malignant tumors are characterized by invasion into surrounding tissues and
metastasis to distant sites. Benign tumors are encapsulated, slow-growing, and well-
defined.
7. A patient develops metaplasia in the esophagus due to chronic acid reflux. This
condition is known as:
A. Barrett's esophagus
B. Esophageal varices
C. Achalasia
D. Esophageal cancer
Answer: A
(2026)
William Paterson University (WPU) – Comprehensive Practice
Examination
Questions 1–200
SECTION 1: Cellular Adaptation, Injury & Neoplasia
(Questions 1–25)
1. A patient with hypertension develops left ventricular hypertrophy. This is an
example of which type of cellular adaptation?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Answer: C
Rationale: Hypertrophy is an increase in cell size. In hypertension, the left ventricle works
against increased pressure, causing heart muscle cells (myocytes) to enlarge as an
adaptive response.
2. The hallmark of apoptosis is:
A. Cell swelling and lysis with inflammation
B. Caseous necrosis
,C. Cell shrinkage, nuclear fragmentation, and formation of apoptotic bodies without
inflammation
D. Coagulative necrosis
Answer: C
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage, chromatin
condensation, nuclear fragmentation, and formation of apoptotic bodies that are
phagocytosed without causing inflammation.
3. A patient who smokes has chronic bronchial irritation. Normal ciliated columnar
epithelium is replaced by stratified squamous epithelium. This is an example of:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another as an adaptive response to chronic irritation. Smoking causes the bronchial
epithelium to change from ciliated columnar to stratified squamous.
4. Which type of necrosis is most commonly associated with tuberculosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis. It appears as a cheesy, white
material and represents a combination of coagulative and liquefactive necrosis.
, 5. A patient has a mutation in the BRCA1 gene. This gene is classified as a:
A. Proto-oncogene
B. Tumor suppressor gene
C. Oncogene
D. DNA repair gene
Answer: B
Rationale: BRCA1 is a tumor suppressor gene. Mutations in tumor suppressor genes lead
to loss of cell cycle regulation and contribute to cancer development.
6. Which of the following is a characteristic of malignant tumors?
A. Well-defined borders
B. Slow growth
C. Invasion and metastasis
D. Encapsulation
Answer: C
Rationale: Malignant tumors are characterized by invasion into surrounding tissues and
metastasis to distant sites. Benign tumors are encapsulated, slow-growing, and well-
defined.
7. A patient develops metaplasia in the esophagus due to chronic acid reflux. This
condition is known as:
A. Barrett's esophagus
B. Esophageal varices
C. Achalasia
D. Esophageal cancer
Answer: A
