WGU D027 – Advanced Pathopharmacological
Foundations (Western Governors University) |
EXAM NEWEST 2026 ACTUAL EXAM TEST BANK
50 QUESTIONS AND CORRECT DETAILED
ANSWERS| FREE PDF Faculty-Approved
Explanations | Grade
Cellular Regulation, Genetics & Cancer Biology
Question 1. A patient with chronic myeloid leukemia is prescribed imatinib. The nurse
understands this medication works by inhibiting which specific target?
A. Topoisomerase II
B. BCR-ABL tyrosine kinase
C. Vascular endothelial growth factor
D. HER2 receptor
The correct answer is B. Imatinib is a tyrosine kinase inhibitor that specifically blocks the
BCR-ABL fusion protein created by the Philadelphia chromosome in CML. Topoisomerase II
inhibitors are a different class of chemotherapy. VEGF inhibitors target angiogenesis. HER2
inhibitors are used in HER2-positive breast cancer.
Question 2. A lung biopsy from a chronic smoker reveals nuclear pyknosis and
karyolysis. The nurse recognizes these findings as indicators of which process?
A. Reversible cellular swelling
B. Apoptosis
C. Irreversible necrosis
D. Autophagy
The correct answer is C. Nuclear pyknosis (chromatin shrinkage) and karyolysis (nuclear
dissolution) are classic features of irreversible cell injury and necrosis. Apoptosis is
programmed cell death without inflammation. Reversible swelling does not involve
nuclear dissolution. Autophagy is a survival mechanism.
,Question 3. A woman with a BRCA1 mutation asks the nurse about her risk for
developing breast cancer. What is the most accurate response?
A. The mutation guarantees she will develop breast cancer.
B. The mutation only increases her risk for ovarian cancer.
C. The mutation carries a 50-80% lifetime risk for breast cancer.
D. The mutation has no impact on her cancer risk.
The correct answer is C. BRCA1 is a tumor suppressor gene. Mutations significantly elevate
lifetime risk of breast cancer (50-80%) and ovarian cancer (20-40%). The mutation does
not guarantee cancer will develop.
Question 4. A patient receiving chemotherapy has an absolute neutrophil count of 400
cells/mm³ and a temperature of 38.5°C. What is the nurse's priority action?
A. Administer acetaminophen and reassess in 4 hours.
B. Continue monitoring and document findings.
C. Immediately notify the provider for possible sepsis.
D. Apply cool compresses and encourage oral fluids.
The correct answer is C. Fever in a neutropenic patient is a medical emergency indicating
possible sepsis. Neutropenic patients have a blunted inflammatory response and may not
show other signs of infection.
Question 5. A patient with metastatic lung cancer is started on bevacizumab. Which
adverse effect requires immediate intervention?
A. Mild hypertension
B. Hemorrhage
C. Fatigue
D. Nausea
The correct answer is B. Bevacizumab is an anti-VEGF monoclonal antibody that carries a
significant risk of hemorrhage. While hypertension is common, it is typically managed
with antihypertensives and does not require the same urgency as active bleeding.
Question 6. A patient with breast cancer is prescribed trastuzumab. Which assessment
is most important for the nurse to monitor?
A. Renal function
B. Cardiac function
C. Liver function
D. Pulmonary function
, The correct answer is B. Trastuzumab carries a risk of cardiotoxicity, particularly when
combined with anthracyclines. Cardiac function should be monitored with ejection fraction
assessments before and during treatment.
Question 7. A patient asks how malignant cells differ from benign cells. Which
characteristic is unique to malignant cells?
A. Slow growth rate
B. Encapsulated structure
C. Loss of differentiation
D. Limited ability to metastasize
The correct answer is C. Malignant cells exhibit anaplasia, which is a loss of differentiation.
They also have rapid growth, no capsule, and the ability to metastasize. Benign cells are
well-differentiated and encapsulated.
Question 8. A patient with cancer is receiving chemotherapy that causes bone marrow
suppression. Which lab value is most critical to monitor?
A. Serum calcium
B. Platelet count
C. Serum albumin
D. Blood urea nitrogen
The correct answer is B. Bone marrow suppression from chemotherapy causes
neutropenia, anemia, and thrombocytopenia. Platelet count is critical because
thrombocytopenia increases bleeding risk and can lead to life-threatening hemorrhage.
Question 9. A patient with a family history of colon cancer asks about genetic testing.
Which gene mutation is most associated with hereditary nonpolyposis colorectal
cancer?
A. BRCA1
B. BRCA2
C. MLH1
D. TP53
The correct answer is C. MLH1 is one of the mismatch repair genes associated with Lynch
syndrome, also known as hereditary nonpolyposis colorectal cancer. BRCA1 and BRCA2
are associated with breast and ovarian cancer. TP53 is associated with Li-Fraumeni
syndrome.
Foundations (Western Governors University) |
EXAM NEWEST 2026 ACTUAL EXAM TEST BANK
50 QUESTIONS AND CORRECT DETAILED
ANSWERS| FREE PDF Faculty-Approved
Explanations | Grade
Cellular Regulation, Genetics & Cancer Biology
Question 1. A patient with chronic myeloid leukemia is prescribed imatinib. The nurse
understands this medication works by inhibiting which specific target?
A. Topoisomerase II
B. BCR-ABL tyrosine kinase
C. Vascular endothelial growth factor
D. HER2 receptor
The correct answer is B. Imatinib is a tyrosine kinase inhibitor that specifically blocks the
BCR-ABL fusion protein created by the Philadelphia chromosome in CML. Topoisomerase II
inhibitors are a different class of chemotherapy. VEGF inhibitors target angiogenesis. HER2
inhibitors are used in HER2-positive breast cancer.
Question 2. A lung biopsy from a chronic smoker reveals nuclear pyknosis and
karyolysis. The nurse recognizes these findings as indicators of which process?
A. Reversible cellular swelling
B. Apoptosis
C. Irreversible necrosis
D. Autophagy
The correct answer is C. Nuclear pyknosis (chromatin shrinkage) and karyolysis (nuclear
dissolution) are classic features of irreversible cell injury and necrosis. Apoptosis is
programmed cell death without inflammation. Reversible swelling does not involve
nuclear dissolution. Autophagy is a survival mechanism.
,Question 3. A woman with a BRCA1 mutation asks the nurse about her risk for
developing breast cancer. What is the most accurate response?
A. The mutation guarantees she will develop breast cancer.
B. The mutation only increases her risk for ovarian cancer.
C. The mutation carries a 50-80% lifetime risk for breast cancer.
D. The mutation has no impact on her cancer risk.
The correct answer is C. BRCA1 is a tumor suppressor gene. Mutations significantly elevate
lifetime risk of breast cancer (50-80%) and ovarian cancer (20-40%). The mutation does
not guarantee cancer will develop.
Question 4. A patient receiving chemotherapy has an absolute neutrophil count of 400
cells/mm³ and a temperature of 38.5°C. What is the nurse's priority action?
A. Administer acetaminophen and reassess in 4 hours.
B. Continue monitoring and document findings.
C. Immediately notify the provider for possible sepsis.
D. Apply cool compresses and encourage oral fluids.
The correct answer is C. Fever in a neutropenic patient is a medical emergency indicating
possible sepsis. Neutropenic patients have a blunted inflammatory response and may not
show other signs of infection.
Question 5. A patient with metastatic lung cancer is started on bevacizumab. Which
adverse effect requires immediate intervention?
A. Mild hypertension
B. Hemorrhage
C. Fatigue
D. Nausea
The correct answer is B. Bevacizumab is an anti-VEGF monoclonal antibody that carries a
significant risk of hemorrhage. While hypertension is common, it is typically managed
with antihypertensives and does not require the same urgency as active bleeding.
Question 6. A patient with breast cancer is prescribed trastuzumab. Which assessment
is most important for the nurse to monitor?
A. Renal function
B. Cardiac function
C. Liver function
D. Pulmonary function
, The correct answer is B. Trastuzumab carries a risk of cardiotoxicity, particularly when
combined with anthracyclines. Cardiac function should be monitored with ejection fraction
assessments before and during treatment.
Question 7. A patient asks how malignant cells differ from benign cells. Which
characteristic is unique to malignant cells?
A. Slow growth rate
B. Encapsulated structure
C. Loss of differentiation
D. Limited ability to metastasize
The correct answer is C. Malignant cells exhibit anaplasia, which is a loss of differentiation.
They also have rapid growth, no capsule, and the ability to metastasize. Benign cells are
well-differentiated and encapsulated.
Question 8. A patient with cancer is receiving chemotherapy that causes bone marrow
suppression. Which lab value is most critical to monitor?
A. Serum calcium
B. Platelet count
C. Serum albumin
D. Blood urea nitrogen
The correct answer is B. Bone marrow suppression from chemotherapy causes
neutropenia, anemia, and thrombocytopenia. Platelet count is critical because
thrombocytopenia increases bleeding risk and can lead to life-threatening hemorrhage.
Question 9. A patient with a family history of colon cancer asks about genetic testing.
Which gene mutation is most associated with hereditary nonpolyposis colorectal
cancer?
A. BRCA1
B. BRCA2
C. MLH1
D. TP53
The correct answer is C. MLH1 is one of the mismatch repair genes associated with Lynch
syndrome, also known as hereditary nonpolyposis colorectal cancer. BRCA1 and BRCA2
are associated with breast and ovarian cancer. TP53 is associated with Li-Fraumeni
syndrome.
